scholarly journals Global prevalence of prolonged gastrointestinal symptoms in COVID-19 survivors and potential pathogenesis: A systematic review and meta-analysis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 301
Author(s):  
Fauzi Yusuf ◽  
Marhami Fahriani ◽  
Sukamto S. Mamada ◽  
Andri Frediansyah ◽  
Azzaki Abubakar ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Meta Analysis ◽  
Gastrointestinal Symptoms ◽  
Global Prevalence ◽  
Number Of Patients ◽  
Gi Symptoms ◽  
Study Characteristics ◽  
Loss Of Appetite ◽  
Cumulative Prevalence

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.

COVID-19 aus der Sicht der Gastroenterologie

2020 ◽  
Vol 145 (15) ◽  
pp. 1033-1038
Author(s):  
Christian Schulz ◽  
Julia Mayerle ◽  
Hans Christian Stubbe ◽  
Simon Sirtl ◽  
Markus M. Lerch ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Respiratory Symptoms ◽  
Gastrointestinal Symptoms ◽  
Clinical Routine ◽  
Fecal Samples ◽  
Oral Transmission ◽  
Number Of Patients ◽  
New Variant ◽  
Therapeutic Procedures ◽  
Loss Of Appetite

AbstractCOVID 19, caused by SARS-CoV2, a new variant of coronaviruses, typically presents with respiratory symptoms. However, in a significat number of patients different organs are involved in the disease, often including gastrointestinal symptoms. These could include loss of appetite, vomiting, abdominal pain and diarrhea, with diarrhea being associated with a more severe course of COVID-19. Because viral RNA can be detected in fecal samples, some implications for clinical routine in diagnostic and therapeutic procedures are grown. Until yet, no clear evidence is given regarding fecal-oral transmission of SARS-CoV2.

scholarly journals The effect of acupuncture on chemotherapy-associated gastrointestinal symptoms in gastric cancer

2017 ◽  
Vol 24 (1) ◽  
pp. 1 ◽  
Author(s):  
J. Zhou ◽  
L. Fang ◽  
W.Y Wu ◽  
F. He ◽  
X.L. Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Abdominal Pain ◽  
Gastrointestinal Symptoms ◽  
Control Group ◽  
Gi Symptoms ◽  
Safe Technique ◽  
And Control ◽  
Experimental Group

Background Gastrointestinal (gi) symptoms are the most notable side effects of chemotherapeutic drugs; such symptoms are currently treated with drugs. In the present study, we investigated the effect of acupuncture on gi symptoms induced by chemotherapy in patients with advanced gastric cancer.Methods A cohort of 56 patients was randomly divided into an experimental group and a control group. All patients received combination chemotherapy with oxaliplatin–paclitaxel. Patients in the experimental group received 30 minutes of acupuncture therapy daily for 2 weeks. The frequency and duration of nausea, vomiting, abdominal pain, and diarrhea, the average days and costs of hospitalization, and quality-of-life scores were compared between the groups.Results Nausea was sustained for 32 ± 5 minutes and 11 ± 3 minutes daily in the control and experimental groups respectively (p < 0.05). On average, vomiting occurred 2 ± 1 times daily in the experimental group and 4 ± 1 times daily in the control group (p < 0.05). Abdominal pain persisted for 7 ± 2 minutes and 16 ± 5 minutes daily in the experimental and control groups respectively (p < 0.05). On average, diarrhea occurred 1 ± 1 times daily in the experimental group and 3 ± 1 times daily in the control group (p < 0.05). The average quality-of-life score was higher in the experimental group than in the control group (p < 0.05). No adverse events were observed for the patients receiving acupuncture.Conclusions Acupuncture, a safe technique, could significantly reduce gi symptoms induced by chemotherapy and enhance quality of life in patients with advanced gastric cancer. 

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 ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Mortality Rate ◽  
Clinical Symptoms ◽  
Descriptive Analysis ◽  
Gastrointestinal Symptoms ◽  
Northwest Mexico ◽  
Obesity And Diabetes ◽  
West Mexico ◽  
Southeast Mexico

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.

scholarly journals Fuke Qianjin Combined with Antibiotic Therapy for Pelvic Inflammatory Disease: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Yu Chen ◽  
Shaobin Wei ◽  
Li Huang ◽  
Mei Luo ◽  
Yang Wu ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Meta Analysis ◽  
Lower Abdominal Pain ◽  
Effective Rate ◽  
Chinese Patent ◽  
Meta Analyses

