Prevalence and prognostic value of gastroenterological manifestations of COVID-19: data from the Russian University Clinic

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Abstract

Aim. Assessment of the prevalence and prognostic value of gastroenterological manifestations in patients with COVID-19.

Materials and methods. A single-center retrospective cohort study was carried out. Only cases with laboratory confirmed detection of SARS-CoV-2 virus RNA using polymerase chain reaction in oro-/nasopharyngeal smear samples were subject to analysis. Patients with documented (according to anamnestic data and/or according to examination data during hospitalization) organic pathology of the gastrointestinal tract (GIT) and/or hepatobiliary system, malignant neoplasms of any localization, as well as pregnant patients were excluded from the general register of retrospective data. The final cohort was divided into two groups depending on the presence of gastrointestinal symptoms: COVID-19 with gastrointestinal symptoms (cases) and COVID-19 without gastrointestinal symptoms (control).

Results. The final sample consisted of 3764 patients, including 2108 (56%) women and 1656 (44%) men. The average age of the subjects included in the analysis was 58.0 years (95% confidence interval – CI 48.6–63.0). In the study cohort, gastroenterological manifestations (alone or in combination) were recorded in 885 (23.51%) patients. Calculation of the odds ratio (OR) of unfavorable and lethal outcomes between the analyzed groups showed that the presence of gastroenterological symptoms significantly increases the chances of lethal outcome in a cohort of elderly and senile patients (OR 1.6817, 95% CI 1.0335–2.7364; p=0.0364), determines a higher risk of hospitalization or transfer to the intensive care unit (OR 1.2959, 95% CI 1.0547–1.5922; p=0.0136), development of acute respiratory distress syndrome (OR 1.5952, 95% CI 1.3164–1.9329; p<0.0001), as well as the need for mechanical ventilation (OR 1.2849, 95% CI 1.077–1.5329; p=0.0054).

Conclusion. The present study has demonstrated that gastroenterological symptoms are detected in about one in four patients infected with the SARS-CoV-2 virus and multiply the risk of adverse and life-threatening complications of COVID-19.

About the authors

Oleg O. Ianushevich

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-4293-8465

академик РАН, доктор медицинских наук, профессор, ректор, заведующий кафедрой пародонтологии

Russian Federation, Moscow

Igor V. Maev

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0001-6114-564X

академик РАН, доктор медицинских наук, профессор, заведующий кафедрой пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

Natella I. Krikheli

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru

доктор медицинских наук, профессор, заведующий кафедрой клинической стоматологии

Russian Federation, Moscow

Oleg V. Levchenko

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0003-0857-9398

доктор медицинских наук, профессор кафедры нейрохирургии и нейрореанимации

Russian Federation, Moscow

Irina V. Rogova

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0001-5868-8870

начальник управления науки, завед.  лабораторией микробиологического анализа Клинического центра COVID-19

Russian Federation, Moscow

Andrei V. Zaborovskii

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-7923-9916

доктор медицинских наук, доцент, заведующий кафедрой фармакологии

Russian Federation, Moscow

Dmitrii N. Andreev

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-4007-7112

кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

Anastasiia L. Kebina

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-7570-9650

ассистент кафедры терапии, клинической фармакологии и скорой медицинской помощи

Russian Federation, Moscow

Dmitrii S. Bordin

Yevdokimov Moscow State University of Medicine and Dentistry; Tver State Medical University

Email: dna-mit8@mail.ru
ORCID iD: 0000-0003-2815-3992

доктор медицинских наук, профессор каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова», зав. отд. патологии поджелудочной железы, желчных путей и верхних отделов пищеварительного тракта ГБУЗ «МКНЦ им. А.С. Логинова», профессор кафедры поликлинической терапии и семейной медицины ФГБОУ ВО ТГМУ

Russian Federation, Moscow;Tver

Igor G. Bakulin

Mechnikov North-Western State Medical University

Email: dna-mit8@mail.ru

доктор медицинских наук, профессор, заведующий кафедрой пропедевтики внутренних болезней, гастроэнтерологии и диетологии

