Prevalence of gastrointestinal and hepatic manifestations among Egyptian adult COVID-19-positive patients: a retrospective cohort study

Abstract

Background and Aim The outbreak of the coronavirus disease in December, 2019, started in China and has become a worldwide threat to humans. Although patients infected with coronavirus disease-2019 (COVID-19) presented predominantly by symptoms of the respiratory tract, gastrointestinal symptoms, and liver injury have also been reported. Materials and methods This study was performed retrospectively at Ahmed Maher Teaching Hospital (Cairo, Egypt). The authors included 340 patients diagnosed between April 5, 2020 and August 29, 2020 with confirmed COVID-19 infection by real-time reverse transcription PCR assay using nasal and pharyngeal swabs. The authors divided the patients into group A that included 210 patients with respiratory manifestations only, group B included 108 patients with respiratory and gastrointestinal tract or hepatic manifestation, and group C included 22 patients with gastrointestinal tract or hepatic manifestations only. Results The most common gastrointestinal symptoms was anorexia with a total of 61 patients (17.9%) followed by diarrhea in 59 patients (17.35%). Only eight patients (2.3%) showed elevated bilirubin with either ascites (four patients) or lower limb edema (six patients). Interestingly, the number of patients needed ICU transfer was 29 (8.5%) and most of them belonged to group B (19 patients) representing 65.5% from the total number of patients admitted to the ICU. Conclusion Most of COVID-19 patients presented mainly with symptoms of respiratory tract, but a large number of patients presented with gastrointestinal symptoms and liver testing abnormalities. The presence of digestive symptoms and liver test dysfunction correlated with more aggressive disease.

Keywords

• gastrointestinal and hepatic manifestations; respiratory manifestations; severe acute respiratory syndrome coronavirus 2