Background. Pelvic inflammatory disease (PID) without timely and proper treatment can cause long-term sequelae; meanwhile, patients will be confronted with the antimicrobial resistance and side effects. Chinese patent medicine as a supplement is used to treat PID with satisfactory clinical efficacy. This study evaluated the efficacy and safety of Fuke Qianjin (FKQJ) combined with antibiotics in the treatment of PID. Methods. Eight electronic databases and other resources were searched to make a collection of the randomized controlled trials (RCTs) from 1990 to 2019. The RCTs contrasting the effect of FKQJ combined with antibiotics regimens and antibiotics alone in reproductive women with PID were included. The antibiotics regimens are all recommended by the guidelines. Two reviewers independently screened the studies, extracted the data, and assessed the methodological quality of the included studies. Then, the meta-analyses were performed by RevMan 5. 3 software if appropriate. Results. Twenty-three RCTs (2527 women) were included in this review. The evidence showed that FKQJ combined with antibiotics improved the markedly effective rate compared to antibiotics alone group (RR = 1.38, 95% CI 1.27 to 1.49, I2 = 42%), shortened the improvement time of low abdominal pain (MD = −1.11, 95% CI −1.39 to −0.84, I2 = 38%), and increased the rate of lower abdominal pain improvement (RR = 1.35, 95% CI 1.19 to 1.55, I2 = 0). The implementation of adjuvant reduced the recurrent rate compared with antibiotics alone (RR = 0.27, 95% CI 0.13 to 0.56, I2 = 0%). Conclusions. Based on available evidence, FKQJ combined with antibiotics therapy have certain outcomes on increasing the markedly effective rate, decreasing the recurrent rate compared with antibiotics alone group. This therapy appears to improve lower abdominal pain and curtail the relief time. Due to the low quality and the risk of bias, any high-quality evidence or longer follow-up period should be advisable and necessary in the future.

619 HIGH DISCOVERY RATE OF GASTRODUODENAL EOSINOPHILIA BUT NOT EOSINOPHILIC ESOPHAGITIS IN PATIENTS WITH CHRONIC GASTROINTESTINAL SYMPTOMS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Nicholas Talley ◽  
Amol Kamboj ◽  
William Chey ◽  
Henrik Rasmussen ◽  
Brian Lacy ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Gastrointestinal Symptoms ◽  
High Rate ◽  
Systematic Evaluation ◽  
Tissue Eosinophilia ◽  
Severity Scores ◽  
Gi Symptoms ◽  
Multi Center Study ◽  
Loss Of Appetite ◽  
Duodenal Biopsies

Abstract   Although the prevalence of eosinophilic gastrointestinal disorders (EGIDs) is increasing, there is evidence that eosinophilic gastritis and/or duodenitis (EG/EoD) are underdiagnosed. Patients with EG/EoD often present with chronic, non-specific gastrointestinal (GI) symptoms, similar to patients with functional GI disorders. We hypothesized that systematic evaluation, including multiple esophageal, gastric and duodenal biopsies, of patients with chronic GI symptoms might reveal a high rate of gastroduodenal eosinophila, with or without eosinophilic esophagitis (EoE). Methods We performed a prospective multi-center study of patients with non-specific GI symptoms for ≥6 months, from 20 sites. Patients completed a questionnaire assessing abdominal pain, abdominal cramping, early satiety, bloating, nausea, vomiting, diarrhea, and loss of appetite. Those with daily average symptom severity scores ≥3/10 for any single symptom underwent esophagogastroduodenoscopy (EGD) with collection of 4 esophageal (EoE), 8 gastric, and 4 duodenal biopsies, analyzed by central pathologists. Histologic criteria for EoE was ≥15eos/hpf in ≥1 esophageal site and for EG/EoD was peak eosinophil counts ≥30/hpf in ≥5 gastric hpfs and/or 3 duodenal hpfs—criteria used in randomized trials. Results Of 556 patients screened, 405 (73%) met symptom criteria and underwent EGD; 181 patients (45%, mean age 45, 73% female) who underwent EGD met the histologic criteria for EG/EoD, and of these, 7% also had EoE diagnosed. Overall 2% met histologic criteria for EoE alone. Of patients who met the histologic criteria for EG/EoD, 93% were previously diagnosed with gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), or functional dyspepsia (FD) (Figure 1). The average duration of GI symptoms in the screened population as well as those that met histologic criteria for EG/EoD was 11 years. Conclusion Forty-five percent of patients with moderate-to-severe GI symptoms who underwent EGD met histologic criteria for EG/EoD. Over 90% of these patients had previously been diagnosed with GERD, IBS, and/or FD, and had minimal overlap with EoE. EGD with systematic gastroduodenal biopsies, and intentional evaluation for tissue eosinophilia, should be performed in patients with chronic GI symptoms. Accurate diagnosis of EG/EoD is required for appropriate, targeted treatment and improved outcomes of patients with moderate-to-severe GI symptoms.

