S1143 High Frequency of Gastrointestinal, Hepatic, and Nutritional Disorders in Hospitalized Patients With COVID-19 Infection: An Early Institutional Experience

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INTRODUCTION: COVID-19 illness is caused by a coronavirus called SARS-CoV-2. Many reports on hospitalized patients with COVID-19 highlight the pulmonary, renal and cardiac involvement. However, there is limited information about GI, Hepatic and Nutritional disorders in the natural history of hospitalized patients with COVID-19. Furthermore, the impact of racial and ethnic differences on outcome and mortality has not been well examined. We undertook a retrospective study for all the adult patients (n = 146) who were hospitalized with suspected COVID-19 infection to evaluate these factors, at the time of early breakout of COVID-19. METHODS: A retrospective study was conducted for the patients (n = 146) who were hospitalized with COVID-19 infection, between 1st Feb to 1st Jun, 2020. RESULTS: Of the 146 patients, 52% were females, 68% were African Americans (AA), 24% Caucasians, 6% Hispanics. The mean age of presentation was 62 years (±17, SD). A large number of patients(41%) were obese(BMI >30). Gastrointestinal manifestations were observed in about 56% of patients, which included diarrhea (24%), nausea (19%), anorexia (14%) and emesis (13%). Other GI manifestations were GI Bleeding (10%) and dysgeusia (3%). Majority of patients (64%) had elevated one or more liver function test, AST was elevated in about 60% of the patients. The other abnormal labs were inflammatory markers (CRP, Ferritin and LDH), and coagulation parameters (D-Dimer, PT/INR). Significant number of patients were Hypertensive(65%) and Diabetics(30%). Acute kidney injury was noted in 30% of the cohort. Overall mortality rate in this group of patients was 24%. The underlying primary cause of death was Respiratory Failure (n = 19), Sepsis(n = 12), GI Bleeding(n = 2), Multi Organ Failure (n = 1) and in these patients. It is noteworthy that the the mortality in AA was 72%, Caucasian was 25%. CONCLUSION: These observations from a single institution demonstrate a higher proportion of AA population who were afflicted with COVID-19 infection. A large number of these patients were obese with associated comorbidities and developed a very high mortality (30%) secondary to COVID-19. Interestingly, a significant number of patients from this group showed higher frequency of GI, hepatic and nutritional derangements. Lastly, the biomarkers of coagulation such as D-Dimer, PT/INR as well as inflammatory markers like CRP, Ferritin, and LDH were elevated in large number of patients. This study highlights involvement of several additional organ systems in patients with COVID-19.