Prevalence and Characteristics of Gastrointestinal Symptoms in Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in the United States: A Multicenter Cohort Study

Redd, Walker D.; Zhou, Juhua; Hathorn, Kelly; McCarty, Thomas R.; Bazarbashi, Ahmad Najdat; Thompson, Christopher C.; Shen, Lin; Chan, Walter W.

doi:10.1053/j.gastro.2020.04.045

Cited by 296 publications

(314 citation statements)

References 8 publications

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“…We could not correlate the presence of SARS-CoV-2 RNA with GI symptoms since this test was not routinely performed in our institution. Despite these limitations, the main strengths of this study are that it has validated the findings of another US study by Redd et al [20] on GI manifestations in COVID-19. Our study also presents data from New York with a significantly higher proportion of African American patients.…”

Section: Discussionsupporting

confidence: 53%

“…In a multicenter study of 191 patients by Zhou et al [14], the presence of GI symptoms was associated with elevated CRP (7.3 vs. 3.8 mg/L, p = 0.021), elevated alanine aminotransferase (64.1 vs. 46.6 units/L, p = 0.049), and lower hemoglobin levels when compared to patients without GI symptoms. However, in the study by Redd and colleagues [20], there were no differences in clinical outcomes in patients with or without GI symptoms. Also, they reported no significant differences in the leukocyte count, hemoglobin, platelets, coagulation, or liver tests in groups with or without GI symptoms.…”

Section: Discussionmentioning

confidence: 81%

“…Anorexia is a nonspecific symptom that could be related to an overall infectious or inflammatory process and hence was not included as a specific GI symptom in our study. In a US study by Redd et al [20], the prevalence of GI symptoms in COVID-19 patients was reported to be as high as 61.3%. In that study, anorexia was reported in 34.8% cases, diarrhea in 33.7%, and nausea in 26.4% cases.…”

Section: Discussionmentioning

confidence: 96%

“…Hence, there is a strong possibility of direct small bowel involvement, resulting in direct cytopathic effects causing GI symptoms. Furthermore, Redd et al [20] noted that loss of smell (anosmia) and loss of taste (ageusia) were commonly associated with nausea (adjusted OR 2.71, 95% CI: 1.21-6.20; p = 0.015) and anorexia (adjusted OR 3.70, 95% CI: 1.49-9.16; p = 0.0048) after controlling for potential confounders. While the exact cause of this association is unclear, it could be due to damage to olfactory and gustatory receptors during viral entry through nasal and oral routes [24].…”

Section: Discussionmentioning

confidence: 99%

“…Hence, there has been an increasing interest in whether GI symptoms are associated with severe disease. There are conflicting reports in terms of whether GI symptoms are associated with severe COVID-19 or not [7,20]. Therefore, in this study, we aimed to analyze if the presence of GI symptoms at the time of hospitalization is associated with mechanical ventilation or mortality when compared to those who did not have GI symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Gastrointestinal Symptoms and Outcomes in Hospitalized Coronavirus Disease 2019 Patients

Ramachandran

Onukogu

Ghanta

et al. 2020

Dig Dis

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Introduction: Gastrointestinal (GI) symptoms are increasingly being recognized in coronavirus disease 2019 (COVID-19). It is unclear if the presence of GI symptoms is associated with poor outcomes in COVID-19. We aim to assess if GI symptoms could be used for prognostication in hospitalized patients with COVID-19. Methods: We retrospectively analyzed patients admitted to a tertiary medical center in Brooklyn,

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gastrointestinal Symptoms and Outcomes in Hospitalized Coronavirus Disease 2019 Patients

Ramachandran

Onukogu

Ghanta

et al. 2020

Dig Dis

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Combined Metabolic Activators Accelerates Recovery in Mild‐to‐Moderate COVID‐19

Altay

Arif

et al. 2021

Advanced Science

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COVID-19 is associated with mitochondrial dysfunction and metabolic abnormalities, including the deficiencies in nicotinamide adenine dinucleotide (NAD + ) and glutathione metabolism. Here it is investigated if administration of a mixture of combined metabolic activators (CMAs) consisting of glutathione and NAD+ precursors can restore metabolic function and thus aid the recovery of COVID-19 patients. CMAs include l-serine, N-acetyl-l-cysteine, nicotinamide riboside, and l-carnitine tartrate, salt form of l-carnitine. Placebo-controlled, open-label phase 2 study and double-blinded phase 3 clinical trials are conducted to investigate the time of symptom-free recovery on ambulatory patients using CMAs. The results of both studies show that the time to complete recovery is significantly shorter in the CMA group (6.6 vs 9.3 d) in phase 2 and (5.7 vs 9.2 d) in phase 3 trials compared to placebo group. A comprehensive analysis of the plasma metabolome and proteome reveals major metabolic changes. Plasma levels of proteins and metabolites associated with inflammation and antioxidant metabolism are significantly improved in patients treated with CMAs as compared to placebo. The results show that treating patients infected with COVID-19 with CMAs lead to a more rapid symptom-free recovery, suggesting a role for such a therapeutic regime in the treatment of infections leading to respiratory problems.

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