Russian Federation, Saint Petersburg

Natalia V. Bakulina

Mechnikov North-Western State Medical University

Email: dna-mit8@mail.ru
ORCID iD: 0000-0003-4075-4096

доктор медицинских наук, профессор каф. терапии и клинической фармакологии

Russian Federation, Saint Petersburg

Nikolai G. Andreev

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-5136-0140

кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

Pavel O. Asadulin

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0001-5236-1770

врач-специалист отд-ния микробиологического анализа Клинического центра COVID-19

Russian Federation, Moscow

Armine S. Bagdasarian

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-0528-2903

врач-специалист Клинического центра COVID-19

Russian Federation, Moscow

Mikhail K. Devkota

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-3736-4196

врач-специалист отделения микробиологического анализа Клинического центра COVID-19, преподаватель кафедры фармакологии 

Russian Federation, Moscow

Natalia R. Evarnitskaia

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0001-6250-1714

врач-специалист отд-ния мик­робиологического анализа Клинического центра COVID-19, ст. лаборант кафедры пародонтологии

Russian Federation, Moscow

Olga V. Krikunova

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0001-6836-1425

врач-специалист отд-ния микробиологического анализа Клинического центра COVID-19, зав. учебной частью каф. клинической функциональной диагностики МГМСУ

Russian Federation, Moscow

Sergei A. Kucher

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0001-7981-1786

врач-специалист отделения микробиологического анализа Клинического центра COVID-19

Russian Federation, Moscow

Filip S. Sokolov

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0003-2813-6498

врач-специалист отделения микробиологического анализа Клинического центра COVID-19, старший лаборант кафедры ЮНЕСКО «Здоровый образ жизни – залог успешного развития»

Russian Federation, Moscow

Aleksei K. Fomenko

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0002-1794-7263

врач-специалист отделения микробиологического анализа Клинического центра COVID-19, преподаватель кафедры фармакологии МГМСУ

Russian Federation, Moscow

Vadim A. Khar'kovskii

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
ORCID iD: 0000-0001-8659-3502

врач-специалист отделения микробиологического анализа Клинического центра COVID-19

