Temple University Hospital, Department of Medicine, Temple University School of Medicine, 3401 North Broad Street, Philadelphia, PA.
Temple University Hospital, Department of Medicine, Section of Gastroenterology and Hepatology, Temple University School of Medicine, 3401 North Broad Street, Philadelphia, PA.
Medicine (Baltimore). 2022 Jun 24;101(25):e29374. doi: 10.1097/MD.0000000000029374.
To characterize outcomes in patients hospitalized with coronavirus disease 2019 (COVID-19) who present with gastrointestinal (GI) symptoms.Clinical outcomes in patients with COVID-19 associated with GI symptoms have been inconsistent in the literature.The study design is a retrospective analysis of patients, age 18 years or older, admitted to the hospital after testing positive for COVID-19. Clinical outcomes included intensive care unit requirements, rates of discharges to home, rates of discharges to outside facilities, and mortality.Seven hundred fifty patients met the inclusion criteria. Three hundred seventy three (49.7%) patients presented with at least one GI symptom and 377 (50.3%) patients presented with solely non-GI symptoms. Patients who presented with at least one GI symptom had significantly lower ICU requirements (17.4% vs 20.2%), higher rates of discharges home (77.2% vs 67.4%), lower rates of discharges to other facilities (16.4% vs 22.8%), and decreased mortality (6.4% vs 9.8%) compared with patients with non-GI symptoms. However, patients who presented with solely GI symptoms had significantly higher ICU requirements (23.8% vs 17.0%), lower rates of discharges home (52.4% vs 78.7%), higher rates of discharges to facilities (28.6% vs 15.6%), and higher mortality (19.0% vs 5.7%) compared with those with mixed GI and non-GI symptoms.Although patients with COVID-19 requiring hospitalization with GI symptoms did better than those without GI symptoms, those with isolated GI symptoms without extra-GI symptoms had worse clinical outcomes. COVID-19 should be considered in patients who present with new onset or worsening diarrhea, nausea, vomiting, and abdominal pain even without pulmonary symptoms.
描述以胃肠道（GI）症状为首发表现的 2019 冠状病毒病（COVID-19）住院患者的临床结局。COVID-19 相关胃肠道症状患者的临床结局在文献中并不一致。本研究设计为回顾性分析经 COVID-19 检测阳性后住院的年龄≥18 岁的患者。临床结局包括入住重症监护病房（ICU）的需求、出院回家的比例、出院至其他医疗机构的比例以及死亡率。750 例患者符合纳入标准。373 例（49.7%）患者至少出现一种胃肠道症状，377 例（50.3%）患者仅出现非胃肠道症状。至少出现一种胃肠道症状的患者 ICU 入住需求显著较低（17.4% vs 20.2%）、出院回家的比例更高（77.2% vs 67.4%）、转往其他医疗机构的比例更低（16.4% vs 22.8%），死亡率更低（6.4% vs 9.8%），而单纯胃肠道症状患者 ICU 入住需求更高（23.8% vs 17.0%）、出院回家的比例更低（52.4% vs 78.7%）、转往医疗机构的比例更高（28.6% vs 15.6%），死亡率更高（19.0% vs 5.7%）。与存在混合胃肠道和非胃肠道症状的患者相比，尽管 COVID-19 住院患者有胃肠道症状者预后好于无胃肠道症状者，但单纯胃肠道症状而无其他非胃肠道症状者的临床结局更差。对于新发或恶化的腹泻、恶心、呕吐和腹痛患者，即使无肺部症状，也应考虑 COVID-19。
