Gastrointestinal Symptoms And Outcomes In Hospitalized Covid 19 Patients During Second Wave In India In Esic Hospital Okhla Phase I New Delhi

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Introduction: COVID 19 is new pandemic disease .it mainly affects respiratory system but can affect many other system in human body. Gastrointestinal system has been found to be affected in many patients. Gastrointestinal (GI) symptoms were very common in patients with coronavirus disease 2019 (COVID-19). It is unclear if the presence of GI symptoms is associated with poor outcomes in COVID-19. We aim to assess GI symptoms and their outcome and severity in covid 19 patients. it could be used for prognostication in hospitalized patients with COVID-19. Methods: We retrospectively analyzed patients admitted to Esic hospital okhla phase 1 new delhi from April 18 2021 to 10th may 2021 . The patient’s case sheets were reviewed for the presence of GI symptoms like nausea, vomiting, dyspepsia, loose stool, abdominal discomfort, abdominal pain, passage of mucus or blood in stool etc at time of admission and during hospital stay. COVID-19 patients having Gastrointestinal symptoms (cases) were compared with COVID-19 patients who have no gastrointestinal symptoms (control). Results: A total of 185 patients suffering from covid 19 disease who were admitted in this hospital were included, of which 45 (20.6%) covid positive patients had minimum 1 or more then one of the GI symptoms (cases). These patients were compared with the 140 COVID-19 patients who don’t have GI symptoms (controls). The average age of cases was 57.6 years (SD 17.2) and that of control was 63.3 years (SD 14.6). No statistically significant difference was noted in comorbidities and laboratory findings. The primary outcome was mortality, which did not differ between cases and controls (42.5 vs 37.85%, p = 0.68). No statistically significant differences were noted in secondary outcomes, including the length of stay (LOS, 7.8 vs. 7.9 days, p = 0.87) and need for mechanical ventilation (29 vs. 26.9%, p = 0.82). Discussion: In our study, the presence of GI manifestations in COVID-19 at the time of admission and during stay in hospital was not associated with increased mortality, LOS, or mechanical ventilation. The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) was started as an epidemic in Wuhan, [Ramachandran/Gajendran/Perisetti/Goyal] China. It was later declared as a global pandemic with New York as the current epicenter [2]. The SARS-CoV-2 mainly spreads through direct exposure (droplets, person to person). However, it is also assumed to be transmitted by fomite transmission, airborne transmission, and feco-oral transmission [1]. The COVID-19 is predominantly a respiratory disease manifested by fever, fatigue, dry cough, anorexia, myalgia, and dyspnea [5]. However, gastrointestinal (GI) manifestations such as nausea, vomiting, diarrhea, and abdominal pain are increasingly being recognized as important manifestations of COVID-19 [4–8]. Other symptoms such as dysgeusia and anosmia are also gaining attention as important symptoms of COVID-19 [9, 10]. The spectrum of COVID-19 infection ranges from mild to critical. Most of the patients (81%) have mild disease, 14% of the patients have severe disease, and 5% of the patients have a critical disease [2, 7]. The factors associated with morbidity and mortality or (severe COVID-19 infection) include advanced age >65 years, chronic respiratory diseases, hypertension, diabetes mellitus (DM), malignancy, and cardiovascular disease or any immunocompromised state [12–14]. In a recent study published from the USA, about 12% of the patients required mechanical ventilation, and the mortality rate of patients on mechanical ventilation was 88% [15]. In a study by Pan et al. [11], the presence of GI symptoms was associated with higher liver enzymes, lower monocyte count, and longer prothrombin time. The overall pooled prevalence of GI symptoms in COVID-19 based on a systematic review