Russian Federation, Moscow

Irina A. Sharina

Yevdokimov Moscow State University of Medicine and Dentistry

Author for correspondence.
Email: dna-mit8@mail.ru
ORCID iD: 0000-0003-0347-0123

врач-специалист Клинического центра COVID-19

Russian Federation

References

  1. Маев И.В., Шпектор А.В., Васильева Е.Ю., и др. Новая коронавирусная инфекция COVID-19: экстрапульмональные проявления. Терапевтический архив. 2020;92(8):4-11 [Maev IV, Shpektor AV, Vasilyeva EYu, et al. Novel coronavirus infection COVID-19: extrapulmonary manifestations. Terapevticheskii Arkhiv (Ter. Arkh.). 2020;92(8):4-11 (in Russian)]. doi: 10.26442/00403660.2020.08.000767
  2. Zhu N, Zhang D, Wang W, et al. China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33. doi: 10.1056/NEJMoa2001017
  3. Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: An overview. J Chin Med Assoc. 2020;83(3):217-20. doi: 10.1097/JCMA.0000000000000270
  4. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433. doi: 10.1016/j.jaut.2020.102433
  5. Roser M, Ritchie H, Ortiz-Ospina E, Hasell J. Coronavirus Pandemic (COVID-19). Published online at OurWorldInData.org. Available at: https://ourworldindata.org/coronavirus. Accessed: 24.05.2021.
  6. Zheng Z, Peng F, Xu B, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect. 2020;81(2):e16-e25. doi: 10.1016/j.jinf.2020.04.021
  7. Wong SH, Lui RN, Sung JJ. Covid-19 and the digestive system. J Gastroenterol Hepatol. 2020;35(5):744-8. doi: 10.1111/jgh.15047
  8. Yan R, Zhang Y, Li Y, et al. Structural basis for the recognition of SARS-CoV-2 by full-length human ACE2. Science. 2020;367(6485):1444-8. doi: 10.1126/science.abb2762
  9. Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell. 2020;181(2):271-80.e8. doi: 10.1016/j.cell.2020.02.052
  10. Malik YA. Properties of Coronavirus and SARS-CoV-2. Malays J Pathol. 2020;42(1):3‐11
  11. Taka E, Yilmaz SZ, Golcuk M, et al. Critical Interactions Between the SARS-CoV-2 Spike Glycoprotein and the Human ACE2 Receptor. J Phys Chem B. 2021. doi: 10.1021/acs.jpcb.1c02048
  12. Sun P, Lu X, Xu C, et al. Understanding of COVID-19 based on current evidence. J Med Virol. 2020;92(6):548-51. doi: 10.1002/jmv.25722
  13. Carcaterra M, Caruso C. Alveolar epithelial cell type II as main target of SARS-CoV-2 virus and COVID-19 development via NF-Kb pathway deregulation: A physio-pathological theory. Med Hypotheses. 2021;146:110412. doi: 10.1016/j.mehy.2020.110412
  14. Lee IC, Huo TI, Huang YH. Gastrointestinal and Liver Manifestations in Patients with COVID-19. J Chin Med Assoc. 2020. doi: 10.1097/JCMA.0000000000000319
  15. Su S, Shen J, Zhu L, et al. Involvement of digestive system in COVID-19: manifestations, pathology, management and challenges. Therap Adv Gastroenterol. 2020;13:1756284820934626. doi: 10.1177/1756284820934626
  16. Tian Y, Rong L, Nian W, He Y. Review article: gastrointestinal features in COVID-19 and the possibility of faecal transmission. Aliment Pharmacol Ther. 2020;51(9):843-51. doi: 10.1111/apt.15731
  17. Xiao F, Tang M, Zheng X, et al. Evidence for Gastrointestinal Infection of SARS-CoV-2. Gastroenterology. 2020;158(6):1831-3.e3. doi: 10.1053/j.gastro.2020.02.055
  18. Mandal A, Konala VM, Adapa S, et al. Gastrointestinal Manifestations in COVID-19 Infection and Its Practical Applications. Cureus. 2020;12(6):e8750. doi: 10.7759/cureus.8750
  19. Mao R, Qiu Y, He JS, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020. doi: 10.1016/S2468-1253(20)30126-6
  20. Elshazli RM, Kline A, Elgaml A, et al. Gastroenterology manifestations and COVID-19 outcomes: A meta-analysis of 25,252 cohorts among the first and second waves. J Med Virol. 2021;93(5):2740-68. doi: 10.1002/jmv.26836
  21. Cruz VMA, Santos E, Cervantes MA, Juárez LM. COVID-19, a worldwide public health emergency. Rev Clin Esp (Barc). 2021;221(1):55-61. doi: 10.1016/j.rceng.2020.03.001
  22. Parasher A. COVID-19: Current understanding of its Pathophysiology, Clinical presentation and Treatment. Postgrad Med J. 2021;97(1147):312-20. doi: 10.1136/postgradmedj-2020-138577
  23. Бордин Д.С., Кирюкова М.А., Шенгелия М.И., Колбасников С.В. Инфекция COVID-19 и органы пищеварения. Эффективная фармакотерапия. 2020;16(15):12-6 [Bordin DS, Kiryukova MA, Shengelia MI, Kolbasnikov SV. COVID-19 infection and digestive organs. Effective pharmacotherapy. 2020;16(15):12-6 (in Russian)]. doi: 10.33978/2307-3586-2020-16-15-12-16
