Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Korean J Intern Med. 2020 Nov;35(6):1261-1269. doi: 10.3904/kjim.2020.196. Epub 2020 Sep 23.
BACKGROUND/AIMS: Coronavirus disease 2019 (COVID-19) can reportedly cause gastrointestinal symptoms. Therefore, we investigated the clinical characteristics of COVID-19 patients with diarrhea.
We included 118 COVID-19 patients admitted to a single hospital from February 20 to March 31, 2020. Medical records with clinical characteristics, laboratory data, treatment course, and clinical outcomes were compared based on the presence or absence of diarrhea. Prognostic factors for disease severity and mortality in COVID-19 were also assessed.
Among patients, 54 (45.8%) had diarrhea, whereas seven (5.9%) had only diarrhea. The median age of patients with diarrhea was 59 years (44 to 64), and 22 (40.7%) were male. Systemic steroid use, intensive care unit admission, septic shock, and acute respiratory distress syndrome were less frequent in the diarrhea group than in the non-diarrhea group. No significant differences were observed in total hospital stay and mortality between groups. On multivariate analysis, age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.01 to 1.12; p = 0.044), diabetes (OR, 3.00; 95% CI, 1.25 to 20.47; p = 0.042), and dyspnea (OR, 41.19; 95% CI, 6.60 to 823.16; p < 0.001) were independent risk factors for septic shock. On Cox regression analysis, diabetes (hazard ratio [HR], 4.82; 95% CI, 0.89 to 26.03; p = 0.043) and chronic obstructive pulmonary disease (HR, 16.58; 95% CI, 3.10 to 88.70; p = 0.044) were risk factors for mortality.
Diarrhea was present in 45.8% of patients and was a common symptom of COVID-19. Although patients with diarrhea showed less severe clinical features, diarrhea was not associated with disease severity or mortality.
背景/目的:据报道,2019 年冠状病毒病(COVID-19)可引起胃肠道症状。因此,我们调查了伴有腹泻的 COVID-19 患者的临床特征。
我们纳入了 2020 年 2 月 20 日至 3 月 31 日期间在一家医院住院的 118 例 COVID-19 患者。根据有无腹泻,比较了具有临床特征、实验室数据、治疗经过和临床结局的病历。还评估了 COVID-19 患者严重程度和死亡率的预后因素。
在患者中,54 例(45.8%)有腹泻,7 例(5.9%)仅有腹泻。有腹泻的患者中位年龄为 59 岁(44 至 64 岁),22 例(40.7%)为男性。与无腹泻组相比,腹泻组全身皮质类固醇使用、入住重症监护病房、感染性休克和急性呼吸窘迫综合征的发生率较低。两组的总住院时间和死亡率无显著差异。多变量分析显示,年龄(比值比[OR],1.06;95%置信区间[CI],1.01 至 1.12;p = 0.044)、糖尿病(OR,3.00;95%CI,1.25 至 20.47;p = 0.042)和呼吸困难(OR,41.19;95%CI,6.60 至 823.16;p < 0.001)是感染性休克的独立危险因素。在 Cox 回归分析中,糖尿病(危险比[HR],4.82;95%CI,0.89 至 26.03;p = 0.043)和慢性阻塞性肺疾病(HR,16.58;95%CI,3.10 至 88.70;p = 0.044)是死亡的危险因素。
腹泻发生在 45.8%的患者中,是 COVID-19 的常见症状。尽管腹泻患者的临床特征较轻,但腹泻与疾病严重程度或死亡率无关。