[新型冠状病毒肺炎患者的胃肠道表现和肝脏疾病]

[Gastrointestinal manifestations and liver disorders in patients with COVID-19].

作者信息

Vázquez-Cruz Elmer, Garay-Ortega Jorge Alonso, Bautista-Santos Aleida, Moreno-Alcántar Rosalba

机构信息

Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Departamento de Gastroenterología. Ciudad de México, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2024 Sep 5;62(suppl 2):1-8. doi: 10.5281/zenodo.10814332.

DOI:10.5281/zenodo.10814332

PMID:39602311

Abstract

BACKGROUND

SARS-CoV-2 infection began in Wuhan, China, in December 2019, where the first cases of pneumonia were described. The infection spread rapidly and was established as a pandemic by the World Health Organization (WHO) in February 2020. In Mexico, the first cases were in March 2020. Although the classic symptoms are respiratory, gastrointestinal symptoms have been described in 17%, as well as hepatic disorders associated with pneumonia.

OBJECTIVE

To describe the gastrointestinal manifestations and hepatic alterations in patients with COVID-19 from July 2020 to January 2021 in a tertiary-care hospital.

MATERIAL AND METHODS

Clinical, cross-sectional, prolective, observational, analytical study, which included patients of 18 years or older hospitalized with COVID-19, confirmed by PCR for SARS-CoV-2.

RESULTS

84 patients were included, 65% male (55). Mean age was of 59 (± 13.3) years. Reported comorbidities were systemic arterial hypertension (51%), type 2 diabetes (38%), and obesity (26%). The predominant pattern was hepatocellular with elevation of AST (38) 45%, ALT (36)42%, GGT (30) 34% and FA (11) 13%. The prevalence of gastrointestinal symptoms was 71% (60/84), with diarrhea being the most frequent 53% (4 bowel movements/day) and dysgeusia (36.9%). There were 12 patients (10.02%) who presented diarrhea as the initial symptom with respiratory complications 5-7 days later.

CONCLUSIONS

Gastrointestinal and hepatic manifestations occurred in 71% of the patients.

摘要

背景

2019年12月，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染始于中国武汉，当地报告了首例肺炎病例。该感染迅速传播，并于2020年2月被世界卫生组织（WHO）认定为大流行病。在墨西哥，首例病例出现在2020年3月。尽管典型症状为呼吸道症状，但17%的患者出现了胃肠道症状，还有与肺炎相关的肝脏疾病。

目的

描述2020年7月至2021年1月在一家三级护理医院中感染新型冠状病毒肺炎（COVID-19）患者的胃肠道表现和肝脏改变。

材料与方法

临床、横断面、前瞻性、观察性、分析性研究，纳入年龄在18岁及以上因COVID-19住院且经SARS-CoV-2聚合酶链反应（PCR）确诊的患者。

结果

纳入84例患者，65%为男性（55例）。平均年龄为59（±13.3）岁。报告的合并症有系统性动脉高血压（51%）、2型糖尿病（38%）和肥胖症（26%）。主要模式为肝细胞型，天门冬氨酸氨基转移酶（AST，38例）升高45%，丙氨酸氨基转移酶（ALT，36例）升高42%，γ-谷氨酰转移酶（GGT，30例）升高34%，碱性磷酸酶（FA，11例）升高13%。胃肠道症状的患病率为71%（60/84），腹泻最为常见，占53%（每日排便4次），味觉障碍占36.9%。有12例患者（10.02%）以腹泻为首发症状，5至7天后出现呼吸道并发症。