Association of Gastrointestinal Manifestations and Laboratory Abnormalities on Clinical Outcomes of COVID-19 Patients in a Tertiary Hospital

Abstract

SARS-CoV-2, the causative agent for COVID-19 disease, initially reported in Wuhan, Hubei China as an outbreak of viral pneumonia. The presentation ranged from asymptomatic to a severe viral pneumonia which can be fatal in high-risk groups. Some patients also presented with gastrointestinal symptoms. Studies on its symptomatology had been widely discussed in various literatures but its effect on aminotransferases and gastrointestinal system in general were still underway. Hence, this study aimed to determine the prevalence of gastrointestinal and liver manifestations and corresponding laboratory abnormalities among COVID-19 patients admitted in a tertiary referral hospital, and to determine its associations with disease severity and clinical outcomes of COVID-19 infection. Cross-sectional study design was used. A 340-sample population was computed with a 95% confidence interval. The population consisted of randomly selected COVID-19 confirmed patients aged >19 years-old admitted at Baguio General Hospital and Medical Center from May 1, 2020 to July 31, 2021. Data were encoded in a spreadsheet; and were analyzed through frequencies, percentages, means and standard deviation. Kruskal-Wallis H Test, One-way ANOVA and Chi-square were used to test for association with <0.01 alpha level of significance. 18.23% COVID-19 patients had GI and liver manifestations. The presence of GI symptoms also showed an increased risk for developing abnormal laboratory parameters (aminotransferases, INR, inflammatory markers, and Procalcitonin). Symptoms and laboratory parameters were also associated with severe COVID-19 infection and abnormal laboratories were also associated with worse outcomes (recovery status, need for ICU admission, mortality and length of hospitalizations), except for GGT. Mild acute liver injury was common in COVID-19 patients and signified better recovery outcomes. In conclusion, these symptoms and laboratory tests provided significant associations which can be used by clinicians in tailoring specific diagnostics and therapeutics; and can simultaneously be used in prognostication of COVID-19 patients.