Patel Ankur P, Sanders Troy K, Prakash Preeti, Law Jade, Alvencar Sujay, Choi Alyssa, Shah Janaki, Patel Karishma, Srivoleti Padmavathi, Chauhan Kirtan, Weissman Simcha, Holzwanger Erik, Dhingra Rohit, Nguyen Michelle, Kim Daniel, Sidhu Tahnee, Stallwood Christopher, Dickstein Aaron, Parekh Nimisha, Altayar Osama, Ciorba Matthew A, Yu Jessica, Chen Lea Ann, Tabibian James H, Limketkai Berkeley N
Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA School of Medicine, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California.
Department of Medicine, Baylor College of Medicine, Houston, Texas.
Gastro Hep Adv. 2022;1(6):909-915. doi: 10.1016/j.gastha.2022.07.002. Epub 2022 Jul 19.
Gastrointestinal (GI) symptoms occur among patients diagnosed with coronavirus disease 2019 (COVID-19), and there is clear evidence that SARS-CoV-2, the causative pathogen, infects the GI tract. In this large, multicenter cohort study, we evaluated variations in gastrointestinal and hepatic manifestations of COVID-19 throughout the United States (US).
Patients hospitalized with a positive COVID-19 test prior to October 2020 were identified at 7 US academic centers. Demographics, presenting symptoms, laboratory data, and hospitalization outcomes were abstracted. Descriptive and regression analyses were used to evaluate GI manifestations and their potential predictors.
Among 2031 hospitalized patients with COVID-19, GI symptoms were present in 18.9%; diarrhea was the most common (15.2%), followed by nausea and/or vomiting (12.6%) and abdominal pain (6.0%). GI symptoms were less common in the Western cohort (16.0%) than the Northeastern (25.6%) and Midwestern (26.7%) cohorts. Compared to nonintensive care unit (ICU) patients, ICU patients had a higher prevalence of abnormal aspartate aminotransferase (58.1% vs 37.3%; < .01), alanine aminotransferase (37.5% vs 29.3%; = .01), and total bilirubin (12.7% vs 9.0%; < .01). ICU patients also had a higher mortality rate (22.7% vs 4.7%; < .01). Chronic liver disease was associated with the development of GI symptoms. Abnormal aspartate aminotransferase or alanine aminotransferase was associated with an increased risk of ICU admission.
We present the largest multicenter cohort of patients with COVID-19 across the United States. GI manifestations were common among patients hospitalized with COVID-19, although there was significant variability in prevalence and predictors across the United States.
胃肠道（GI）症状在确诊为2019冠状病毒病（COVID-19）的患者中出现，并且有明确证据表明致病病原体严重急性呼吸综合征冠状病毒2（SARS-CoV-2）会感染胃肠道。在这项大型多中心队列研究中，我们评估了美国各地COVID-19患者胃肠道和肝脏表现的差异。
在7个美国学术中心识别出2020年10月之前COVID-19检测呈阳性的住院患者。提取人口统计学信息、出现的症状、实验室数据和住院结局。采用描述性和回归分析来评估胃肠道表现及其潜在预测因素。
在2031例COVID-19住院患者中，18.9%出现胃肠道症状；腹泻最为常见（15.2%），其次是恶心和/或呕吐（12.6%）以及腹痛（6.0%）。西部队列（16.0%）的胃肠道症状比东北部（25.6%）和中西部（26.7%）队列少见。与非重症监护病房（ICU）患者相比，ICU患者天门冬氨酸氨基转移酶异常的患病率更高（58.1%对37.3%；P<0.01），丙氨酸氨基转移酶异常的患病率更高（37.5%对29.3%；P = 0.01），总胆红素异常的患病率更高（12.7%对9.0%；P<0.01）。ICU患者的死亡率也更高（22.7%对4.7%；P<0.01）。慢性肝病与胃肠道症状的发生有关。天门冬氨酸氨基转移酶或丙氨酸氨基转移酶异常与入住ICU的风险增加有关。
我们展示了美国最大的多中心COVID-19患者队列。胃肠道表现在COVID-19住院患者中很常见，尽管美国各地的患病率和预测因素存在显著差异。
