Association of Gastrointestinal Symptoms with Severity of COVID-19 in a University Hospital of Bangladesh

Abstract

Background: The World has experienced a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since March 11, 2020. At least 216 countries, areas or territories had affected cases of more than seven hundred million confirmed cases of COVID-19, including more than six million deaths. Most patients with COVID-19 present with typical respiratory symptoms and signs. But the number of COVID-19 patients experiencing gastrointestinal symptoms i.e. anorexia, nausea, vomiting, diarrhea and dysgeusia are significant and cannot be overlooked. In some cases, digestive symptoms may occur in the absence of any respiratory symptoms. Method: This cross-sectional study was carried out in the COVID-19 outpatient and inpatient department of BSMMU involving at least 79consecutive patients who were RT-PCR positive for coronavirus 2 (SARS-CoV-2). Gastrointestinal symptoms including anorexia, nausea, vomiting, altered taste, diarrhea, hematemesis or melena recorded precisely by face to face interview. Patients were classified as severe and non-severe COVID-19 according to Interim Guidance, 27th May, 2020 on the Management of COVID-19 from WHO. For the convenience of analysis, patients were divided in to severe (severe & critical) & non-severe (mild & moderate) groups on the basis of presence of hypoxaemia (SPo2 < 90%) on the basis of WHO case definition. Presence of gastrointestinal symptoms and their associations with severity of COVID-19 were analyzed statistically. Result: Among 79 patients, 39 participants were in severe COVID group and 40 were in non-severe COVID group. Baseline characteristics were evenly distributed. Among GI symptoms anorexia (70.88%) and diarrhea (62.02%) were more prevalent and melena (2.53%) was least prevalent. Dysgeusia was present in 36.70% patients. There is no significant association between severities of diarrhea with severity of COVID-19. Three or more GI symptoms are present in both groups. Conclusion: Gastrointestinal symptoms were commonly found in COVID-19 patients. Anorexia and diarrhea were more prevalent in this study. But this study did not exhibit any association between GI symptoms and severity of disease. Larger multi-centered study is warranted to explore this association.