Prevalence, Mechanism, and Implications of Gastrointestinal Symptoms in COVID-19

Abstract

Background; The COVID-19 pandemic has steered the exceptional disorder among the health care system. Gastrointestinal disorder and mortality are considerably associated with the utilization of health care which is disrupted by coronavirus pandemic. Aim: The aim of the present study was to assess the prevalence, mechanism and implications of Gastrointestinal Symptoms in COVID-19. Materials and Methods: This retrospective study was carried out on consecutive patients of laboratory tested severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and received inpatients/ emergency care at Isra University Hospital, Hyderabad for duration of six months between November 2020 to April 2021. The SARS-CoV-2 tested patients of either symptomatic or asymptomatic were enrolled in this study. The prevalence, mechanism, and implications of gastrointestinal symptoms were evaluated with COVID-19 among patients. The basic parameters such as GI symptoms, health care utilization, clinical predictor, and medication used were assessed with three Functional gastrointestinal and motility disorders (familial dysautonomia (FD), gastroparesis, and Irritable bowel syndrome (IBS)). The nasopharyngeal swab was used for SARS-CoV-2 testing. The COVID-19 sensitivity and specificity were 95% and 98% respectively. STATA version 15.1 was used for data analysis. Results: Of the total SARS-CoV-2 tested patients in our hospital, 1540 FGIMD patients underwent testing for SARS-CoV-2 were enrolled. COVID-19 RNA positive test rate was found 15.3% (235/1540) during the same period. Of all the tested patients, SARS-CoV-2 positive rate was higher (p<0.05) in COVID-19 patients with risk factors such as obesity, hypertension, autoimmune disease, diabetes, and cardiovascular disease) at 57.5% (885/1540) compared to 42.5% (655/1540) without risk factors. The COVID-19 prevalence in FGIMD patients was 3.3% (51/1540), 4.8% in IBS (56/1174), gastroparesis3.12% (24/770), and FD 2.4% (30/1250) in our hospital. Increased diarrhea, vomiting/nausea, weight loss, abdominal pain, and constipation were observed in FGIMD patients along with increases in H2 blocker, proton pump inhibitor and opioid use. The outpatient’s visits, diagnostic tests such as lower and upper endoscopies and hospitalization were higher during COVID-19 pandemic compared to the pandemic prior period. Conclusion: The prevalence of gastrointestinal symptoms was found higher in functional gastrointestinal and motility disorders patients during COVID-19 pandemic with increase healthcare utilization and medication usage. Key words: Gastrointestinal Symptoms, COVID-19 pandemic, Respiratory syndrome