Aljaroudi Mahdi E, Alghamdi Sulaiman K, Al Salman Balqis A, Alabdulghani Mohammed J
Gastroenterology and Hepatology, Dammam Medical Complex, Dammam, SAU.
Gastroenterology and Hepatology, King Fahad General Hospital Hofuf, Al Ahssa, SAU.
Cureus. 2022 Apr 29;14(4):e24580. doi: 10.7759/cureus.24580. eCollection 2022 Apr.
Background Coronavirus disease 2019 (COVID-19) classically presents as a respiratory illness with fever, dry cough, and dyspnea on exertion. Along with respiratory signs and symptoms, gastrointestinal (GI) manifestations and liver injury have been recognized during the progression of the disease. This study aimed to determine the prevalence of GI symptoms and hepatic injury during COVID-19 infections and their consequences on the outcome of the disease. Methodology We conducted a retrospective survey of 715 participants age 16 or older diagnosed with COVID-19 and reported GI and hepatic manifestations in the Dammam Medical Complex in Dammam, Eastern Province, Saudi Arabia, from March 1, 2020, to May 31, 2020. We recorded clinical manifestations, laboratory test results, patient demographics, comorbidities, and treatments. Results The mean age of the study population was 46 years (88% were male, 12% were female), and 80% were non-Saudi. While most patients recovered and were discharged (n=603, 84.62%), 100 (13.99%) died due to COVID-19. Type 2 diabetes was present in 182 patients (79%) discharged and 45 patients (21%) who died. Hypertension was present in 26 (67%) discharged and 158 patients (81%) who died. Cardiovascular disease was present in 26 patients (67%) discharged and 13 (33%) who died. Chronic kidney disease was found in 11 patients (61%) discharged and six (33%) who died. Diarrhea was present in 11% of patients, nausea in 8%, and vomiting in 9% of patients. Twenty percent of patients had at least one GI symptom. Only 10% of those who died had GI symptoms, while 88% of those discharged had GI symptoms. Serum levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase, and γ-glutamyl transpeptidase were generally higher in the patients who died than in those who were discharged. Conclusions We noted an increase in at least one liver enzyme with no clinically significant acute liver injury or cases of acute liver failure as sequelae of COVID-19. However, the presence of injury at the time of admission resulted in a significantly higher mortality rate. Only a small number of patients infected with COVID-19 exhibited GI manifestations. The etiology of severe acute respiratory syndrome coronavirus 2-related GI involvement is due to multiple factors. It is not yet fully understood if GI manifestations are clinical signs of high viral loads or another physiological process. The clinical manifestation and laboratory test results indicate that COVID-19 impacts the hepatic system and GI tract, indicating that COVID-19 infection may risk liver and GI tract injury.
2019年冠状病毒病（COVID-19）通常表现为伴有发热、干咳和劳力性呼吸困难的呼吸道疾病。在疾病进展过程中，除了呼吸道症状和体征外，胃肠道（GI）表现和肝损伤也已得到确认。本研究旨在确定COVID-19感染期间胃肠道症状和肝损伤的患病率及其对疾病结局的影响。
我们对2020年3月1日至2020年5月31日期间在沙特阿拉伯东部省达曼的达曼医疗中心确诊为COVID-19并报告有胃肠道和肝脏表现的715名16岁及以上参与者进行了回顾性调查。我们记录了临床表现、实验室检查结果、患者人口统计学特征、合并症和治疗情况。
研究人群的平均年龄为46岁（88%为男性，12%为女性），80%为非沙特人。虽然大多数患者康复并出院（n = 603，84.62%），但有100例（13.99%）因COVID-19死亡。出院的182例患者（79%）和死亡的45例患者（21%）患有2型糖尿病。出院的26例患者（67%）和死亡的158例患者（81%）患有高血压。出院的26例患者（67%）和死亡的13例患者（33%）患有心血管疾病。出院的11例患者（61%）和死亡的6例患者（33%）患有慢性肾脏病。11%的患者出现腹泻，8%的患者出现恶心，9%的患者出现呕吐。20%的患者至少有一种胃肠道症状。死亡患者中只有10%有胃肠道症状，而出院患者中有88%有胃肠道症状。死亡患者的血清丙氨酸氨基转移酶、天冬氨酸氨基转移酶、总胆红素、碱性磷酸酶和γ-谷氨酰转肽酶水平通常高于出院患者。
我们注意到至少一种肝酶升高，但没有临床上显著的急性肝损伤或急性肝衰竭病例作为COVID-19的后遗症。然而，入院时存在损伤导致死亡率显著升高。只有少数感染COVID-19的患者表现出胃肠道表现。严重急性呼吸综合征冠状病毒2相关胃肠道受累的病因是多因素的。胃肠道表现是否是高病毒载量的临床体征或另一种生理过程尚未完全了解。临床表现和实验室检查结果表明，COVID-19影响肝脏系统和胃肠道，表明COVID-19感染可能有肝脏和胃肠道损伤风险。
