Prevalence of Gastrointestinal Symptoms in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Results of the Prospective Controlled Multinational GI-COVID-19 Study

• Published in: The American journal of gastroenterology Vol. 117; no. 1; pp. 147 - 157
• Main Authors: Marasco, Giovanni, Cremon, Cesare, Barbaro, Maria Raffaella, Salvi, Daniele, Cacciari, Giulia, Kagramanova, Anna, Bordin, Dmitry, Drug, Vasile, Miftode, Edgidia, Fusaroli, Pietro, Mohamed, Salem Youssef, Ricci, Chiara, Bellini, Massimo, Rahman, M. Masudur, Melcarne, Luigi, Santos, Javier, Lobo, Beatriz, Bor, Serhat, Yapali, Suna, Akyol, Deniz, Sapmaz, Ferdane Pirincci, Urun, Yonca Yilmaz, Eskazan, Tugce, Celebi, Altay, Kacmaz, Huseyin, Ebik, Berat, Binicier, Hatice Cilem, Bugdayci, Mehmet Sait, Yağcı, Munkhtsetseg Banzragch, Pullukcu, Husnu, Kaya, Berrin Yalınbas, Tureyen, Ali, Hatemi, İbrahim, Koc, Elif Sitre, Sirin, Goktug, Calıskan, Ali Riza, Bengi, Goksel, Alıs, Esra Ergun, Lukic, Snezana, Trajkovska, Meri, Hod, Keren, Dumitrascu, Dan, Pietrangelo, Antonello, Corradini, Elena, Simren, Magnus, Sjolund, Jessica, Tornkvist, Navkiran, Ghoshal, Uday C., Kolokolnikova, Olga, Colecchia, Antonio, Serra, Jordi, Maconi, Giovanni, De Giorgio, Roberto, Danese, Silvio, Portincasa, Pietro, Di Stefano, Michele, Maggio, Marcello, Philippou, Elena, Lee, Yeong Yeh, Venturi, Alessandro, Borghi, Claudio, Zoli, Marco, Gionchetti, Paolo, Viale, Pierluigi, Stanghellini, Vincenzo, Barbara, Giovanni
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer 01-01-2022; Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
• Subjects: Coronaviruses; COVID-19; COVID-19 - complications; Demographics; Diarrhea; Egypt - epidemiology; Enrollments; Europe - epidemiology; Female; Functional GI Disorders; Gastroenteritis - epidemiology; Gastroenteritis - etiology; Gastroenterology; Hospitalization; Humans; Infections; Interviews as Topic; Laboratories; Male; Middle Aged; Motility; Nausea; Prevalence; Prospective Studies; Questionnaires; Russia - epidemiology; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Surveys and Questionnaires; Ventilators; Europe; Egypt; Russia; Italy
• ISSN: 0002-9270; 1572-0241
• DOI: 10.14309/ajg.0000000000001541

Gastrointestinal (GI) symptoms in coronavirus-19 disease (COVID-19) have been reported with great variability and without standardization. In hospitalized patients, we aimed to evaluate the prevalence of GI symptoms, factors associated with their occurrence, and variation at 1 month.
The GI-COVID-19 is a prospective, multicenter, controlled study. Patients with and without COVID-19 diagnosis were recruited at hospital admission and asked for GI symptoms at admission and after 1 month, using the validated Gastrointestinal Symptom Rating Scale questionnaire.
The study included 2036 hospitalized patients. A total of 871 patients (575 COVID+ and 296 COVID-) were included for the primary analysis. GI symptoms occurred more frequently in patients with COVID-19 (59.7%; 343/575 patients) than in the control group (43.2%; 128/296 patients) (P < 0.001). Patients with COVID-19 complained of higher presence or intensity of nausea, diarrhea, loose stools, and urgency as compared with controls. At a 1-month follow-up, a reduction in the presence or intensity of GI symptoms was found in COVID-19 patients with GI symptoms at hospital admission. Nausea remained increased over controls. Factors significantly associated with nausea persistence in COVID-19 were female sex, high body mass index, the presence of dyspnea, and increased C-reactive protein levels.
The prevalence of GI symptoms in hospitalized patients with COVID-19 is higher than previously reported. Systemic and respiratory symptoms are often associated with GI complaints. Nausea may persist after the resolution of COVID-19 infection.