COVID-19 Disease Outcomes: Does Gastrointestinal Burden Play a Role?

Mona A Hegazy; Rania Mohamed Lithy; Hoda M Abdel-Hamid; Mahmoud Wahba; Omar Ahmed Ashoush; Mohamed Tharwat Hegazy; Maha Hossam El-Din Ibrahim; Dalia Abdelfatah; Ahmed Abdelghani

doi:10.2147/CEG.S297428

COVID-19 Disease Outcomes: Does Gastrointestinal Burden Play a Role?

Clin Exp Gastroenterol. 2021 May 24:14:199-207. doi: 10.2147/CEG.S297428. eCollection 2021.

Authors

Mona A Hegazy¹, Rania Mohamed Lithy², Hoda M Abdel-Hamid³, Mahmoud Wahba¹, Omar Ahmed Ashoush¹, Mohamed Tharwat Hegazy¹, Maha Hossam El-Din Ibrahim¹, Dalia Abdelfatah⁴, Ahmed Abdelghani¹

Affiliations

¹ Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
² Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
³ Chest Diseases Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
⁴ Biostatistics and Cancer Epidemiology Department, National Cancer Institute, Cairo University, Cairo, Egypt.

Abstract

Background: The novel coronavirus disease 2019 presents an urgent threat to global health. As the epidemic grows, prognosis prediction is essential for monitoring risky patient. It is thus important to consider gastrointestinal manifestations and the duration of symptoms as predictors of prognosis. Our aim was to determine the correlation of gastrointestinal symptoms and laboratory markers with disease outcomes and whether symptom duration varies substantially between patients. We also undertook this study to determine the optimal time to predict COVID-19 outcome.

Patients and methods: A total of 190 patients with polymerase chain reaction-confirmed COVID-19 were followed up until recovery. We proposed a correlation between gastrointestinal symptoms and disease severity (based on clinical data, and diagnostic investigations) to estimate the duration of symptoms as a predictor of COVID-19 prognosis.

Results: The prevalence of gastrointestinal symptoms was 49.5%, consisting mainly of diarrhea in 27.9% of patients. In addition, a longer disease duration and higher temperature were observed in patients with diarrhea. Symptom duration was variable, with a median of 12 days and a range of 1-55 days. Statistical analysis indicated that patients with a duration of symptoms ≥12 day had more severe symptoms and a worse prognosis. Patients who complained of diarrhea had 2.7 times the odds of a longer duration of symptoms, and those with a history of chronic lung disease have 7.2 times the odds of a longer duration of symptoms.

Conclusion: GIT manifestations (mainly diarrhea) and the duration of symptoms of COVID-19 provide prognostic evidence of COVID-19 outcomes, irrespective of earlier categorization by the World Health Organization. Thus, patients with mild symptoms who present with diarrhea and a duration of symptoms longer than 12 days are expected to have a worse prognosis.

Keywords: COVID-19; GIT manifestations; prognosis; symptoms duration.

Grants and funding

All authors declare the absence of any financial or personal relationships with other people or organizations that could inappropriately influence and bias the work.