Clinical gastrointestinal manifestations in patients with COVID-19

Authors

DOI:

https://doi.org/10.33448/rsd-v10i13.21542

Keywords:

COVID-19; Signs and Symptoms, Digestive; Gastrointestinal tract.

Abstract

Objective: To identify the clinical manifestations of the gastrointestinal tract in patients affected by COVID-19 and monitored by the Municipal Health Department of Aracaju. Methodology: retrospective, cross-sectional, survey-type study, carried out from March to July 2020, based on information contained in a database of the Health Department of Aracaju. Sample composed of 3,342 patients registered in the telemonitoring program of the Department, who were tested and confirmed by RT-PCR for SARS-CoV-2. Data analyzed using percentage frequency, Pearson, Shapiro-Wilks and Mann-Whitney tests. Adopted significance level of 5%. Results and Discussion: 938 (27.36%) patients with gastrointestinal manifestations were registered: diarrhea 637 (18.58%), abdominal pain 158 (4.61%), nausea 156 (4.55%), vomiting 89 (2 .6%) and anorexia 119 (3.47%). With a mean age of 39.1 (±14.8) years, 563 (60%) were female and 930 (99.9%) lived in Aracaju or nearby. The mean age of severe cases was 55.5 (±18.9) years and 53.9% were male. The average duration of gastrointestinal symptoms was 6.5 days. All severe cases were hospitalized and, of these, 4 (0.5%) died. Main comorbidities associated with severe cases (p<0.05): cardiovascular diseases, diabetes mellitus, chronic kidney disease, cancer and neurological diseases. Conclusion: there was an important association between gastrointestinal symptoms in patients with COVID-19, especially in young and female patients. The presence of previous comorbidities was a statistically significant factor for the appearance of digestive tract manifestations.

References

Ahmed, A. O. E., Mohamed, S. F., Saleh, A. O., Al-Shokri, S. D., Ahmed, K., & Mohamed, M. F. H. (2020). Acute abdomen-like-presentation associated with SARS-CoV-2 infection. IDCases, 21, e00895. doi: 10.1016/j.idcr.2020.e00895

Ata, F., Almasri, H., Sajid, J., & Yousaf, Z. (2020). COVID-19 presenting with diarrhoea and hyponatraemia. BMJ Case Reports, 13(6), e235456. doi: 10.1136/bcr-2020-235456

Brooks, E. F., & Bhatt, A. S. (2021). The gut microbiome: a missing link in understanding the gastrointestinal manifestations of COVID-19? Molecular Case Studies, 7(2), a006031. doi: 10.1101/mcs.a006031

D’Amico, F., Baumgart, D. C., Danese, S., & Peyrin-Biroulet, L. (2020). Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management. Clinical Gastroenterology and Hepatology, 18(8), 1663–1672. doi: 10.1016/j.cgh.2020.04.001

Elshazli, R. M., Kline, A., Elgaml, A., Aboutaleb, M. H., Salim, M. M., Omar, M., Munshi, R., Mankowski, N., Hussein, M. H., Attia, A. S., Toraih, E. A., Settin, A., Killackey, M., Fawzy, M. S., & Kandil, E. (2021). Gastroenterology manifestations and COVID‐19 outcomes: A meta‐analysis of 25,252 cohorts among the first and second waves. Journal of Medical Virology, 93(5), 2740–2768. doi: 10.1002/jmv.26836

Freire, M; & Pattussi, M. (2018). Tipos de estudo In Estrela, C. (Org.), Metodologia Científica: Ciência, Ensino, Pesquisa (pp. 187-188). São Paulo: Editora Artes Médicas.

Fu, B., Qian, K., & Fu, X. (2020). SARS-CoV-2-Induced Vomiting as Onset Symptom in a Patient with COVID-19. Digestive Diseases and Sciences, 65(6), 1568–1570. doi: 10.1007/s10620-020-06285-4

Grossberg, L. B., Pellish, R. S., Cheifetz, A. S., & Feuerstein, J. D. (2020). Review of Societal Recommendations Regarding Management of Patients With Inflammatory Bowel Disease During the SARS-CoV-2 Pandemic. Inflammatory Bowel Diseases. doi: 10.1093/ibd/izaa174