scholarly journals Effectiveness of mebeverine in patients with post-cholecystectomy gastrointestinal spasm: results of prospective observational program “odyssey”

2018 ◽  
Vol 90 (8) ◽  
pp. 40-47 ◽  
Author(s):  
I V Maev ◽  
Yu A Kucheravy ◽  
V V Tsukanov ◽  
E Yu Eremnia ◽  
D N Andreev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Abdominal Pain ◽  
Surgical Treatment ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Marked Change ◽  
Numeric Rating Scale ◽  
Observational Assessment

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.

scholarly journals Analysis of Gastrointestinal Symptoms in 281 Cases of Hospitalized Covid 19 Patients, Single-Center Study

2021 ◽  
Author(s):  
Gözde Derviş Hakim ◽  
Şükran Köse ◽  
Pınar Şamlıoğlu ◽  
Cengiz Ceylan ◽  
Mehmet Can Uğur ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Respiratory Symptoms ◽  
Clinical Presentation ◽  
Gastrointestinal Symptoms ◽  
Clinical Analysis ◽  
Clinical Findings ◽  
Gastrointestinal System ◽  
Detailed Review ◽  
Single Center Study ◽  
Gi Symptoms

Objective: Although Covid-19 which has been identified as the disease caused by SARS COV-2 virus mainly affects the respiratory tract, it was observed that many systems were affected. The gastrointestinal system is one of the main systems involved. The aim of this manuscript was to perform epidemiological, virological, and clinical analysis of 59 Covid 19-positive patients with gastrointestinal symptoms. Method: Covid-19 diagnosed patients have been started to be admitted since March, 20, 2020. Epidemiological, demographical, clinical findings, laboratory analyses as well as hospitalization periods and disease progression of the patients presenting gastrointestinal system (GIS) symptoms admitted between March, 31, 2020 and August, 1, 2020. Results: Totally 710 Covid 19-positive patients hospitalized were screened. Among these patients, those with incomplete medical history and deficient data were excluded. The analysis of 281 patients admitted due to Covid-19 diagnosis with complete data since admission revealed that 59 patients presented GIS symptoms at admission. The aforesaid patients were compared with 222 patients admitted due to Covid-19 without GIS symptoms within the same period. GIS symptoms were detected on 59 (59/281) (20.99%) patients admitted due to Covid-19. Detailed review of these patients revealed that 18 (18/59) (30.50%) patients had nausea-vomiting, 10 (10/59) (16.95%) patients had abdominal pain, and 31 (31/59) (52.55%) patients had GIS bleeding. It was observed that vomiting was added into the clinical presentation in 7 of 18 patients. Although there is not any diarrhea symptom alone, total number of cases with diarrhea+abdominal pain, diarrhea+nausea-vomiting, diarrhea+nausea-vomiting+abdominal pain was 17 (17/59) (28.81%) of 59 patients. Conclusion: According to the results of this study, we have found 20.99% gi symptoms in the hospitalizated patients due to Covid 19. Although GIS symptoms are not associated with disease severity, they are important for the identification and spread of the disease, along with respiratory symptoms.

Should Levetiracetam or Phenytoin Be Used for Posttraumatic Seizure Prophylaxis? A Systematic Review of the Literature and Meta-analysis

Neurosurgery ◽  
2016 ◽  
Vol 79 (6) ◽  
pp. 775-782 ◽  
Author(s):  
Nickalus R. Khan ◽  
Matthew A. VanLandingham ◽  
Tamara M. Fierst ◽  
Caroline Hymel ◽  
Kathryn Hoes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antiepileptic Drug ◽  
Random Effects ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Seizure Prophylaxis ◽  
Number Of Patients ◽  
Severe Tbi ◽  
Antiepileptic Drug Therapy

