scholarly journals COVID-19 and gastrointestinal symptoms in Mexico, a systematic review: does location matter?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Antonio Pizuorno ◽  
Nora A. Fierro ◽  
Edgar D. Copado-Villagrana ◽  
María E. Herrera-Solís ◽  
Gholamreza Oskrochi ◽  
...  

Abstract Background Covid-19 in Mexico is on the rise in different parts of the country. We aimed to study the symptoms and comorbidities that associate with this pandemic in 3 different regions of Mexico. Methods We analyzed data from SARS-CoV-2 positive patients evaluated at healthcare centers and hospitals of Mexico (n = 1607) including Northwest Mexico (Sinaloa state), Southeast Mexico (Veracruz state) and West Mexico (Jalisco state) between March 1 and July 30, 2020. Mexico consists of a total population that exceeds 128 million. Demographics, comorbidities and clinical symptoms were collected. Statistical descriptive analysis and correlation analyses of symptoms, comorbidities and mortality were performed. Results A total of 1607 hospitalized patients positive for COVID-19 across all 3 regions of Mexico were included. The average age was 54.6 years and 60.4% were male. A mortality rate of 33.1% was observed. The most common comorbidities were hypertension (43.2%), obesity (30.3%) and diabetes (31.4%). Hypertension was more frequent in West (45%), followed by Northwest (37%) and Southeast Mexico (29%). Obesity was around 30% in Northwest and West whereas an 18% was reported in Southeast. Diabetes was most common in West (34%) followed by Northwest (22%) and Southeast (13%). This might be related to the highest mortality rate in Northwest (31%) and West (37%) when compared to Southeast. Most common symptoms in our overall cohort were fever (80.8%), cough (79.8%), headache (66%), dyspnea (71.1%), myalgia (53.8%), joints pain (50.8%) and odynophagia (34.8%). Diarrhea was the main gastrointestinal (GI) symptom (21.3%), followed by abdominal pain (18%), and nausea/ vomiting (4.5%). Diarrhea and abdominal pain were more common in West (23.1 and 21%), followed by Southeast (17.8, and 9.8%) and Northwest (11.4 and 3.1%). Conclusion Our study showed a high mortality rate likely related to high frequencies of comorbidities (hypertension, obesity and diabetes). Mortality was different across regions. These discrepancies might be related to the differences in the frequencies of comorbidities, and partially attributed to differences in socio-economic conditions and quality of care. Thus, our findings stress the need for improved strategies to get better outcomes in our population.

2018 ◽  
Vol 90 (8) ◽  
pp. 40-47 ◽  
Author(s):  
I V Maev ◽  
Yu A Kucheravy ◽  
V V Tsukanov ◽  
E Yu Eremnia ◽  
D N Andreev ◽  
...  

Aim: to assess the effectiveness of mebeverine 200 mg BID in patients with post-cholecystectomy gastrointestinal spasm not requiring surgical treatment. Materials and methods. 218 patients were included in 16 clinical centers in 14 cities in Russia. All patients had post-cholecystectomy gastrointestinal spasms, not requiring surgical treatment and received mebeverine (Duspatalin®) 200 mg BID. The observational assessment period lasted from the moment of their inclusion into the study up to 6 weeks post inlusion. The therapy results were evaluated using visual analog scales (GPA and 11-point numeric rating scale) by patient self-assessment of the dynamics of spasm/discomfort and other post-cholecystectomic gastrointestinal symptoms after 2 and 6 weeks of treatment. Gastrointestinal Quality of Life Index (GIQLI) was used to assess patient quality of life. Results and discussion. All 218 patients completed the 2-week mebeverine treatment course, 101 of them finished the 6-week course (“prolonged population”). Significant positive changes in the relief of abdominal pain and dyspepsia were noted as well as normalization of stool frequency and consistency. A more marked change in values was observed during prolonged (up to 6 weeks) therapy. Both 2-week and 6-week mebeverine courses led to a normalization of patient quality of life. After 6 week therapy, an effect of mebeverine on the quality of life 91% of patients was observed comparable to cholecystectomy itself, speficially related to the quality of life subscore ‘symptoms’. Conclusion. The results of our study demonstrate that mebeverine (Duspatalin®) therapy leads to an effective elimination of clinical symptoms associated with post-cholecystectomy GI-spasm disorders, like abdominal pain, symptoms of dyspepsia and stooldisorders. A more marked change in values was observed during prolonged (up to 6 weeks) therapy.


