Better clinical outcomes in hospitalized COVID-19 minority patients with accompanying gastrointestinal symptoms

Fallouh, Nabil; Naik, Katrina; Udochi, ChiChi; Horowitz, Adam Z.; Ayanian, Shant; Humes, Kathryn; Izzi, Farida M.; Borum, Marie L.; Reyes, Juan

doi:10.1016/j.jnma.2021.05.016

Cited by 6 publications

(9 citation statements)

References 17 publications

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“…Further, 78 studies were excluded as 61 were single‐arm studies and 17 did not provide sufficient data. Therefore, 24 comparative observational studies 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 were deemed appropriate for inclusion (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 24 studies included in this review, 20 reported on hospitalized patients only. 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 34 , 36 The remainder 14 , 33 , 35 , 37 provided data on a mixed cohort of patients including those hospitalized (in‐patients) and those not admitted (outpatients/ambulatory).…”

Section: Resultsmentioning

confidence: 99%

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Meta‐analysis of the demographic and prognostic significance of gastrointestinal symptoms in COVID‐19 patients

Zaman

Hajibandeh

et al. 2022

JGH Open

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Background and Aim To evaluate the demographic and prognostic significance of gastrointestinal (GI) symptoms in patients with coronavirus disease 2019 (COVID‐19). Methods A systematic search of electronic information sources was conducted. Combined overall effect sizes were calculated using random‐effects models for baseline demographic factors and outcomes including mortality, intensive care unit (ICU) admission, and length of hospital stay. Results Twenty‐four comparative observational studies reporting a total of 51 522 COVID‐19 patients with ( n = 6544) or without ( n = 44 978) GI symptoms were identified. The patients with GI symptoms were of comparable age (mean difference [MD]: 0.25, 95% confidence interval [CI] −2.42 to 2.92, P = 0.86), rate of pre‐existing hypertension (odds ratio [OR]: 1.11, 95% CI 0.86–1.42, P = 0.42), diabetes mellitus (OR: 1.14, 95% CI 0.91–1.44, P = 0.26), and coronary artery disease (OR: 1.00, 95% CI 0.86–1.16, P = 0.98) compared with those without GI symptoms. However, there were significantly more male patients in the GI symptoms group (OR: 0.85, 95% CI 0.75–0.95, P = 0.005). The presence of GI symptoms was associated with similar risk of mortality (OR: 0.73; 95% CI 0.47–1.13, P = 0.16), ICU admission (OR: 1.15; 95% CI 0.67–1.96, P = 0.62), and length of hospital stay (MD: 0.43; 95% CI −0.73 to 1.60, P = 0.47) when compared with their absence. Conclusion Meta‐analysis of the best possible available evidence demonstrated that GI symptoms in COVID‐19 patients do not seem to affect patients with any specific demographic patterns and may not have any important prognostic significance. Although no randomized studies can be conducted on this topic, future high‐quality studies can provide stronger evidence to further understand the impact of GI symptoms on outcomes of COVID‐19 patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Meta‐analysis of the demographic and prognostic significance of gastrointestinal symptoms in COVID‐19 patients

Zaman

Hajibandeh

et al. 2022

JGH Open

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“…The outcomes of patients with COVID-19 presenting with GI symptoms have varied. The positive association between GI symptoms at presentation and better outcomes in patients with COVID-19 compared with those who only presented with non-GI symptoms has been described in the literature [2–5,7] . It is possible that infection of the GI system may portend a less severe phenotype of the disease than infection of other organ systems, particularly the respiratory system.…”

Section: Discussionmentioning

confidence: 95%

“…The positive association between GI symptoms at presentation and better outcomes in patients with COVID-19 compared with those who only presented with non-GI symptoms has been described in the literature. [2][3][4][5]7] It is possible that infection of the GI system may portend a less severe phenotype of the disease than infection of other organ systems, particularly the respiratory system. One study found that the main cause of death in patients with COVID-19 were related to respiratory disease.…”

Section: Totalmentioning

confidence: 99%

“…Initial symptoms of COVID-19 at the start of the pandemic were mainly characterized by respiratory manifestations but are now found to be heterogenous and can involve gastrointestinal (GI) symptoms [1] . Outcomes of patients with COVID-19 presenting with GI symptoms have been discrepant: some studies suggest better outcomes in patients with COVID-19 who present with GI symptoms while other studies suggest a poorer prognosis [2–7] . Clinical outcomes associated with GI symptoms described in these studies have largely been with concomitant extra-GI symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Gastrointestinal symptoms in patients hospitalized with COVID-19

et al. 2022

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To characterize outcomes in patients hospitalized with coronavirus disease 2019 (COVID-19) who present with gastrointestinal (GI) symptoms.Clinical outcomes in patients with COVID-19 associated with GI symptoms have been inconsistent in the literature.The study design is a retrospective analysis of patients, age 18 years or older, admitted to the hospital after testing positive for COVID-19. Clinical outcomes included intensive care unit requirements, rates of discharges to home, rates of discharges to outside facilities, and mortality.Seven hundred fifty patients met the inclusion criteria. Three hundred seventy three (49.7%) patients presented with at least one GI symptom and 377 (50.3%) patients presented with solely non-GI symptoms. Patients who presented with at least one GI symptom had significantly lower ICU requirements (17.4% vs 20.2%), higher rates of discharges home (77.2% vs 67.4%), lower rates of discharges to other facilities (16.4% vs 22.8%), and decreased mortality (6.4% vs 9.8%) compared with patients with non-GI symptoms. However, patients who presented with solely GI symptoms had significantly higher ICU requirements (23.8% vs 17.0%), lower rates of discharges home (52.4% vs 78.7%), higher rates of discharges to facilities (28.6% vs 15.6%), and higher mortality (19.0% vs 5.7%) compared with those with mixed GI and non-GI symptoms.Although patients with COVID-19 requiring hospitalization with GI symptoms did better than those without GI symptoms, those with isolated GI symptoms without extra-GI symptoms had worse clinical outcomes. COVID-19 should be considered in patients who present with new onset or worsening diarrhea, nausea, vomiting, and abdominal pain even without pulmonary symptoms.

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Diarrhea and Coronavirus Disease 2019 Infection

Friedel

Cappell

2023

Gastroenterology Clinics of North America

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Better clinical outcomes in hospitalized COVID-19 minority patients with accompanying gastrointestinal symptoms

Cited by 6 publications

References 17 publications

Meta‐analysis of the demographic and prognostic significance of gastrointestinal symptoms in COVID‐19 patients

Meta‐analysis of the demographic and prognostic significance of gastrointestinal symptoms in COVID‐19 patients

Gastrointestinal symptoms in patients hospitalized with COVID-19

Diarrhea and Coronavirus Disease 2019 Infection

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