Abstract BACKGROUND: Posttraumatic seizure (PTS) is a significant complication of traumatic brain injury (TBI). OBJECTIVE: To perform a systematic review and meta-analysis to compare levetiracetam with phenytoin for seizure prophylaxis in patients diagnosed with severe TBI. METHODS: An inclusive search of several electronic databases and bibliographies was conducted to identify scientific studies that compared the effect of levetiracetam and phenytoin on PTS. Independent reviewers obtained data and classified the quality of each article that met inclusion criteria. A random effects meta-analysis was then completed. RESULTS: During June and July 2015, a systematic literature search was performed that identified 6097 articles. Of these, 7 met inclusion criteria. A random-effects meta-analysis was performed. A total of 1186 patients were included. The rate of seizure was 35 of 654 (5.4%) in the levetiracetam cohort and 18 of 532 (3.4%) in the phenytoin cohort. Our meta-analysis revealed no change in the rate of early PTS with levetiracetam compared with phenytoin (relative risk, 1.02; 95% confidence interval, 0.53-1.95; P = .96). CONCLUSION: The lack of evidence on which antiepileptic drug to use in PTS is surprising given the number of patients prescribed an antiepileptic drug therapy for TBI. On the basis of currently available Level III evidence, patients treated with either levetiracetam or phenytoin have similar incidences of early seizures after TBI.

Foodborne Outbreak investigation: Al-Ahsa, Saudi Arabia, 2021. A retrospective cohort study (Preprint)

2022 ◽  
Author(s):  
Abdulmohsen Alahmad ◽  
Shady Abdulrahman Kamel
Keyword(s):  
Abdominal Pain ◽  
Incubation Period ◽  
Retrospective Cohort ◽  
Gastrointestinal Symptoms ◽  
Control Measures ◽  
P Value ◽  
Food History ◽  
Food Items ◽  
Number Of Patients ◽  
Laboratory Results

BACKGROUND On 10 September 2021, Al-Ahsa General Health Directorate reported unexpected number of patients had presented with gastrointestinal symptoms. All the patients gave a history of sharing a common meal as they ate from dinner was served at the mother's house the day before. OBJECTIVE We investigated to verify the outbreak, determine its magnitude, identify the source and implement control measures. METHODS A retrospective cohort design was conducted. Cases were defined as any person who ate dinner at the family gathering on the 9th of September 2021 and developed any or a combination of the following symptoms: diarrhea, vomiting, fever, or abdominal pain within 26 hours of food consumption. We collected information on demographics, symptoms, and food history using a semi-structured questionnaire. We reviewed hospital records for symptoms and Vital sings. We reviewed available laboratory results for cases, we conducted active case search to identify more cases. statistical analyses were performed using SPSS 21.0. RESULTS Twenty subjects were defined as cases (74%) and seven as non-cases (26%). among cases, 16 were females (80%), and 4 were males (20%). The ages ranged between 2–70 years. Among cases (59.3%) had vomiting, (59.3%) had a fever, (48.1%) developed diarrhea, (25%) abdominal pain. The incubation period ranged from 10-26 hours (mean 17.8). The relative risks and p- value were calculated for food items to assess the association between consumption of individual food items and subsequent illness. Among 8 food items consumed, red pasta with chicken (Relative Risk RR= 3.14, 95% CI = 3.2-424.6) and pizza (RR= 1.73, 95% CI = 1.74-42.2) were significantly associated with illness. CONCLUSIONS According to the epidemiological investigation, symptoms, incubation period, and laboratory results there might be some differential diagnosis, but we were unable to more definitively identify the source of the outbreak. We recommend more education to the households about food safety

Gastrointestinal symptoms of pelvic radiation disease (part 1): literature review

2020 ◽  
Vol 18 (2) ◽  
pp. 40-45 ◽  
Author(s):  
Helen Ludlow ◽  
John Green
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Literature Review ◽  
Patient Experience ◽  
Gastrointestinal Symptoms ◽  
Pelvic Radiation ◽  
Gi Symptoms ◽  
Pelvic Cancer ◽  
The Impact

Radiotherapy used to treat cancers in the pelvic region can have lasting side effects, and the persistence of these symptoms for 3 months or more is described as pelvic radiation disease (PRD). The growing number of pelvic cancer patients being diagnosed and successfully treated is increasing the incidence of PRD. This review examines the literature on the gastrointestinal symptoms of PRD. This includes how PRD is defined, how it is identified and how it relates specifically to the three pelvic cancers in which it most commonly manifests (prostate, gynaecological and colorectal). It pays particular attention to the impact of PRD on patient experience and quality of life. This review is the first part in a series on the GI symptoms of PRD.

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