Clinical Characteristics and Outcomes of COVID-19 Patients with Gastrointestinal Manifestations Seen in a Tertiary Hospital: A Retrospectve, Cohort Study

Abstract

Signifcance:
Patents with Coronavirus Disease 2019 (COVID-19) usually haverespiratory symptoms. However, some patents present with gastrointestnal(GI) symptoms. Studies on the associaton of clinical outcomes and GIsymptoms are confictng. Atenton to atypical symptoms like digestvesymptoms is important for extensive identfcaton, implementaton of efcientquarantne protocols and ultmate control of COVID-19 transmission. Findingscan also contribute to Philippine data on the management of COVID-19.

Objectves:
This study aims to determine the associaton of GI symptomswith severity of COVID-19 infecton and mortality in COVID-19 patents.

Methods:
In this retrospectve, single-center, cohort, data from 348 adultswith confrmed-COVID-19 patents admited in Manila Doctors Hospital fromMarch 1, 2020 to August 31, 2020 were reviewed. Demographic profle,disease severity and clinical outcomes were summarized and the associatonof GI symptoms and disease severity was determined using logistc regression.

Results:
Of the 348 patents, 38.5% had GI symptoms. Diarrhea was the mostcommon symptom (50%). Patents with GI symptoms were older (54.42±17.92vs 47.7±17.49, p<0.01), had higher values of AST (44.1±57.39 vs 32.1±39.2,p=0.017), ALT (57.23±67.92 vs 44.72±43.95, p=0.029), creatnine (166.19±325.43vs 99.8±158.32, p=0.014), BUN (6.59±10.21 vs 4.49±5.92, p=0.015), andquanttatve CRP (17.12±41.33 vs 7.08±23.38, p=0.005), lower procalcitonin(0.32±0.6 vs 0.8±2.85, p=0.009) and albumin (25.85±14.89 vs 20.14±17.33,p< 0.01), and higher incidence of bilateral pneumonia (63% vs 50%, p=0.006).These patents had moderate (p=0.003) and critcal (p=0.049) severity onadmission. During hospitalizaton, those with GI symptoms had higher casesof critcal illness (28% vs 21%, p=0.0480), but no statstcal diference indeath (19% vs 14%, p=0.1510) compared to those without GI manifestatons.\

Conclusion:
Gastrointestnal manifestatons are common in COVID-19. GIsymptoms were associated with moderate and critcal disease but werenot associated with higher death rates.