scholarly journals Clinical Case Series of Gastrointestinal Symptoms in Patients With Novel Coronavirus 2019 Infection

2021 ◽  
Author(s):  
Hamideh Abbaspour Kasgari ◽  
Amir Mohammad Shabani ◽  
Hafez Fakheri ◽  
Parnian Mohammadzadeh
Keyword(s):  
Respiratory Symptoms ◽  
Acute Phase Proteins ◽  
Severe Disease ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Stable Condition ◽  
Signs And Symptoms ◽  
Case Series Study ◽  
Gi Symptoms ◽  
Loss Of Appetite

Background: Various digestive symptoms have been frequently reported in a significant portion of patients infected with the virus since the outbreak of Coronavirus Disease 2019 (COVID-19). Most patients with COVID-19 have a fever accompanied by respiratory signs and symptoms, such as cough and dyspnea. We present 36 cases with a chief complaint of Gastrointestinal (GI) symptoms along with respiratory symptoms. In this study, we aimed at investigating the prevalence and outcomes of COVID-19 patients with digestive symptoms. Methods: A variety of observed GI symptoms included nausea and vomiting (72.2%), diarrhea (25%), abdominal pain (19.4%), loss of appetite (14%), and anosmia (14%). The most nonGI symptoms were dyspnea (66.7%), fever (66.7%), dry cough (58.3%), myalgia (52.4%), and others. Six patients (16.6%) were critically ill, 7 (19.4%) were in stable condition, and 23 patients (64%) showed moderate symptoms. Among the patients, 7 (19.5%) needed critical care and were admitted to ICU. Leucopenia, lymphopenia, and elevated acute-phase proteins were other features observed in these patients. The most common antiviral regimen was hydroxychloroquine and oseltamivir. Finally, 32 patients (89%) were discharged, and 4 (11%) died. Conclusion: This case series study highlights that patients with COVID-19 are prone to GI symptoms along with fever and respiratory symptoms. Patients may even present with digestive symptoms and without any respiratory symptoms. Hence, clinicians should pay more attention to these patients and help diagnose COVID-19 earlier to start prompt treatment before the occurrence of severe disease.

scholarly journals Extrapulmonary manifestations and complications of severe acute respiratory syndrome coronavirus 2 infection: a systematic review

2021 ◽  
Author(s):  
J Cho ◽  
J Lee ◽  
CH Sia ◽  
CS Koo ◽  
BYQ Tan ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Respiratory Symptoms ◽  
Case Reports ◽  
Meta Analysis ◽  
Severe Disease ◽  
Late Phase ◽  
Cardiac Injury ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Venous Thromboembolic Events

Introduction: We aimed to describe the extrapulmonary manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, including their frequency, onset with respect to respiratory symptoms, pathogenesis and association with disease severity. Methods: We searched the MEDLINE and Embase databases for SARS-CoV-2-related studies. Meta-analysis, observational studies, case series and case reports published in English or Chinese between 1 January and 1 May 2020 were included. Reports with only paediatric or obstetric cases were excluded. Results: 169 articles were included. Early manifestations (preceding respiratory symptoms until Day 6 of onset) included olfactory and gustatory disturbance (self-reported in up to 68% and 85% of cases, respectively), gastrointestinal symptoms (up to 65.9%) and rash (up to 20.4%). From Day 7 onwards, hypercytokinaemia, paralleled multi-organ complications including acute cardiac injury (pooled incidence of 17.7% in 1,412 patients, mostly with severe disease and 17.4% mortality), kidney and liver injury (up to 17% and 33%, respectively) and thrombocytopenia (up to 30%). Hypercoagulability resulted in venous thromboembolic events in up to 31% of all patients. Uncommon disease presentation and complications comprised Guillain-Barré syndrome, rhabdomyolysis, otitis media, meningoencephalitis and spontaneous pneumomediastinum. Conclusion: Although the systemic manifestations of SARS-CoV-2 infection are variegated, they are deeply interwoven by shared mechanisms. Two phases of extrapulmonary disease were identified: (a) an early phase with possible gastrointestinal, ocular and cutaneous involvement and (b) a late phase characterised by multiorgan dysfunction and clinical deterioration. A clear, multidisciplinary consensus to define and approach thromboinflammation and cytokine release syndrome in SARS-CoV-2 is needed.

