Gastrointestinal Bleeding, but Not Other Gastrointestinal Symptoms, Is Associated With Worse Outcomes in COVID-19 Patients
oleh: Hongxin Chen, Hongxin Chen, Hongxin Chen, Zhenhua Tong, Zhenhua Tong, Zhuang Ma, Zhuang Ma, Zhuang Ma, Li Luo, Yufu Tang, Yufu Tang, Yue Teng, Yue Teng, Hao Yu, Hao Yu, Hao Meng, Hao Meng, Chengfei Peng, Chengfei Peng, Quanyu Zhang, Quanyu Zhang, Tianyi Zhu, Tianyi Zhu, Tianyi Zhu, Haitao Zhao, Haitao Zhao, Haitao Zhao, Guiyang Chu, Guiyang Chu, Hongyu Li, Hongyu Li, Hui Lu, Xingshun Qi, Xingshun Qi
| Format: | Article |
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| Diterbitkan: | Frontiers Media S.A. 2021-10-01 |
Deskripsi
Background: Patients with coronavirus disease 2019 (COVID-19) can present with gastrointestinal (GI) symptoms. However, the prevalence of GI symptoms and their association with outcomes remain controversial in COVID-19 patients.Methods: All COVID-19 patients consecutively admitted to the Wuhan Huoshenshan hospital from February 2020 to April 2020 were collected. Disease severity and outcomes were compared between COVID-19 patients with and without GI symptoms. Logistic regression analyses were performed to evaluate the association of GI symptoms with the composite endpoint and death in COVID-19 patients. A composite endpoint was defined as transfer to intensive care unit, requirement of mechanical ventilation, and death. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.Results: Overall, 2,552 COVID-19 patients were included. The prevalence of GI symptoms was 21.0% (537/2,552). Diarrhea (8.9%, 226/2,552) was the most common GI symptom. Patients with GI symptoms had significantly higher proportions of severe COVID-19 and worse outcomes than those without. Univariate logistic regression analyses demonstrated that GI symptoms were significantly associated with the composite endpoint (OR = 2.426, 95% CI = 1.608–3.661; P < 0.001) and death (OR = 2.137, 95% CI = 1.209–3.778; P = 0.009). After adjusting for age, sex, and severe/critical COVID-19, GI symptoms were still independently associated with the composite endpoint (OR = 2.029, 95% CI = 1.294–3.182; P = 0.002), but not death (OR = 1.726, 95% CI = 0.946–3.150; P = 0.075). According to the type of GI symptoms, GI bleeding was an independent predictor of the composite endpoint (OR = 8.416, 95% CI = 3.465–20.438, P < 0.001) and death (OR = 6.640, 95% CI = 2.567–17.179, P < 0.001), but not other GI symptoms (i.e., diarrhea, abdominal discomfort, nausea and/or vomiting, constipation, acid reflux and/or heartburn, or abdominal pain).Conclusion: GI symptoms are common in COVID-19 patients and may be associated with their worse outcomes. Notably, such a negative impact of GI symptoms on the outcomes should be attributed to GI bleeding.