Gastrointestinal Symptoms and Outcomes in Hospitalized Coronavirus Disease 2019 Patients

Ramachandran, Preethi; Onukogu, Ifeanyichkwu; Ghanta, Snigdha; Gajendran, Mahesh; Perisetti, Abhilash; Goyal, Hemant; Aggarwal, Alok

doi:10.1159/000509774

Cited by 89 publications

(105 citation statements)

References 23 publications

(41 reference statements)

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“…Patients infected with SARS-CoV-2 have an incubation period of 3-14 days with a mean period of 5 days (1,5,6). The most common symptoms of COVID-19 include fever, cough, fatigue, and bleeding (2,4,5,(7)(8)(9)(10)(11). Other symptoms include taste changes, headache, abdominal pain, diarrhea, and gastrointestinal bleeding (2,4,5,(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

“…The most common symptoms of COVID-19 include fever, cough, fatigue, and bleeding (2,4,5,(7)(8)(9)(10)(11). Other symptoms include taste changes, headache, abdominal pain, diarrhea, and gastrointestinal bleeding (2,4,5,(7)(8)(9)(10)(11). If left untreated, COVID-19 can lead to pneumonia, acute respiratory distress syndrome (ARDS), and acute respiratory failure resulting in death (1,5,6).…”

Section: Introductionmentioning

confidence: 99%

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Racial and Gender-Based Differences in COVID-19

Kopel

Perisetti

Roghani

et al. 2020

Front. Public Health

Self Cite

272

234

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The novel coronavirus disease (COVID-19) has become a global health crisis since its first appearance in Wuhan, China. Current epidemiological studies suggest that COVID-19 affects older patients with multiple comorbidities, such as hypertension, obesity, and chronic lung diseases. The differences in the incidence and severity of COVID-19 are likely to be multifaceted, depending on various biological, social, and economical factors. Specifically, the socioeconomic differences and psychological impact of COVID-19 affecting males and females are essential in pandemic mitigation and preparedness. Previous clinical studies have shown that females are less susceptible to acquire viral infections and reduced cytokine production. Female patients have a higher macrophage and neutrophil activity as well as antibody production and response. Furthermore, in-vivo studies of the angiotensin-converting enzyme 2 (ACE2) showed higher expression in the kidneys of male than female patients, which may explain the differences in susceptibility and progression of COVID-19 between male and female patients. However, it remains unknown whether the expression of ACE2 differs in the lungs of male or female patients. Disparities in healthcare access and socioeconomic status between ethnic groups may influence COVID-19 rates. Ethnic groups often have higher levels of medical comorbidities and lower socioeconomic status, which may increase their risk of contracting COVID-19 through weak cell-mediated immunity. In this article, we examine the current literature on the gender and racial differences among COVID-19 patients and further examine the possible biological mechanisms underlying these differences.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Racial and Gender-Based Differences in COVID-19

Kopel

Perisetti

Roghani

et al. 2020

Front. Public Health

Self Cite

272

234

View full text Add to dashboard Cite

show abstract

“…In contrast, among non-IBD patients, studies have reported diarrhea in 2-10%, nausea or vomiting in 1-10% and abdominal pain in 2.2-5.8% [ 60 - 62 ]. The diagnosis of IBD flare-up is challenging in the context of COVID-19, as the typical presenting features of IBD, such as diarrhea, abdominal pain and fever, along with elevated inflammatory markers, may also be secondary to COVID-19 [ 63 , 64 ]. However, rectal bleeding is not common in COVID-19 [ 63 ].…”

Section: Gi Manifestations Of Covid-19mentioning

confidence: 99%

Inflammatory bowel disease amid the COVID-19 pandemic: impact, management strategies, and lessons learned

Gajendran

Perisetti

Aziz

et al. 2020

aog

Self Cite

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The current outbreak of COVID-19 pandemic caused by SARS-CoV-2 has affected nearly 188 countries. Patients with severe COVID-19 are more commonly elderly and suffer from comorbidities such as hypertension, diabetes mellitus, coronary artery disease, chronic pulmonary disease, obesity, and cancer. Inflammatory bowel disease (IBD) affects as many as 6.8 million people globally, and a significant proportion of them are treated with immunosuppressants. Hence, there is an ongoing concern over the impact of COVID-19 on IBD patients and their susceptibility to it. So far, there are about 1439 IBD patients in the Surveillance Epidemiology of Coronavirus under Research Exclusion (SECURE-IBD) registry reported to be infected with SARS-CoV-2. There are many unique challenges and dilemmas that need to be taken into account when managing an IBD patient with COVID-19. The management of each patient should be individualized. The IBD societies and experts have strongly recommended that patients should not discontinue their IBD medications. If the patients have symptoms of COVID-19 or IBD flare-up, they are recommended to call their IBD physician first to discuss their medication. In addition, IBD patients are urged to practice social distancing strictly to minimize the chances of infection. As COVID-19 is rapidly evolving, our experience and understanding of its impact on the IBD population may potentially change in the near future.

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“…[2][3][4][5] Beyond impacting neurological functions, SARS-CoV-2 infections have also been reported to affect the cardiovascular and gastrointestinal systems. [6][7][8][9] An especially troubling issue is that some symptoms can last for months beyond the primary infection, even in the absence of detectable virus. [10][11][12] It is unclear why some patients, often referred to as "long haulers," have prolonged effects.…”

Section: Introductionmentioning

confidence: 99%

Abnormal antibodies to self-carbohydrates in SARS-CoV-2 infected patients

Butler

Gildersleeve

2020

Preprint

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SARS-CoV-2 is a deadly virus that is causing the global pandemic coronavirus disease 2019 (COVID-19). Our immune system plays a critical role in preventing, clearing, and treating the virus, but aberrant immune responses can contribute to deleterious symptoms and mortality. Many aspects of immune responses to SARS-CoV-2 are being investigated, but little is known about immune responses to carbohydrates. Since the surface of the virus is heavily glycosylated, pre-existing antibodies to glycans could potentially recognize the virus and influence disease progression. Furthermore, antibody responses to carbohydrates could be induced, affecting disease severity and clinical outcome. In this study, we used a carbohydrate antigen microarray with over 800 individual components to profile serum anti-glycan antibodies in COVID-19 patients and healthy control subjects. In COVID-19 patients, we observed abnormally high IgG and IgM antibodies to numerous self-glycans, including gangliosides, N-linked glycans, LacNAc-containing glycans, blood group H, and sialyl Lewis X. Some of these anti-glycan antibodies are known to play roles in autoimmune diseases and neurological disorders, which may help explain some of the unusual and prolonged symptoms observed in COVID-19 patients. The detection of antibodies to self-glycans has important implications for using convalescent serum to treat patients, developing safe and effective SARS-CoV-2 vaccines, and understanding the risks of infection. In addition, this study provides new insight into the immune responses to SARS-CoV-2 and illustrates the importance of including host and viral carbohydrate antigens when studying immune responses to viruses.

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Gastrointestinal Symptoms and Outcomes in Hospitalized Coronavirus Disease 2019 Patients

Cited by 89 publications

References 23 publications

Racial and Gender-Based Differences in COVID-19

Racial and Gender-Based Differences in COVID-19

Inflammatory bowel disease amid the COVID-19 pandemic: impact, management strategies, and lessons learned

Abnormal antibodies to self-carbohydrates in SARS-CoV-2 infected patients

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