Gastrointestinal Symptoms Common in Patients Hospitalized With COVID-19

Nearly 1 in 5 US patients hospitalized with COVID-19 experienced gastrointestinal symptoms, according to findings from a multicenter cohort study published online ahead of print in Gastro Hep Advances.

“Although gastrointestinal manifestations were common among patients hospitalized with COVID-19, there was significant variability in prevalence across the United States and between intensive care unit (ICU) and non-ICU patients in our cohort of patients,” wrote corresponding author Berkeley N. Limketkai, MD, PhD, of the David Geffen School of Medicine at the University of California Los Angeles, and coauthors. “This variability could be attributed to differing viral strains and severity of illness.”

The study included 2031 patients hospitalized for COVID-19 before October 2020 across seven academic centers in the United States.

All in all, 18.9% of patients had gastrointestinal symptoms. Diarrhea was most common, followed by nausea/vomiting, and abdominal pain. The study also found higher rates of gastrointestinal symptoms in patients from the Midwest (26.7%) and Northeast (25.6%) compared with the western United States (16.0%).

Gastrointestinal symptoms did not differ with ICU status. However, the prevalence of abnormal aspartate aminotransferase, alanine aminotransferase, and total bilirubin was higher in patients requiring ICU care. Elevated aspartate aminotransferase affected 58.1% of ICU patients compared with 37.3% of non-ICU patients; alanine aminotransferase, 37.5% of ICU patients compared with 29.3% of non-ICU patients; and total bilirubin, 12.7% of ICU patients compared with 9.0% of non-ICU patients, researchers reported. The mortality rate was also higher among patients who received ICU care: 22.7%, compared with 4.7% for patients not treated in the ICU.

Chronic liver disease was linked with gastrointestinal manifestations of COVID-19, the study found, while abnormal aspartate aminotransferase or alanine aminotransferase predicted ICU admission.

“Overall, we present the largest known multicenter cohort of patients throughout the United States with COVID-19,” researchers wrote. “This data can serve as a foundational resource for studies evaluating the evolution of the COVID-19 pandemic.”

—Jolynn Tumolo

Reference:
Patel AP, Sanders TK, Prakash P, et al. Gastrointestinal manifestations of coronavirus disease 2019 across the United States: a multi-center cohort study. Gastro Hep Advances. Published online ahead of print July 19, 2022.