COVID-19 and related gastrointestinal symptoms: An observational study

Year 2022, , 244 - 248, 30.05.2022

Ali Cihat Yıldırım , Sevil Alkan Cevıker Sezgin Zeren Mehmet Fatih Ekıcı , Faik Yaylak Mustafa Cem Algın Özlem Arık

https://doi.org/10.5472/marumj.1121879

Cited By: 2

Abstract

Objective: COVID-19 pandemic has infected the entire world and causes obsolete morbidity and mortality. While respiratory
symptoms are the most frequently reported, several recent studies revealed that gastrointestinal symptoms are not uncommon. Our
aim in this observational study is to reveal the gastrointestinal symptoms of COVID-19 patients.

Patients and Methods: Data of COVID-19 patients with gastrointestinal symptoms were recorded and retrospectively analyzed during
their hospital follow-up period. 82 patients participated in the study and later on had a positive polymerase chain reaction (PCR)
test. Gender, age, systemic and gastrointestinal complaints, medical and surgical disease history, laboratory results, thorax computer
tomography (CT) findings, and characteristics of gastrointestinal system (GIS) symptoms of patients were also recorded. Data were
analyzed by statistical software.

Results: The most common typical symptoms of COVID-19 patients were cough, anosmia, debility, and shortness of breath. Further,
most of the gastrointestinal symptoms found in COVID-19 patients were nonspecific abdominal pain.
Lymphopenia and elevated liver transaminases were the most common findings of the tests. Patients with diarrhea indicated watery
diarrhea. Two patients also had ileus, they healed spontaneously without surgical intervention. Furthermore, all patients were
discharged without any problems.

Conclusion: Gastrointestinal symptoms are typical in COVID-19 patients. However, these symptoms do not seem to have a detrimental
effect on the progression of the disease. In our study group, there was no need for surgical intervention, but COVID-19 patients with
gastrointestinal symptoms should be treated by a multidisciplinary approach. 

Keywords

COVID-19, Gastrointestinal symptom, Diarrhea, Intestinal obstruction

References

• Mao R, Qiu Y, He JS, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020 Jul; 5(7): 667-678. doi: 10.1016/ S2468-1253(20)30126-6.
• Patel KP, Patel PA, Vunnam RR, et al. Gastrointestinal, hepatobiliary, and pancreatic manifestations of COVID-19. J Clin Virol. 2020 Jul; 128: 104386. doi: 10.1016/j. jcv.2020.104386.
• Zarifian A, Zamiri Bidary M, Arekhi S, et al. Gastrointestinal and hepatic abnormalities in patients with confirmed COVID-19: A systematic review and meta-analysis. J Med Virol. 2021 Jan; 93(1): 336-350. doi: 10.1002/jmv.26314.
• Sultan S, Altayar O, Siddique SM, et al. AGA Institute Rapid Review of the Gastrointestinal and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19. Gastroenterology. 2020 Jul; 159(1): 320-334.e27. doi: 10.1053/j.gastro.2020.05.001.
• Villapol S. Gastrointestinal symptoms associated with COVID-19: impact on the gut microbiome. Transl Res. 2020 Dec; 226: 57-69. doi: 10.1016/j.trsl.2020.08.004.
• Tian Y, Rong L, Nian W, He Y. Review article: gastrointestinal features in COVID-19 and the possibility of faecal transmission. Aliment Pharmacol Ther. 2020 May; 51(9): 843- 851. doi: 10.1111/apt.15731.
• Ma C, Cong Y, Zhang H. COVID-19 and the Digestive System. Am J Gastroenterol. 2020 Jul; 115(7): 1003-1006. doi: 10.14309/ajg.000.000.0000000691.
• Aktas B, Aslim B. Gut-lung axis and dysbiosis in COVID-19. Turk J Biol. 2020 Jun; 44(3): 265-272. doi: 10.3906/biy-2005- 102.
• Kopel J, Perisetti A, Gajendran M, Boregowda U, Goyal H. Clinical Insights into the Gastrointestinal Manifestations of COVID-19. Dig Dis Sci. 2020 Jul; 65(7): 1932-1939. doi: 10.1007/s10620.020.06362-8.
• Suresh Kumar VC, Mukherjee S, Harne PS, et al. Novelty in the gut: a systematic review and meta-analysis of the gastrointestinal manifestations of COVID-19. BMJ Open Gastroenterol. 2020 May; 7(1): e000417. doi: 10.1136/ bmjgast-2020-000417.
• El Moheb M, Naar L, Christensen MA, et al. Gastrointestinal Complications in Critically Ill Patients With and Without COVID-19. JAMA. 2020 Sep; 324(18): 1899–901. doi: 10.1001/jama.2020.19400.
• Cha MH, Regueiro M, Sandhu DS. Gastrointestinal and hepatic manifestations of COVID-19: A comprehensive review. World J Gastroenterol. 2020 May; 26(19): 2323-2332. doi: 10.3748/wjg.v26.i19.2323.
• El Ouali S, Achkar JP, Lashner B, Regueiro M. Gastrointestinal manifestations of COVID-19. Cleve Clin J Med. 2021 Feb. doi: 10.3949/ccjm.87a.ccc049.
• Tan ND, Qiu Y, Xing XB, Ghosh S, Chen MH, Mao R. Associations Between Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blocker Use, Gastrointestinal Symptoms, and Mortality Among Patients With COVID-19. Gastroenterology. 2020 Sep; 159(3): 1170- 1172.e1. doi: 10.1053/j.gastro.2020.05.034.
• Mönkemüller K, Fry L, Rickes S. COVID-19, coronavirus, SARS-CoV-2 and the small bowel. Rev Esp Enferm Dig. 2020 May; 112(5): 383-388. doi: 10.17235/reed.2020.7137/2020.
• Lee SW, Ha EK, Yeniova AÖ, et al. Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching. Gut. 2021 Jan; 70(1): 76-84. doi: 10.1136/gutjnl-2020-322248.