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

Marasco G 1 , Cremon C 1 , Barbaro MR 1 , Salvi D 2 , Cacciari G 1 , Kagramanova A 3 Show all authors , Bordin D 4 , Drug V 5 , Miftode E 6 , Fusaroli P 7 , Mohamed SY 8 , Ricci C 9 , Bellini M 10 , Rahman MM 11 , Melcarne L 12 , Santos J 13 , Lobo B 13 , Bor S 14 , Yapali S 15 , Akyol D 16 , Sapmaz FP 17 , Urun YY 18 , Eskazan T 19 , Celebi A 20 , Kacmaz H 21 , Ebik B 22 , Binicier HC 23 , Bugdayci MS 24 , Yağcı MB 25 , Pullukcu H 16 , Kaya BY 18 , Tureyen A 18 , Hatemi İ 19 , Koc ES 15 , Sirin G 20 , Calıskan AR 21 , Bengi G 23 , Alıs EE 26 , Lukic S 27 , Trajkovska M 28 , Hod K 29 , Dumitrascu D 30 , Pietrangelo A 31 , Corradini E 31 , Simren M 32 , Sjolund J 32 , Tornkvist N 32 , Ghoshal UC 33 , Kolokolnikova O 34 , Colecchia A 35 , Serra J 36 , Maconi G 37 , De Giorgio R 38 , Danese S 39 , Portincasa P 40 , Di Stefano M 41 , Maggio M 42 , Philippou E 43 , Lee YY 44 , Venturi A 1 , Borghi C 1 , Zoli M 1 , Gionchetti P 1 , Viale P 1 , Stanghellini V 1 , Barbara G 1 , and the GI-COVID19 Study Group

Affiliations 

  • 1 IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
  • 2 Department of Medical and Surgical Sciences, University of Bologna, Italy
  • 3 Moscow Clinical Scientific Center, Moscow, Russia
  • 4 A. S. Loginov Moscow Clinical Scientific Center, Moscow, Russia
  • 5 Department of Gastroenterology, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
  • 6 Department of Infectious Diseases, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
  • 7 Gastroenterology Unit, Imola Hospital, Imola, Italy
  • 8 Gastroenterology and Hepatology Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt
  • 9 Department of Experimental and Clinical Sciences, University of Brescia, Spedali Civili di Brescia, Brescia, Italy
  • 10 Gastroenterology Unit, University of Pisa, Pisa, Italy
  • 11 Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh
  • 12 Hospital Universitari Parc Taulí, Sabadell - CIBEREHD Centro de Investigación Biomédica en Red, Spain
  • 13 Hospital General Vall d'Hebron, Barcelona, Spain
  • 14 Division of Gastroenterology, Ege University, Izmir, Turkey
  • 15 Division of Gastroenterology, Acibadem University, Altunizade Acibadem Hospital, Istanbul, Turkey
  • 16 Ege University Department of Infectious Diseases, Izmir, Turkey
  • 17 University of Health Sciences, Keciören Education and Research Hospital, Division of Gastroenterology, Keciören, Turkey
  • 18 Division of Gastroenterology, Eskisehir City Hospital, Eskisehir, Turkey
  • 19 Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Division of Gastroenterology, Turkey
  • 20 Division of Gastroenterology, Kocaeli University, Kocaeli, Turkey
  • 21 Division of Gastroenterology, Adiyaman Education and Research Hospital, Adiyaman, Turkey
  • 22 Division of Gastroenterology, University of Health Sciences, Diyabakır Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey
  • 23 Division of Gastroenterology, Dokuz Eylül University, Izmir, Turkey
  • 24 Division of Gastroenterology, İstanbul Aydın University Florya Liv Hospital, Istanbul, Turkey
  • 25 Division of Gastroenterology, Darıca Farabi Education and Research Hospital, Kocaeli, Turkey
  • 26 Department of Infectious Diseases, İstanbul Aydın University Florya Liv Hospital, Istanbul, Turkey
  • 27 University Clinical Centre of Serbia, Clinic for Gastroenterohepatology, Belgrade, Serbia
  • 28 Clinic of Gastroenterohepatology, Skopje, North Macedonia
  • 29 Assuta Medical Centers, Tel Aviv, Israel
  • 30 Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca Romania
  • 31 Internal Medicine Unit, Modena University Hospital, University of Modena and Reggio Emilia, Modena, Italy
  • 32 Sahlgrenska University Hospital, Gothenburg, Sweden
  • 33 Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
  • 34 Medsi Clinical Hospital, Russia
  • 35 Gastroenterology Unit, Verona University Hospital, Verona, Italy
  • 36 CIBERehd, University Hospital Germans Trias i Pujol, Barcelona, Spain
  • 37 Sacco Hospital, University of Milan, Milan, Italy
  • 38 University of Ferrara, Ferrara, Italy
  • 39 Humanitas Hospital, Milan, Italy
  • 40 Internal Medicine Unit, Bari University Hospital, Bari, Italy
  • 41 First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
  • 42 Geriatric Clinic Unit, Medical Geriatric Rehabilitative Department, University Hospital of Parma, Parma, Italy
  • 43 Department of Life and Health Sciences, Cyprus University of Nicosia, Cyprus
  • 44 School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
Am J Gastroenterol, 2022 Jan 01;117(1):147-157.
PMID: 34751672 DOI: 10.14309/ajg.0000000000001541

Abstract

INTRODUCTION: 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.

METHODS: 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.

RESULTS: 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.

DISCUSSION: 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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