Milano Angelo, Efthymakis Konstantinos, D'Ardes Damiano, Tana Marco, Mazzotta Elena, De Febis Giulia, Laterza Francesco, Tarquini Pierluigi, Marini Enrico, Porreca Ettore, Cipollone Francesco, Neri Matteo
UOSD Endoscopia Digestiva e Gastroenterologia, Ospedale Clinicizzato 'SS Annunziata', ASL2 Abruzzo, Chieti, Italy.
Medicina Generale 1, Ospedale Clinicizzato 'SS Annunziata', ASL2 Abruzzo, Chieti, Italy.
Therap Adv Gastroenterol. 2022 Jun 21;15:17562848221104610. doi: 10.1177/17562848221104610. eCollection 2022.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus enters the cells angiotensin-converting enzyme 2 receptor; therefore, tissues expressing this receptor are potential targets for infection. Although many studies have observed gastrointestinal (GI) symptoms in coronavirus disease 2019 (COVID-19) patients, prevalence and clinical impact are still uncertain due to the heterogeneity of reports and obstacles to generalization.
In this cross-sectional study, we included symptomatic patients requiring hospital admission, with a confirmed diagnosis of COVID-19 by nasopharyngeal polymerase chain reaction test, between 18 March and 30 May 2020. Demographic data, symptoms at onset, vital signs, and laboratory tests at admission were recorded.
In all, 300 patients were included (57%M, 43%F). GI symptoms were mainly diarrhea (13%), anorexia (4.3%), vomiting (3%), and abdominal pain (2.3%). Overall, males were younger (68 years 76 years; = 0.01); patients with GI manifestations at disease onset required significantly faster hospital admission and showed larger GI complication rates. GI symptoms were associated with abnormal high aspartate aminotransferase and alanine aminotransferase serum titers, especially in male patients.
Our study on an Italian population during the outbreak of the COVID-19 pandemic shows that GI symptoms are part of the spectrum of the SARS-CoV-2 infection and could be the only manifestations at disease onset. Although patients with GI symptoms were associated with faster hospital admission and liver involvement, prognosis was not affected.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）通过血管紧张素转换酶2受体进入细胞；因此，表达该受体的组织是潜在的感染靶点。尽管许多研究观察到2019冠状病毒病（COVID-19）患者出现胃肠道（GI）症状，但由于报告的异质性和推广的障碍，其患病率和临床影响仍不确定。
在这项横断面研究中，我们纳入了2020年3月18日至5月30日期间因症状明显而需住院、经鼻咽聚合酶链反应检测确诊为COVID-19的患者。记录了人口统计学数据、发病时的症状、生命体征和入院时的实验室检查结果。
共纳入300例患者（男性占57%，女性占43%）。胃肠道症状主要为腹泻（13%）、厌食（4.3%）、呕吐（3%）和腹痛（2.3%）。总体而言，男性患者年龄较轻（68岁对76岁；P = 0.01）；发病时出现胃肠道表现的患者入院速度明显更快，胃肠道并发症发生率更高。胃肠道症状与天冬氨酸转氨酶和丙氨酸转氨酶血清滴度异常升高有关，尤其是男性患者。
我们对意大利人群在COVID-19大流行期间的研究表明，胃肠道症状是SARS-CoV-2感染谱的一部分，可能是疾病发作时的唯一表现。尽管有胃肠道症状的患者入院速度更快且有肝脏受累情况，但预后并未受到影响。