2014 ◽  
Vol 38 (12) ◽  
pp. 3075-3081 ◽  
Author(s):  
Viktor Wanjura ◽  
Patrik Lundström ◽  
Johanna Österberg ◽  
Ib Rasmussen ◽  
Britt-Marie Karlson ◽  
...  

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 301
Author(s):  
Fauzi Yusuf ◽  
Marhami Fahriani ◽  
Sukamto S. Mamada ◽  
Andri Frediansyah ◽  
Azzaki Abubakar ◽  
...  

Background: This study aimed to determine the cumulative prevalence of prolonged gastrointestinal (GI) symptoms, including nausea, vomiting, diarrhea, lack of appetite, abdominal pain, and dysgeusia, in survivors of both mild and severe COVID-19 worldwide and to discuss the potential pathogenesis.   Methods: Three databases (PubMed, Scopus, and Web of Science) were searched for relevant articles up to January 30, 2021. Data on study characteristics, clinical characteristics during follow-up, the number of patients with prolonged GI symptoms, and total number of COVID-19 survivors were retrieved according to PRISMA guidelines. The quality of eligible studies was assessed using the Newcastle-Ottawa scale. The pooled prevalence of specific prolonged GI symptoms was calculated and the association between COVID-19 severity and the occurrence of prolonged GI symptoms was assessed if appropriate.   Results: The global prevalence of prolonged nausea was 3.23% (95% CI: 0.54%–16.53%) among 527 COVID-19 survivors. Vomiting persisted in 93 of 2,238 COVID-19 survivors (3.19%, 95% CI: 1.62%–6.17%) and prolonged diarrhea was found in 34 of 1,073 survivors (4.12%, 95% CI: 1.07%–14.64%). A total of 156 patients among 2,238 COVID-19 survivors (4.41%, 95% CI: 1.91%–9.94%) complained of persistent decreased or loss of appetite. The cumulative prevalence of prolonged abdominal pain was 1.68% (95% CI: 0.84%–3.32%), whereas persistent dysgeusia was identified in 130 cases among 1,887 COVID-19 survivors (7.04%, 95% CI: 5.96%–8.30%). Data was insufficient to assess the relationship between COVID-19 severity and the occurrence of all prolonged GI symptoms.   Conclusion: Persistent GI symptoms among COVID-19 survivors after discharge or recovery raises a concern regarding the long-term impact of the COVID-19 infection on the quality of life of the survivors. Despite several potential explanations proposed, studies that aim to follow patients after recovery from COVID-19 and determine the pathogenesis of the prolonged symptoms of COVID-19 survivors are warranted.   PROSPERO registration: CRD42021239187.


2021 ◽  
Vol 11 ◽  
Author(s):  
Esther Colomier ◽  
Joost Algera ◽  
Chloé Melchior

Irritable bowel syndrome (IBS) is one of the most common disorders of the gut-brain axis, which affects approximately 4% of the global population. The Rome IV criteria define IBS as chronic or recurrent abdominal pain associated with altered bowel habits. Patients can be categorized in four subtypes: IBS with predominant constipation (IBS-C), predominant diarrhea (IBS-D), mixed bowel habits (IBS-M), and unclassified (IBS-U). IBS is associated with a lower quality of life, reduced work productivity, and high healthcare costs. When comparing subtypes, patients with IBS-D report lower disease related quality of life. Due to the scope of this review, we have solely focused on patients with IBS-D. Choosing the right pharmacological treatment in these patients remains challenging due to the heterogeneous patient population, patients’ expectation of the treatment outcome, unavailability of efficacious drugs, and the multifactorial and incompletely understood underlying pathophysiology. Currently, pharmacological treatment options target individual symptoms, such as abdominal pain, altered bowel habits, and bloating. In this review, we aimed to summarize the current and recent pharmacological treatment options in IBS-D, targeting the predominant gastrointestinal symptoms. Additionally, we proposed a pharmacological treatment algorithm which healthcare professionals could use when treating individual patients with IBS-D.