Iser, B. P. M., Sliva, I., Raymundo, V. T., Poleto, M. B., Schuelter-Trevisol, F., & Bobinski, F. (2020). Definição de caso suspeito da COVID-19: uma revisão narrativa dos sinais e sintomas mais frequentes entre os casos confirmados. Epidemiologia e Serviços de Saúde, 29(3). doi: 10.5123/s1679-49742020000300018

Kariyawasam, J. C., Jayarajah, U., Riza, R., Abeysuriya, V., & Seneviratne, S. L. (2021). Gastrointestinal manifestations in COVID-19. Transactions of The Royal Society of Tropical Medicine and Hygiene. doi: 10.1093/trstmh/trab042

Liu, J., Cui, M., Yang, T., & Yao, P. (2020). Correlation between gastrointestinal symptoms and disease severity in patients with COVID-19: a systematic review and meta-analysis. BMJ Open Gastroenterology, 7(1), e000437. doi: 10.1136/bmjgast-2020-000437

Mandal, A., Konala, V. M., Adapa, S., Naramala, S., & Gayam, V. (2020). Gastrointestinal Manifestations in COVID-19 Infection and Its Practical Applications. Cureus. doi: 10.7759/cureus.8750

Mao, R., Liang, J., Shen, J., Ghosh, S., Zhu, L.-R., Yang, H., Wu, K.-C., & Chen, M.-H. (2020). Implications of COVID-19 for patients with pre-existing digestive diseases. The Lancet Gastroenterology & Hepatology, 5(5), 425–427. doi: 10.1016/s2468-1253(20)30076-5

Menon, T., Sharma, R., Earthineni, G., Iftikhar, H., Sondhi, M., Shams, S., Khurshid Ahmed, N., Khan, H., Rathore, S. S., & Singh, R. (2021). Association of Gastrointestinal System With Severity and Mortality of COVID-19: A Systematic Review and Meta-Analysis. Cureus. doi: 10.7759/cureus.13317

Poggiali, E., Ramos, P. M., Bastoni, D., Vercelli, A., & Magnacavallo, A. (2020). Abdominal Pain: A Real Challenge in Novel COVID-19 Infection. European Journal of Case Reports in Internal Medicine, 7(4). doi: 10.12890/2020_001632

Saeed, U., Sellevoll, H. B., Young, V. S., Sandbaek, G., Glomsaker, T., & Mala, T. (2020). Covid-19 may present with acute abdominal pain. British Journal of Surgery, 107(7), e186-e187. doi: 10.1002/bjs.11674

Schmulson, M., Dávalos, M. F., & Berumen, J. (2020). Alerta: los síntomas gastrointestinales podrían ser una manifestación de la COVID-19. Revista de Gastroenterología de México, 85(3), 282–287. doi: 10.1016/j.rgmx.2020.04.001

Thevarajan, I., Buising, K. L., & Cowie, B. C. (2020). Clinical presentation and management of COVID ‐19. Medical Journal of Australia, 213(3), 134–139. doi: 10.5694/mja2.50698

Valdes, J. A. M. et al. Perforated Gastric Ulcer Related to SARS Cov-2 (COVID-19). EC Gastroenterology and Digestive System, 7(8), 144-152.

Wong, S. H., Lui, R. N., & Sung, J. J. (2020). Covid‐19 and the digestive system. Journal of Gastroenterology and Hepatology, 35(5), 744–748. doi: 10.1111/jgh.15047

Zhai, L.-L., Wang, W., Wu, L., & Tang, Z.-G. (2020). COVID-19 with abdominal symptoms and acute abdominal pain: a guide to identification for general practice. British Journal of General Practice, 70(696), 358–359. doi: 10.3399/bjgp20x710693

Published

17/10/2021

How to Cite

SILVA, L. F. A. da; CARDOSO, D. S.; SOUSA, L. F. de O.; DOURADO, M. R. M.; JESUS, P. H. S. de; LIMA, E. O.; BRITTO NETO, H. S.; MEDINA, M. S. L.; SILVEIRA, L. T.; ROCHA, C. G. S.; ANDRADE, A. R. O. de; TRINDADE, L. M. D. F. Clinical gastrointestinal manifestations in patients with COVID-19. Research, Society and Development, [S. l.], v. 10, n. 13, p. e423101321542, 2021. DOI: 10.33448/rsd-v10i13.21542. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/21542. Acesso em: 7 dec. 2021.

Issue

Section

Health Sciences