Gastrointestinal Manifestations and Liver Injury: Correlation with Mortality and Clinical Outcomes in Patients with COVID-19

Abstract

Background and aims: Reports indicate that patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection present with gastrointestinal (GI) manifestations and abnormal liver function; however, the impact on clinical findings is unclear. The aim of this study is to report the impact of gastrointestinal and liver injury (LI) associated with coronavirus disease (COVID-19). Material and methods: The authors retrospectively evaluated patients who presented to the emergency department and were diagnosed with COVID-19 by PCR nasopharyngeal swab. Primary outcomes were the impact of GI findings and LI on in-hospital mortality. Secondary outcomes were length of stay in hospital and need for intensive care unit (ICU) level care. Results: Of the entire cohort, 64.0% had LI during hospitalisation. LI was present in 88.7% of those who died. In multivariate analysis, GI manifestations were associated with decreased risk of mortality (odds ratio [OR]: 0.46; 95% confidence interval [CI]: 0.24–0.90; p=0.002). GI symptoms did not impact length of stay, 5.06 days for patients with GI symptoms versus 4.74 in patients without (OR: 1.01; 95% CI: 0.96–1.07; p=0.43), or need for ICU (OR: 0.97; 95% CI: 0.60–1.58; p=0.9076) (Table 1). In multivariate analysis, LI was associated with increased mortality (OR: 8.60; 95% CI: 3.49–21.15; p<0.0001), need for ICU (OR: 10.94; 95% CI: 4.07–29.45; p<0.0001), and length of stay 5.87 days versus 3.01 days (OR: 1.23; 95% CI: 1.14–1.32; p<0.0001). Conclusion: The results of the data analysis show that GI symptoms may inversely correlate with mortality, while LI is associated with increased mortality, length of stay, and ICU admission.

Keywords

• coronavirus disease (covid-19)
• gastrointestinal (gi) manifestations
• intensive care unit (icu)
• liver injury (li)
• mortality