The Spectrum of Gastrointestinal Symptoms in Patients With Coronavirus Disease-19: Predictors, Relationship With Disease Severity, and Outcome.
The Spectrum of Gastrointestinal Symptoms in Patients With Coronavirus Disease-19: Predictors, Relationship With Disease Severity, and Outcome.
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DOI：
10.14309/ctg.0000000000000259
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发表时间：
2020-12
影响因子：
3.6
通讯作者：
Dhiman RK
中科院分区：
文献类型：
--
作者：
Ghoshal UC;Ghoshal U;Mathur A;Singh RK;Nath A;Garg A;Singh D;Singh S;Singh J;Pandey A;Rai S;Vasanth S;Dhiman RK
我们前瞻性地研究了新冠肺炎患者胃肠道(GI)症状的频率、谱和预测因素，以及胃肠道症状与病情严重程度和预后的关系。在印度北部的一所大学医院转诊实验室诊断出连续患有新冠肺炎的患者，通过单变量和多变量分析，评估了包括胃肠道症状在内的临床表现，他们的预测因素，以及这些症状的出现、疾病严重程度和结果之间的关系。在2020年4月至5月期间，16317名受试者的口咽和鼻咽拭子中检测出严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)RNA，其中252人(1.5%)呈阳性。在44例有症状的患者中，18例(40.9%)有非胃肠道症状，15例(34.1%)同时有胃肠道和非胃肠道症状，11例(25.0%)仅有胃肠道症状。33例为轻至中度，8例为重度，5例为危重。死亡5例(1.98%)。在多变量分析中，与胃肠道症状相关的因素包括无接触史、存在非胃肠道症状和合并疾病。与没有胃肠道症状的患者相比，有胃肠道症状的患者更容易出现严重的危重疾病和致命的结局。82%的新冠肺炎患者没有症状，10.3%的患者有胃肠道症状；严重和致命疾病的发生率分别只有5%和2%。在多变量分析中，胃肠道症状的出现与严重疾病和致死结局相关。胃肠道症状的独立预测因素包括无接触史、存在非胃肠道症状和合并疾病。
We prospectively studied the frequency, spectrum, and predictors of gastrointestinal (GI) symptoms among patients with coronavirus disease-19 (COVID-19) and the relationship between GI symptoms and the severity and outcome. Consecutive patients with COVID-19, diagnosed in a university hospital referral laboratory in northern India, were evaluated for clinical manifestations including GI symptoms, their predictors, and the relationship between the presence of these symptoms, disease severity, and outcome on univariate and multivariate analyses. Of 16,317 subjects tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in their oropharyngeal and nasopharyngeal swabs during April–May 2020, 252 (1.5%) were positive. Of them, 208 (82.5%) were asymptomatic; of the 44 symptomatic patients, 18 (40.9%) had non-GI symptoms, 15 (34.1%) had a combination of GI and non-GI symptoms, and 11 (25.0%) had GI symptoms only. Thirty-three had mild-to-moderate disease, 8 severe, and 5 critical. Five patients (1.98%) died. On multivariate analysis, the factors associated with the presence of GI symptoms included the absence of contact history and presence of non-GI symptoms and comorbid illnesses. Patients with GI synptoms more often had severe, critical illness and fatal outcome than those without GI symptoms. Eighty-two percent of patients with COVID-19 were asymptomatic, and 10.3% had GI symptoms; severe and fatal disease occurred only in 5% and 2%, respectively. The presence of GI symptoms was associated with a severe illness and fatal outcome on multivariate analysis. Independent predictors of GI symptoms included the absence of contact history, presence of non-GI symptoms, and comorbid illnesses.