2020 ◽  
Vol 13 (5) ◽  
pp. 273-279
Author(s):  
Monica Kumar

The management of symptoms related to the gastrointestinal tract is an ongoing challenge in the care of patients with advanced malignancy. Clinical symptoms are often detrimental to a patient’s quality of life. The goal of palliative medicine includes care of the mind, body, and spirit. Symptom management and improving quality of life for patients and their families is paramount. As the population ages, this results in more complex health needs and the need for a multidisciplinary team approach. This article will outline a general and systematic approach to managing gastrointestinal symptoms in palliative care; it will emphasise the importance of holistic medicine in improving a patient’s quality of life.


2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Mohamad Shahrir Abdul Rahim ◽  
Ibrahim Lutfi bin Shuaib ◽  
Sazilah binti Ahmad Sarji

The incidence of gastroparesis in Malaysia is not well documented. Gastroparesis may present with various combinations of debilitating sign and symptoms that decrease quality of life and increases morbidity. It is diagnosed based on clinical symptoms and exclusion of the obstruction. There should be a high index of suspicion in patients who present with symptoms to avoid missing the diagnosis. There are various approaches to study the gastric motility. Here’s a case of a young adult woman with type 1 diabetes mellitus suffering severe gastrointestinal symptoms. In this case, radionuclide scintigraphy is used as one of the investigation to confirm the diagnosis of gastroparesis. Radionuclide scintigraphy remains a hallmark in the diagnosis of gastroparesis after excluding mechanical obstruction.


2021 ◽  
Vol 2 (1) ◽  
pp. 25-32
Author(s):  
V.O. Boyko

This review analyzes the clinical symptoms, differential diagnosis of COVID-19 and influenza to facilitate clinical diagnosis of both diseases. The development of the COVID-19 epidemic occurred with an exponential growth of the incidence due to the high contagiousness of the virus, asymptomatic carriage. The situation was aggravated by the contagiousness of the patient in the last 2–3 days of the incubation period (before clinical manifestations), which made it difficult to isolate patients and contacts in a timely. The spectrum of damage to the organs and systems is constantly expanding with a more detailed study of the clinical course of COVID-19. Sometimes, the manifestations of COVID-19 persist even during the period of convalescence, which cause a decrease in the performance and quality of life of patients. The article discusses neurological manifestations, gastrointestinal symptoms and features of pneumonia in COVID-19. The clinical features of influenza and the main differences in the clinical course from COVID-19 are also demonstrated.


2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Ji-Gan Wang ◽  
Zhi-Juan Zhong ◽  
Meng Li ◽  
Jun Fu ◽  
Yu-Heng Su ◽  
...  

Background. This study aimed to describe the clinical symptoms, laboratory findings, treatment, and outcomes of coronavirus disease 2019-related multisystem inflammatory syndrome in children to provide a reference for clinical practice. Methods. We employed a literature search of databases such as PubMed, Web of Science, EMBASE, and Johns Hopkins University for articles on COVID-19-related multisystem inflammatory syndrome in children published between April 1, 2020, and January 15, 2021. High-quality articles were selected for analysis on the basis of their quality standard scores. Using R3.6.3 software, meta-analyses of random- or fixed-effects models were used to determine the prevalence of comorbidities. Subgroup analysis was also performed to determine heterogeneity. Results. A total of 57 articles (2,290 pediatric patients) were included in the study. Clinical Manifestations. :ncidences of fever, gastrointestinal symptoms, respiratory symptoms, and musculoskeletal symptoms (myalgias or arthralgias) were 99.91% (95% CI: 99.67–100%), 82.72% (95% CI: 78.19–86.81%), 53.02% (45.28–60.68%), and 14.16% (95% CI: 8.4–21.12%), respectively. The incidences of rash, conjunctival injection, lymphadenopathy, dry cracked lips, neurologic symptoms (headache, altered mental status, or confusion), swollen hands and feet, typical Kawasaki disease, and atypical Kawasaki disease were 59.34% (95% CI: 54.73–63.87%), 55.23% (95% CI: 50.22–60.19%), 27.07% (95% CI: 19.87–34.93%), 46.37% (95% CI: 39.97–52.83%), 28.87% (95% CI: 22.76–35.40%), 28.75% (95% CI: 21.46–36.64%), 17.32% (95% CI: 15.44–19.29%), and 36.19% (95% CI: 21.90–51.86%), respectively. The incidences of coronary artery dilation, aneurysm, pericardial effusion, myocarditis, myocardial dysfunction, high troponin, and N-terminal pro-B-type natriuretic peptide were 17.83%, 6.85%, 20.97%, 35.97%, 56.32%, 76.34%, and 86.65%, respectively. The incidences of reduced lymphocytes, thrombocytopenia, hypoalbuminemia, elevated C-reactive protein, ferritin, LDH, interleukin-6, PCT, and FIB were 61.51%, 26.42%, 77.92%, 98.5%, 86.79%, 80.59%, 89.30%, 85.10%, and 87.01%, respectively. PICU Hospitalization Rate and Mortality. The incidences of PICU hospitalization or with shock were 72.79% and 55.68%, respectively. The mortality rate was 1.00%. Conclusion and Relevance. PICU hospitalization and shock rates of multisystem inflammatory syndrome in children associated with COVID-19 were high, and its cumulative multiorgans and inflammatory indicators are increased, but if treated in time, the mortality rate was low.


