Gastrointestinal manifestations of COVID-19 in a single center in the Eastern Province of Saudi Arabia

Abstract

Background: Several gastrointestinal (GI) symptoms have been associated with novel coronavirus disease-2019 (COVID-19). Their prevalence and relation to the severity and hospital outcome of COVID-19 have not been well reported in the Middle East and Saudi Arabia. We aimed to examine the GI manifestations of COVID-19 and their association with the severity and hospital outcome of COVID-19 infection. Methods: We conducted a retrospective observational study of hospitalized COVID-19 patients who had a positive SARS-COV2 PCR test and were admitted at a university hospital in Saudi Arabia, from March to September 2020. The primary objective of the study was to describe the GI manifestations of COVID-19. The secondary objective was to investigate the association of GI manifestations with severity and outcome of COVID-19 infection. Results: We included 390 patients, of which 111 (28.5%) presented with GI manifestations. The most common presentation was diarrhea followed by nausea, vomiting, and abdominal pain. Patients without GI manifestations had a higher risk of severe-critical COVID-19 infection evident by the development of lung infiltration in more than 50% of lung fields within 24–48 h, acute respiratory distress syndrome, altered mental status, multiorgan failure, and cytokine storm syndrome ( P < 0.05). These patients had a higher mortality rate compared to patients with GI manifestations ( P = 0.01). A lower odds of death was seen among patients with GI symptoms (AOR 0.36; 95% CI, 0.158–0.82; P = 0.01). Conclusion: COVID-19 infection presents commonly with GI manifestations. Patients with GI manifestations have less severe COVID-19 disease and lower mortality rates.

Gastrointestinal symptoms among COVID‐19 patients presenting to a primary health care center of Nepal: A cross‐sectional study

“…Among GI complaints, diarrhea was the most common complaint that was reported in 40.6% of our patients, followed by nausea/vomiting in 40%. Similar findings have been reported in different parts of the world by different investigators 19,20,23–25 . However, a meta‐analysis conducted by Dong et al 20 reported anorexia at 17% as the most common symptom in COVID‐19 patients, followed by diarrhea at 8%, nausea, and vomiting at 7%, and abdominal pain at 3%.…”

“… 17 , 18 , 19 , 20 , 21 , 22 However, many studies reported GI symptoms in less than 30% of patients infected with COVID‐19, ranging from 12.1% to 29.9%. 23 , 24 , 25 , 26 , 27 , 28 , 29 A higher prevalence of GI symptoms could be due to the tendency to admit as many RT‐PCR‐positive patients as possible in our study center to isolate and prevent the spread of infection during the study period.…”

“…Similar findings have been reported in different parts of the world by different investigators. 19 , 20 , 23 , 24 , 25 However, a meta‐analysis conducted by Dong et al 20 reported anorexia at 17% as the most common symptom in COVID‐19 patients, followed by diarrhea at 8%, nausea, and vomiting at 7%, and abdominal pain at 3%. Studies done in Arab and Turkish countries reported similar incidences of GI symptoms as reported by Dong and co‐workers.…”

Prevalence of Different Gastrointestinal Manifestations in Patients with Covid 19 Presenting to Gastroenterology OPD at Rawal Institute of Health Sciences, Islamabad

“…The prevalence of GI complications in our study was 35.23%. Many of the previously conducted studies have shown varying results such as in a Saudi study conducted by Al Argan RJ et al 15 has shown that GI manifestation accounts for 28.5%, and a meta-analysis conducted by Merola E and colleagues, 16 has observed that GI manifestations were the most common clinical manifestations and accounts for 11.51%, in another study conducted at Iraq by Sulaiman T and colleagues, 17 had observed lower prevalence of GI manifestation which accounts for 23.6% of the patients admitted with COVID-19. While, study from Southern US has shown higher prevalence of GI manifestations (40.7%) among COVID-19 patients.…”