Gastrointestinal Symptoms Associated with Unfavorable Prognosis of Covid-19 Patients

Abstract

Background: COVID-19 pandemic or coronavirus is a systemic disease taken into consideration for vascular system-specific tropism where microcirculation alteration has a significant pathogenic role. The coronavirus affects the gastrointestinal tract, abdominal manifestation, and hepatobiliary system. Aim: the aim of the present study was to evaluate the association of gastrointestinal symptoms with unfavorable prognosis of coronavirus patients. Materials and Methods: This single-center cross-sectional study was carried out on 486 patients with or without gastrointestinal symptoms and was conducted for six months duration from January to June 2021 at Gastroenterology department, Isra University Hospital, Hyderabad. All these patients were categorized into two main groups; group-I patients exposed to coronavirus with gastrointestinal symptoms while group-II patients exposed to COVID-19 without gastrointestinal symptoms. Gastrointestinal symptoms were associated with acute respiratory distress syndrome (ARDS), continuous renal replacement therapy (CRRT), non-invasive ventilator treatment, tracheotomy, and tracheal intubation. Multivariable and unilateral regression models were utilized for data analysis. Results: Of the total 486 patients, 157 (32.3%) were with gastrointestinal symptom patients while 329 (67.7%) were without GI symptoms. Propensity scores were analyzed in both groups. Both groups were equally susceptible to higher mortality risks but COVID-19 patients with gastrointestinal symptoms were at high risk of acute respiratory distress syndrome. Of the 157 patients with GI symptoms, 44 (28.03%) were initially diagnosed and 113 (71.97%) were diagnosed in hospital. The prevalence of vomiting or nausea, diarrhea, abdominal distention, and abdominal pain were 30 (19.1%), 83 (52.9%), 18 (11.5%), and 26 (16.6%) respectively. Dyspnea, fatigue, fever, chest tightness, and cough were common COVID-19 symptomatic patients. The prevalence of GI symptoms patients had dyspnea 23 (14.6%), fatigue 45 (28.7%), fever 128 (81.5%), chest tightness 25 (15.9%), and cough 72 (45.9%) were statistically significant and higher compared to the no symptoms of gastrointestinal disease patients. Conclusion: Our study found the high prevalence of COVID-19 patients with gastrointestinal symptoms compared to without gastrointestinal symptoms in COVID-19 patients and associated with non-invasive mechanical ventilation and risks of acute respiratory distress syndrome. Hence, COVID-19 patients with gastrointestinal symptoms should be taken care of in healthcare protection. Keywords: COVID-19, Gastrointestinal symptoms, ARDS or acute respiratory distress syndrome