A cross-sectional study of gastrointestinal manifestations in COVID-19 Egyptian patients

Ahmed Abozaid Ahmed Teima; Amany Abas Amer; Lamiaa I Mohammed; Zeinab A Kasemy; Samar Ha Aloshari; Mohamed Meligy Ahmed; Ahmed Abuamer; Ahmed Shaban; Hassan Ahmed Elzohry; Sayed F Abdelwahab; Heba Mohamed Abdallah; Sabry Moawad Abdelmageed; Mohamed A Sakr; Mohamed Abdel-Samiee

doi:10.1016/j.amsu.2021.103234

A cross-sectional study of gastrointestinal manifestations in COVID-19 Egyptian patients

Ann Med Surg (Lond). 2022 Feb:74:103234. doi: 10.1016/j.amsu.2021.103234. Epub 2022 Jan 11.

Authors

Affiliations

¹ Department of Tropical Medicine, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt.
² Shebin El-Kom Chest Hospital, Shebin El-Kom, Egypt.
³ Department of Public Health and Community Medicine, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt.
⁴ Department of Public Health and Community Medicine, Faculty of Medicine, Taiz University, Yemen.
⁵ Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt.
⁶ Department of Pharmaceutics and Industrial Pharmacy, Taif College of Pharmacy, Taif University, PO Box11099, Taif, 21944, Saudi Arabia.
⁷ Department of Clinical Pathology, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt.
⁸ Department of Clinical Biochemistry and Molecular Diagnostics, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt.
⁹ Medical Microbiology and Immunology Department, Faculty of Medicine, Suez University, Suez, Egypt.

Abstract

Background: The latest novel corona virus disease (COVID-19) pandemic shows a significant health concern. We aimed to study the prevalence of gastrointestinal symptoms among COVID-19 Egyptian patients.

Methods: A cross-sectional study was carried out on 860 patients with COVID-19 infection classified according to Ministry of Health Program (MOHP) into three groups (280 patients with mild infection, 258 patients with moderate disease and 322 patients with severe disease). All patients were subjected to medical history, clinical examination, laboratory investigations, high-resolution computed tomography chest (HRCT chest) and other investigations when needed in some patients e.g., upper gastro-intestinal (GI) endoscopy, abdomino-pelvic ultrasound and ECHO.

Results: Gastro-intestinal symptoms were present in 27.2% of the studied patients. The most common reported GIT symptoms were vomiting, diarrhea, abdominal/gastric pain, followed by nausea. GIT symptoms presence was significantly higher in severe cases in comparison to mild or moderate cases. C-reactive protein (CRP), serum ferritin, Aspartate aminotransferase (AST), bilirubin, and creatinine were significantly associated with the presence of GI symptoms.

Conclusions: GI symptoms are prevalent among COVID-19 patients, the most common were vomiting and diarrhea and were associated with COVID-19 severity.

Keywords: ACE2, angiotensin convertory enzyme 2; ALT, alanine aminotransferase; AST, Aspartate aminotransferase; CO-RAD, COVID-19 Reporting and Data System; COVID-19; COVID-19, Corona virus disease; CRP, C-reactive protein; Fecal-oral viral transmission; GI, Gastrointestinal; GIT manifestations in COVID-19; HRCT chest, high-resolution computed tomography chest; IL, interleukin; LDH, Lactate Dehydrogenase; MOHP, Ministry of Health Program; PCR, Polymearase chain reaction; Pandemic; TNF, tumor necrosis factor.