  24. Шенгелия М.И., Иванова В.А., Вечорко В.И., и др. Гастроэнтерологические проявления у пациентов с инфекцией COVID-19. Эффективная фармакотерапия. 2020;16(30):44-9 [Shengelia MI, Ivanova VA, Vechorko VI, et al. Gastroenterological manifestations in patients with COVID-19 infection. Effective pharmacotherapy. 2020;16(30):44-9 (in Russian)]. doi: 10.33978/2307-3586-2020-16-30-44-49
  25. Jin X, Lian JS, Hu JH, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. 2020;69(6):1002-9. doi: 10.1136/gutjnl-2020-320926
  26. Pan L, Mu M, Yang P, et al. Clinical Characteristics of COVID-19 Patients With Digestive Symptoms in Hubei, China: A Descriptive, Cross-Sectional, Multicenter Study. Am J Gastroenterol. 2020;115(5):766-73. doi: 10.14309/ajg.0000000000000620
  27. Zhang JJ, Dong X, Cao YY, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020. doi: 10.1111/all.14238
  28. Redd WD, Zhou JC, Hathorn KE, et al. Prevalence and Characteristics of Gastrointestinal Symptoms in Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in the United States: A Multicenter Cohort Study. Gastroenterology. 2020;159(2):765-7.e2. doi: 10.1053/j.gastro.2020.04.045
  29. Ramachandran P, Onukogu I, Ghanta S, et al. Gastrointestinal Symptoms and Outcomes in Hospitalized Coronavirus Disease 2019 Patients. Dig Dis. 2020;38(5):373-9. doi: 10.1159/000509774
  30. Oshima T, Siah KTH, Yoshimoto T, et al. Impacts of the COVID2019 pandemic on functional dyspepsia and irritable bowel syndrome: A population-based survey. J Gastroenterol Hepatol. 2020:10.1111/jgh.15346. doi: 10.1111/jgh.15346
  31. Bishehsari F, Adnan D, Deshmukh A, et al. Gastrointestinal Symptoms Predict the Outcomes From COVID-19 Infection. J Clin Gastroenterol. 2021. doi: 10.1097/MCG.0000000000001513
  32. Adnan D, Deshmukh A, Khan SR, et al. Gastrointestinal Symptoms Predict the Outcomes of COVID-19 Infection. Am J Gastroenterol. 2020;115:S685-S686. doi: 10.14309/01.ajg.0000707480.23480.66
  33. Zawada AE, Moszak M, Skrzypczak D, Grzymisławski M. Gastrointestinal complications in patients with diabetes mellitus. Adv Clin Exp Med. 2018;27(4):567-72. doi: 10.17219/acem/67961
  34. Kurniawan AH, Suwandi BH, Kholili U. Diabetic Gastroenteropathy: A Complication of Diabetes Mellitus. Acta Med Indones. 2019;51(3):263-71.
  35. Chen R, Yu YL, Li W, et al. Gastrointestinal Symptoms Associated With Unfavorable Prognosis of COVID-19 Patients: A Retrospective Study. Front Med (Lausanne). 2020;7:608259. doi: 10.3389/fmed.2020.608259
  36. Li X, Zhong X, Wang Y, et al. Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis. PLoS One. 2021;16(5):e0250602. doi: 10.1371/journal.pone.0250602
  37. Du P, Li D, Wang A, et al. A Systematic Review and Meta-Analysis of Risk Factors Associated with Severity and Death in COVID-19 Patients. Can J Infect Dis Med Microbiol. 2021;2021:6660930. doi: 10.1155/2021/6660930.

Supplementary files

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2. Fig. 1. Total number of persons infected with SARS-CoV-2 worldwide (data from Johns Hopkins University, May 24, 2021) [5].

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3. Fig. 2. Frequency of comorbid conditions among the total pool of hospitalized patients with COVID-19.

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4. Fig. 3. Distribution of patients according to the degree of lung damage according to computed tomography data among the total pool of hospitalized patients with COVID-19.

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5. Fig. 4. Frequency of major drug classes among the total pool of hospitalized patients with COVID-19.

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6. Fig. 5. Diagram of the formation of the final cohort of patients.

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7. Fig. 6. Prevalence of gastroenterological manifestations in patients with COVID-19.

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8. Fig. 7. Average duration of hospitalization in the study groups.

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9. Fig. 8. Risk of adverse and fatal outcomes in patients with COVID-19 gastroenterological manifestations.

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