2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Ioanna Gouni-Berthold

Abstract Familial chylomicronemia syndrome (FCS) is a rare genetic disorder characterized by severely high triglycerides (TGs). It is associated with a marked increase in risk of recurrent, potentially fatal acute pancreatitis (AP), and symptoms including abdominal pain, fatigue, and anxiety that may substantially reduce quality of life (QoL). A 46-year-old woman with FCS and severely high TGs initially presented with necrotizing pancreatitis with pseudocysts, having previously experienced recurrent AP. The patient reported constant abdominal pain and fatigue, which were evident in her demeanor. Initial management included maximum doses of omega-3 fatty acids and fibrates, plus an extremely restricted diet (reduced intake: calories, fats, simple sugars; no alcohol). Despite adherence to all management strategies, TGs remained at approximately 2800 mg/dL (31.6 mmol/L) and symptoms persisted. The patient was enrolled in COMPASS, a phase 3, placebo-controlled trial to evaluate the effect of an investigational drug, volanesorsen, on fasting TGs in patients with hypertriglyceridemia (fasting TGs ≥ 500 mg/dL [≥5.7 mmol/L]). The woman, a confirmed FCS patient, continued into the open-label extension study, during which fasting TGs decreased to 146 mg/dL (1.7 mmol/L) following 4 months of treatment. The restrictive diet was maintained throughout treatment and no serious adverse events were reported. Along with sustained TG reduction, the patient experienced progressive, perceived improvements in observable QoL measures and a marked reduction in symptom severity and frequency. In a patient with FCS, reduction in TGs following volanesorsen therapy appeared to be associated with marked improvement in clinical symptoms and observed QoL.


Author(s):  
Shahnawaz Khatti ◽  
Riaz Ahmed Memon ◽  
Abdul Salam Memon ◽  
Fazila Hashmi ◽  
Sandesh Kumar ◽  
...  

Objective: To determine the frequency and presentation of colorectal carcinoma (CRC) among the patients presenting with lower gastrointestinal (GI) symptoms. Study Design: Observational study Place and Duration: Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad from January 2013 to February 2014. Methodology: A sample of 105 patients complaining of lower GI symptoms was selected. Data regarding the age, sex, presenting symptoms and signs, local examination and location of lesions were noted in a pre-structured proforma. Patients were examined by digital rectal examination (DRE), proctoscopy, colonoscopy; computerized tomography and biopsy. Data analyzed on SPSS 21.0 at 95% CI (P≤ 0.05). Results: Age of the patients was 53.17±14.90 years (95%CI: 51.28 to 55.05). Of 105 subjects; 65 (61.9%) were males and 40 (38.09%) were females. The CRC was observed in 11 (10.47%) patients of ≤ 40 years, 77 (73.3%) patients of 40 – 59.9 years and 17 (16.19%) cases were ≥60 years of age. Anemia 81 (77.14%), weight loss 74 (70.47%), abdominal pain 60 (57.14%), bleeding per rectum 79 (75.23%), tenesmus 55 (52.38%) and constipation 48 (45.71%) were common presenting symptoms of the CRC patients. Adenocarcinoma was found in 87 (82.85%), carcinoid tumor in 11 (10.47%), lymphoma in 5 (4.76%) and squamous cell carcinoma in 2 (1.9%). Conclusion: Colorectal adenocarcinoma was most common tumor found in males in their sixth decade of life. Anemia, weight loss, abdominal pain and bleeding per rectum were common clinical symptoms and rectum was common tumor site.


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