Gastrointestinal involvement in COVID-19 patients: a retrospective study from a Greek COVID-19 referral hospital

Panagiotis Tsibouris; Konstantinos Ekmektzoglou; Alexandra Agorogianni; Chrysostomos Kalantzis; Antonia Theofanopoulou; Klearchos Toumbelis; Leonidas Petrogiannopoulos; Charalambos Poutakidis; Stavroula Goggaki; Ioannis Braimakis; Erasmia Vlachou; Abraham Pouliakis; Periklis Apostolopoulos

Authors Panagiotis Tsibouris, Konstantinos Ekmektzoglou, Alexandra Agorogianni, Chrysostomos Kalantzis, Antonia Theofanopoulou, Klearchos Toumbelis, Leonidas Petrogiannopoulos, Charalambos Poutakidis, Stavroula Goggaki, Ioannis Braimakis, Erasmia Vlachou, Abraham Pouliakis, Periklis Apostolopoulos.

Abstract

Background Much attention has been paid to the study and reporting of gastrointestinal (GI) symptoms in COVID-19 patients. Moreover, an increasing number of COVID-19 patients have been noted to experience hepatic and pancreatic injury. In this study, we retrospectively investigated symptoms and laboratory findings related to the GI system in a single center in Athens, Greece, and assessed the role of these parameters in relation to survival and disease severity.

Method We retrospectively studied 61 adult COVID-19 patients admitted to the Army Share Fund Hospital (NIMTS) in Athens, Greece, from April 6th to May 6th, 2020.

Results Sixty-one COVID-19 cases were assessed in the study period. Regarding both survival and disease severity, diarrhea was the most common finding. The multivariate analysis revealed that elevated serum aspartate aminotransferase levels and low serum albumin levels were associated with worse patient survival (odds ratio [OR] 1.029, 95% confidence interval [CI] 1.007-1.05, P=0.0088; and OR 0.219, 95%CI 0.066-0.723, P=0.0127, respectively). As far as disease severity is concerned, only a low serum albumin level (measured at hospital admission) was correlated with more severe disease (OR 0.025, 95%CI 0.004-0.161, P=0.0001).

Conclusions Outpatients with new-onset GI symptoms should be considered for COVID-19 testing in a high COVID-19 prevalence setting, as these symptoms are observed more and more in clinical settings. As prospective studies begin to emerge, clinicians will have more robust research data to diagnose COVID-19 patients earlier and identify patients in need of more intensive treatment.

Keywords COVID-19, SARS-CoV-2, gastrointestinal symptoms, Greece, retrospective

Ann Gastroenterol 2020; 33 (5): 465-472