Gastrointestinal manifestations of COVID-19: results from a European centre. Issue 5 (May 2021)

• Record Type: Journal Article
• Authors: Leal, Tiago; Costa, Emanuel; Arroja, Bruno; Gonçalves, Raquel; Alves, Joana
• Is Part Of: European journal of gastroenterology & hepatology. Volume 33:Issue 5(2021)
• Publication Date: 2021-05
• Subjects: coronavirus disease 2019 -- gastrointestinal -- outcome; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Digestive organs -- Diseases; Liver -- Diseases; Periodicals; 616.33
• DOI: 10.1097/MEG.0000000000002152
• Languages: English
• ISSNs: 0954-691X

Abstract

Abstract : Background: Infection due to severe acute respiratory syndrome coronavirus 2 is typically associated with a respiratory syndrome, but gastrointestinal symptoms have been described in early reports from China. However, data from European centres are scarce. Objectives: We aimed to characterise the gastrointestinal manifestations of patients with coronavirus disease 2019 (COVID-19) and their disease course. Methods: Patients admitted at our centre between March and April 2020 with diagnosis of COVID-19 were included. Asymptomatic patients or those without symptom information were excluded. Clinical features, laboratory data and disease severity (mechanical ventilation, intensive care admission or death) were analysed. Results: Two-hundred one patients were included (median age 71 years; 56.2% male). Digestive symptoms were reported by 60 (29.9%) patients during the disease course, being part of the disease presentation in 34 (16.9%). The most frequent were diarrhoea in 36 patients (17.9%). Patients with gastrointestinal symptoms were younger ( P = 0.032), had higher haemoglobin levels ( P = 0.002) and lower C-reactive protein ( P = 0.045) and potassium levels ( P = 0.004). Patients with digestive symptoms had less severe disease (28.3 vs. 44.0%; P = 0.038). Regarding liver damage, aspartate aminotransferase (AST) was elevated in 65.2% of patients and alanine aminotransferase (ALT) in 62.7%, but these patients did not present a more severe disease (elevated AST P = 0.062; elevated ALT P = 0.276). Conclusion: A significant portion of COVID-19 patients have digestive symptoms, mostly at presentation. This should be taken into account in order to keep a high level of suspicion to reach an early diagnosis and setup infection control measures to control the transmission rate. This subgroup of patients appears to have a less severe disease course.