scholarly journals Gastrointestinal symptoms in COVID-19 patients: a case series

2020 ◽  
Vol 9 (9) ◽  
pp. 3866
Author(s):  
Shahida Naghma ◽  
Deepak Kumar
Keyword(s):  
Gastrointestinal Symptoms ◽  
Hospital Setting ◽  
Case Series ◽  
Oral Transmission ◽  
Virus Rna ◽  
Faecal Samples ◽  
Gi Symptoms ◽  
Sample Testing ◽  
Loss Of Appetite ◽  
Global Threat

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents an ongoing global threat. Common clinical features reported in early confirmed infections included fever, cough, and myalgias or fatigue. But as testing capacity and case numbers have increased worldwide, gastrointestinal (GI) symptoms such as diarrhoea, nausea/vomiting, abdominal pain, and loss of appetite have been increasingly recognized. Authors present a case series of gastrointestinal symptoms in COVID-19 patients and how they were managed at the hospital. However, correlations between the presence of fecal virus RNA and severity of digestive symptoms, namely, diarrhoea severity could not be established due to unavailability of the test in the hospital setting. Although knowledge about the viability of SARS-CoV-2 is limited, the virus could remain viable in the environment for days, which could lead to faeco-oral transmission. Various studies conducted on COVID-19 patients recommended routine stool sample testing with real-time RT-PCR after the clearance of viral RNA in a patient’s respiratory samples. Strict precautions to prevent transmission should be taken for patients who are in hospital or self-quarantined if their faecal samples test positive. Optimally, testing for COVID-19 should be performed using both respiratory and stool samples, if available.

scholarly journals Cutaneous manifestations of COVID-19 in Mexican patients: A case series and review of literature

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199719
Author(s):  
Juan Carlos Palomo-Pérez ◽  
Maria Elisa Vega-Memije ◽  
David Aguilar-Blancas ◽  
Erik González-Martínez ◽  
Lucia Rangel-Gamboa
Keyword(s):  
Respiratory Symptoms ◽  
Case Series ◽  
Signs And Symptoms ◽  
Skin Lesions ◽  
World Health ◽  
Medical Community ◽  
Atypical Pneumonia ◽  
Cutaneous Lesions ◽  
Cutaneous Manifestations ◽  
Mexican Patients

China officially recognized atypical pneumonia outbreak in December 2019; on 11 March 2020, the World Health Organization declared COVID-19 as a pandemic that is produced by a new coronavirus, named SARS-CoV-2, of rapid transmissibility, which can be asymptomatic, with mild to severe respiratory symptoms, and with cardiovascular, neurological, gastrointestinal, and cutaneous complications. Considering that the pandemic prolonged more than initially expected was prognostic, it is essential for the medical community to identify the signs and symptoms of COVID-19. Thus, this work’s objectives were to present cases of cutaneous lesions observed in COVID-19 Mexican patients. We register cutaneous lesions in COVID-19 patients referred from internal medicine and otorhinolaryngology services to dermatology. We presented four interesting cases with cutaneous lesions, including exanthema morbilliform, urticaria, chilblains, ecchymosis, and facial edema, and review the available literature. The most frequent cutaneous markers are rash, chilblains, and urticaria. Skin lesions may be the first manifestation of COVID-19, accompany initial respiratory symptoms, or appear during the disease course. Symptoms associated with vascular changes (livedo reticularis and vasculitis) are considered of poor prognosis.

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 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.

ROLE OF PIROXICAM IN CONTROLLING FEVER IN COVID 19 - AN OBSERVATIONAL CASE SERIES STUDY

2021 ◽  
pp. 24-25
Author(s):  
Kumar Vineet ◽  
Vibhu Jain ◽  
Adiveeth Deb ◽  
Amit Yadav
Keyword(s):  
Severe Disease ◽  
Case Series ◽  
Treatment Method ◽  
Blood Oxygen ◽  
Limited Data ◽  
Disease Category ◽  
Blood Oxygen Saturation ◽  
Symptomatic Management ◽  
Case Series Study ◽  
Time Basis

