GASTROINTESTINAL MANIFESTATIONS IN COVID-19: A PROSPECTIVE STUDY

Aims Gastrointestinal manifestations are common during coronavirus disease (COVID-19) infection. They can occur before respiratory symptoms, resulting in a diagnostic delay and an increased risk of disease transmission. The current study reports major gastrointestinal manifestations as initial symptoms of COVID-19.

Methods This prospective, descriptive, cross-sectional, and single-center study of 713 cases was conducted in a field hospital over a 5-week period from June 21 to July 25, 2020.

Results The average age of our patients was 31.95 years. Clinically, on admission, anorexia was the main symptom, present in 32.3% of patients. Gastrointestinal manifestations were present in 14.9% of patients, including watery diarrhea in 8.6% of cases, nausea and/or vomiting in 4.6% of cases, and abdominal pain in 1.6% of cases.

Six hundred thirty-two patients were treated in accordance with one of the two therapeutic protocols recommended by the National Ministry of Health. The treatment-related effects that occurred in 61.4% of patients were primarily digestive in 55.3% of cases.

In multivariate analysis, following adjustment of the studied parameters, only the presence of gastrointestinal manifestations (OR: 1.478 confidence 95% CI: 1.286–1.698; p<0.001) and treatment side effects (OR=1.069, CI: 1.020–1.119, p=0.005) altered the rate of negative polymerase chain reaction (PCR) tests on day 10.

Conclusions Gastrointestinal manifestations are common during COVID-19 and seem to be linked to a longer duration of disease. SARS-CoV-2 can persist in the digestive tract, with the possibility of fecal–oral transmission. Therefore, strict precautions when performing gastrointestinal endoscopy and handling stools from infected patients.

Publication History

Article published online:
14 April 2022