Gurung Shekhar, Karki Saurab, Pathak Bishnu Deep, Yadav Gopal K, Bhatta Gaurab, Thapa Sumin, Banmala Sabin, Thapa Anil J, Roka Kumar
Department of Internal Medicine Bharatpur Hospital Chitwan Nepal.
Nepalese Army Institute of Health Sciences (NAIHS) Shree Birendra Hospital, Chhauni Kathmandu Nepal.
Health Sci Rep. 2023 Sep 14;6(9):e1568. doi: 10.1002/hsr2.1568. eCollection 2023 Sep.
Coronavirus disease 2019 (COVID-19) is a major public health problem causing significant morbidity and mortality worldwide. Apart from respiratory symptoms, gastrointestinal symptoms like nausea, vomiting, diarrhea, and abdominal discomfort are quite common among COVID-19 patients. The gastrointestinal tract can be a potential site for virus replication and feces a source of transmission. Thus, ignorance of enteric symptoms can hinder effective disease control. The objective of this study is to see the gastrointestinal manifestation of the disease and its effect on morbidity and mortality.
This observational cross-sectional retrospective study was carried out among 165 laboratory-confirmed COVID-19 patients in primary health care of Gorkha, Nepal from March 1, 2021 to March 1, 2022. A systematic random sampling method was adopted while data were entered and analyzed by Statistical Package for Social Sciences version 21.
Of 165 patients, 97 patients (58.78%) had enteric involvement. Among gastrointestinal symptoms, diarrhea in 67 patients (40.6%) and nausea and/or vomiting in 66 patients (40%) were the most common symptoms, followed by abdominal pain in 27 patients (16.4%) and anorexia in 19 patients (11.5%). Of the majority of cases with gastrointestinal involvement, 63 (63%) were below 50 years of age. Many of the patients who received vaccination had gastrointestinal symptoms (79%). Complications like acute respiratory distress syndrome, shock, and arrhythmia developed in 9.7% of patients, with the death of eight patients. COVID-19 vaccination was associated with 4.32 times higher odds of having gastrointestinal involvement in subsequent COVID-19 infection.
Diarrhea followed by nausea/vomiting was among the most common gastrointestinal symptoms affecting younger age groups in our study. Enteric symptoms were more common among vaccinated people rather than among nonvaccinated ones.
2019冠状病毒病（COVID-19）是一个重大的公共卫生问题，在全球范围内导致了显著的发病率和死亡率。除呼吸道症状外，恶心、呕吐、腹泻和腹部不适等胃肠道症状在COVID-19患者中相当常见。胃肠道可能是病毒复制的潜在部位，粪便则是传播源。因此，忽视肠道症状会阻碍疾病的有效控制。本研究的目的是观察该疾病的胃肠道表现及其对发病率和死亡率的影响。
本观察性横断面回顾性研究于2021年3月1日至2022年3月1日在尼泊尔戈尔哈初级卫生保健机构的165例实验室确诊的COVID-19患者中进行。采用系统随机抽样方法，数据录入并使用社会科学统计软件包第21版进行分析。
165例患者中，97例（58.78%）有肠道受累。在胃肠道症状中，67例（40.6%）出现腹泻，66例（40%）出现恶心和/或呕吐是最常见的症状，其次是27例（16.4%）腹痛和19例（11.5%）厌食。在大多数肠道受累病例中，63例（63%）年龄在50岁以下。许多接种疫苗的患者有胃肠道症状（79%）。9.7%的患者出现急性呼吸窘迫综合征、休克和心律失常等并发症，8例患者死亡。COVID-19疫苗接种与后续COVID-19感染时出现肠道受累的几率高4.32倍相关。
在我们的研究中，腹泻继之以恶心/呕吐是影响较年轻年龄组的最常见胃肠道症状。肠道症状在接种疫苗者中比未接种疫苗者中更常见。
