Gastrointestinal symptoms and complications in patients hospitalized due to COVID-19, an international multicentre prospective cohort study (TIVURON project).
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Cárdenas-Jaén Karina, Sánchez-Luna Sergio A, Vaillo-Rocamora Alicia, Castro-Zocchi Micaela Riat, Guberna-Blanco Laura, Useros-Brañas Daniel, Remes-Troche José M, Ramos-De la Medina Antonio, Priego-Parra Bryan A, Velarde-Ruiz Velasco José A, Martínez-Ayala Pedro, Urzúa Álvaro, Guiñez-Francois Dannette, Pawlak Katarzyna M, Kozłowska-Petriczko Katarzyna, Gorroño-Zamalloa Irati, Urteaga-Casares Clara, Ortiz-Polo Inmaculada, Del Val Antoñana Adolfo, Lozada-Hernández Edgard E, Obregón-Moreno Enrique, García-Rayado Guillermo, Domper-Arnal María José, Casas-Deza Diego, Esteban-Cabello Elena I, Díaz Luis A, Riquelme Arnoldo, Martínez-Lozano Helena, Navarro-Romero Francisco, Olivas Ignasi, Iborra-Muñoz Guillem, Calero-Amaro Alicia, Caravaca-García Ibán, Lacueva-Gómez Francisco J, Pastor-Mateu Rubén, Lapeña-Muñoz Berta, Sastre-Lozano Violeta, Pizarro-Vega Nazaret M, Melcarne Luigi, Pedrosa-Aragón Marc, Mira José J, MStat Aurora Mula, Carrillo Irene, de-Madaria Enrique
Аннотация
METHODS: This international multicentre prospective cohort study recruited COVID-19 patients hospitalized at 31 centres in Spain, Mexico, Chile, and Poland, between May and September 2020. Patients were followed-up until 15 days post-discharge and completed comprehensive questionnaires assessing GI symptoms and complications. A descriptive analysis as well as a bivariate and multivariate analysis were performer using binary logistic regression. p<0.05 was considered significant.
RESULTS: Eight hundred twenty-nine patients were enrolled; 129 (15.6%) had severe COVID-19, 113 (13.7%) required ICU admission, and 43 (5.2%) died. Upon admission, the most prevalent GI symptoms were anorexia (n=413; 49.8%), diarrhoea (n=327; 39.4%), nausea/vomiting (n=227; 27.4%), and abdominal pain (n=172; 20.7%), which were mild/moderate throughout the disease and resolved during follow-up. One-third of patients exhibited liver injury. Non-severe COVID-19 was associated with ≥2 GI symptoms upon admission (OR 0.679; 95% CI 0.464-0.995; p=0.046) or diarrhoea during hospitalization (OR 0.531; 95% CI 0.328-0.860; p=0.009). Multivariate analysis revealed that worse hospital outcomes were not independently associated with liver injury or GI symptoms.
CONCLUSION: GI symptoms were more common than previously documented, and were mild, rapidly resolved, and not independently associated with COVID-19 severity. Liver injury was a frequent complication in hospitalized patients not independently associated with COVID-19 severity.