INTRODUCTION- COVID 19 pandemic is creating havoc in medical infrastructure. Further misery is created by the fact that there is no proven treatment of COVID 19 infection. Most of the drugs given currently in COVID 19 is for symptomatic management of infection. Updated protocols released on time to time basis have drugs which are based more on clinical observations rather than experimental ones. These drugs consists mainly repositioned drugs already approved by FDA for other disease treatment. METHOD- In our study, we have used Piroxicam polyhedral crystals sublingually for control of fever in COVID 19 pneumonia which was not controlled by Paracetamol and steroids combination. It was advised in patients progressing to severe disease category or developing pneumonia. RESULT- Our case series with limited data shows that cases have responded well to Piroxicam in control of fever. They became normothermic after single dose of drug. Further, patients' blood oxygen levels have also improved with therapy; however, with limited data, a cause-effect relationship could not be determined. CONCLUSION- At present, Piroxicam can be advised in COVID 19 infection under medical supervision for control of persistent high fever. In future, randomised studies are needed to further consolidate above claim that Piroxicam is helpful in controlling fever as well as improving blood oxygen saturation of cases

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.

A case series study of hypopituitarism in older patients with and without gastrointestinal symptoms

2018 ◽  
Vol 130 (5) ◽  
pp. 501-506 ◽  
Author(s):  
Xiaowei Li ◽  
Hang Yang ◽  
Zhijun Duan ◽  
Qingyong Chang ◽  
Xiaoting Wei ◽  
...  
Keyword(s):  
Older Patients ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Case Series Study ◽  
Series Study

scholarly journals Immune Response, Viral Shedding Time, and Clinical Characterization in COVID-19 Patients With Gastrointestinal Symptoms

2021 ◽  
Vol 8 ◽  
Author(s):  
Huan Yang ◽  
Xiangyu Xi ◽  
Weimin Wang ◽  
Bing Gu
Keyword(s):  
Immune Response ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Gastrointestinal Symptoms ◽  
Kidney Injury ◽  
Percentage Increase ◽  
Viral Shedding ◽  
Reactive Protein ◽  
Gi Symptoms ◽  
Ig G

Background and Aims: Gastrointestinal (GI) symptoms are frequently observed in coronavirus disease (COVID-19) symptoms. Previous studies have mainly focused on epidemiology and characteristics in patients with GI symptoms, little is known about the roles of the immune response in susceptibility to and severity of infection. Here, we analyzed COVID-19 cases to determine immune response and clinical characteristics in COVID-19 patients with GI symptoms.Methods: Based on the presence of GI symptoms, 79 patients in Xuzhou were divided into GI and non-GI groups. A retrospective study investigating the clinical characteristics, selected laboratory abnormalities, immune response, treatment, and clinical outcome was performed to compare patients with or without GI symptoms.Results: Approximately 25% of patients reported at least one GI symptom. Our results showed significantly higher rates of fatigue, increased LDH, increased CK, higher percentage increase neutrophil-to-lymphocyte ratio (NLR), lymphopenia, and bilateral pneumonia in patients with GI symptoms. No significant changes in serum amylase (SAA), immunoglobulin (Ig) G, IgM, C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), viral shedding time, liver injury, and kidney injury between the two groups were observed. The clinical type on admission of patients with GI symptoms reported significantly higher rates of critical disease type (20 vs. 3.3%; p = 0.033). However, the survival rate did not differ between the two groups.Conclusions: Increase in total lymphocytes and NLR as well as the elevation of CRP, SAA, PCT, IL-6, CK, and LDH were closely associated with COVID-19 with GI symptoms, implying reliable indicators COVID-19 patients with GI symptoms were more likely to develop into a severe disease.

scholarly journals Abdominal Signs and Symptoms of COVID-19 in Children

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Rana Saleh ◽  
Hamid Rahimi ◽  
Niloofar Javadi ◽  
Sheida Amini ◽  
Shima Saeidi ◽  
...  
Keyword(s):  
Current Knowledge ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Signs And Symptoms ◽  
Mesenteric Lymphadenitis ◽  
Pulmonary Manifestations

: COVID-19 is an ongoing pandemic that is not known well. According to our current knowledge, although respiratory manifestations are the most common symptoms of COVID-19, but non-pulmonary manifestations are also commonly reported, such as rashes, appendicitis, volvulus, diverticulitis, and mesenteric lymphadenitis. In this case series, we introduced four children with COVID-19 who presented with gastrointestinal symptoms.

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