Gastro Hep Advances (Jan 2022)

Gastrointestinal Manifestations of Coronavirus Disease 2019 Across the United States: A Multicenter Cohort Study

  • Ankur P. Patel,
  • Troy K. Sanders,
  • Preeti Prakash,
  • Jade Law,
  • Sujay Alvencar,
  • Alyssa Choi,
  • Janaki Shah,
  • Karishma Patel,
  • Padmavathi Srivoleti,
  • Kirtan Chauhan,
  • Simcha Weissman,
  • Erik Holzwanger,
  • Rohit Dhingra,
  • Michelle Nguyen,
  • Daniel Kim,
  • Tahnee Sidhu,
  • Christopher Stallwood,
  • Aaron Dickstein,
  • Nimisha Parekh,
  • Osama Altayar,
  • Matthew A. Ciorba,
  • Jessica Yu,
  • Lea Ann Chen,
  • James H. Tabibian,
  • Berkeley N. Limketkai

Journal volume & issue
Vol. 1, no. 6
pp. 909 – 915

Abstract

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Background and Aims: Gastrointestinal (GI) symptoms occur among patients diagnosed with coronavirus disease 2019 (COVID-19), and there is clear evidence that SARS-CoV-2, the causative pathogen, infects the GI tract. In this large, multicenter cohort study, we evaluated variations in gastrointestinal and hepatic manifestations of COVID-19 throughout the United States (US). Methods: Patients hospitalized with a positive COVID-19 test prior to October 2020 were identified at 7 US academic centers. Demographics, presenting symptoms, laboratory data, and hospitalization outcomes were abstracted. Descriptive and regression analyses were used to evaluate GI manifestations and their potential predictors. Results: Among 2031 hospitalized patients with COVID-19, GI symptoms were present in 18.9%; diarrhea was the most common (15.2%), followed by nausea and/or vomiting (12.6%) and abdominal pain (6.0%). GI symptoms were less common in the Western cohort (16.0%) than the Northeastern (25.6%) and Midwestern (26.7%) cohorts. Compared to nonintensive care unit (ICU) patients, ICU patients had a higher prevalence of abnormal aspartate aminotransferase (58.1% vs 37.3%; P < .01), alanine aminotransferase (37.5% vs 29.3%; P = .01), and total bilirubin (12.7% vs 9.0%; P < .01). ICU patients also had a higher mortality rate (22.7% vs 4.7%; P < .01). Chronic liver disease was associated with the development of GI symptoms. Abnormal aspartate aminotransferase or alanine aminotransferase was associated with an increased risk of ICU admission. Conclusion: We present the largest multicenter cohort of patients with COVID-19 across the United States. GI manifestations were common among patients hospitalized with COVID-19, although there was significant variability in prevalence and predictors across the United States.

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