scholarly journals CYTOMEGALOVIRUS-INDUCED GASTROINTESTINAL BLEEDING AND PANCREATITIS COMPLICATING SEVERE COVID-19 PNEUMONIA: A PARADIGMATIC CASE.

2020 ◽  
Vol 12 (1) ◽  
pp. e2020060 ◽  
Author(s):  
Giacomo Marchi ◽  
Alice Vianello ◽  
Ernesto Crisafulli ◽  
Alessio Maroccia ◽  
Stefano Francesco Crinò ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Bleeding ◽  
Respiratory Symptoms ◽  
Clinical Manifestations ◽  
Immune Dysregulation ◽  
Multiple Infections ◽  
Key Points ◽  
Gi Symptoms ◽  
Clinical Description ◽  
High Level

Key points: COVID-19 is a novel pandemic disease whose pathophysiology and clinical description are still not completely defined. Besides respiratory symptoms, gastrointestinal (GI) symptoms (especially including anorexia, diarrhea, and abdominal pain) represent the commonest clinical manifestations. Emerging data point out that severe SARS-CoV-2 infection causes an immune dysregulation, which in turn may favor other infections. Here we describe a patient with severe COVID-19 pneumonia who developed in the resolving phase abdominal pain associated to cytomegalovirus (CMV)-induced duodenitis with bleeding, and pancreatitis. A high level of suspicion toward multiple infections, including CMV, should be maintained in COVID-19 patients with heterogeneous clinical manifestations.

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.

scholarly journals Newly Reported Studies on the Increase in Gastrointestinal Symptom Prevalence with COVID-19 Infection: A Comprehensive Systematic Review and Meta-Analysis

Diseases ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 41
Author(s):  
Hakan Akin ◽  
Ramazan Kurt ◽  
Fatih Tufan ◽  
Ahmed Swi ◽  
Resat Ozaras ◽  
...  
Keyword(s):  
Systematic Review ◽  
Abdominal Pain ◽  
Respiratory Symptoms ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Significant Heterogeneity ◽  
Gi Tract ◽  
Chinese Studies ◽  
Gi Symptoms

Background and Aim: Although constitutional and respiratory symptoms such as cough and fever are the most common symptoms in patients infected with COVID-19, gastrointestinal (GI) tract involvement has been observed by endoscopic biopsies. Multiple GI symptoms, including diarrhea, nausea or vomiting and abdominal pain, have also been reported. This review aims to present the currently available data regarding the GI symptoms of COVID-19 patients, and to compare the frequency of GI symptoms in early stage (Eastern) mostly Chinese data to the current stage (Western) non-Chinese data. Methods: We performed a systematic literature search to identify both published studies by using PubMed, Google Scholar, and CNKI (Chinese medical search engine), and yet unpublished studies through medRxiv and bioRxiv. We also reviewed the cross references of the detected articles. We conducted a Medical Subject Headings (MeSH) search up until 20 September 2020. We pooled the prevalence of symptoms of diarrhea, anorexia, nausea, vomiting, and abdominal pain by using the Freeman–Tukey’s transforming random effect model. Results: A total of 118 studies were included in the systematic review and 44 of them were included in the meta-analysis. There was a significant heterogeneity between the studies; therefore, the random effects model was used. The pooled prevalence estimate of any GI symptoms reported was found to be 0.21 (95%CI, 0.16–0.27). Anorexia was the most commonly reported GI symptom at 18% (95%CI, 0.10–0.27) followed by diarrhea at 15% (95%CI, 0.12–0.19). Diarrhea, abdominal pain, nausea/vomiting, and respiratory symptoms were more common in non-Chinese studies. The prevalence of abdominal pain was lower in the “inpatient-only” studies when compared with studies that included outpatients only and those including both inpatients and outpatients. Conclusions: In this comprehensive systematic review and meta-analysis study, we observed higher rates of diarrhea, nausea/vomiting, and abdominal pain in COVID-19 infected patients among non-Chinese studies compared to Chinese studies. We also observed a higher prevalence of GI symptoms in Chinese studies than was reported previously. Non-respiratory symptoms, including GI tract symptoms, should be more thoroughly and carefully evaluated and reported in future studies.

scholarly journals Поражение пищеварительного тракта как проявление COVID-19 у ребенка 4 лет

Doctor Ru ◽  
2021 ◽  
Vol 20 (3) ◽  
pp. 56-59
Author(s):  
I.M. Osmanov ◽  
◽  
O.N. Solodovnikova ◽  
S.N. Borzakova ◽  
T.V. Sbrodova ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Bacterial Infections ◽  
Clinical Manifestations ◽  
Enteric Infection ◽  
The Novel ◽  
Key Points ◽  
Enteric Infections ◽  
Coronavirus Infection ◽  
Novel Coronavirus

Objective of the Paper: To represent a case of the novel coronavirus infection COVID-19 in a 4-year-old child with isolated bowel damage. Key Points. COVID-19 impacts several systems and organs. Usually, children have mild or asymptomatic disease. Clinical manifestations of COVID-19 in children can be damage not only of respiratory tract, but also of GIT, requiring differential diagnosis of enteric infections (both viral and bacterial). Prompt diagnosis of COVID-19 is essential for antiepidemic measures and suppression an infectious process. The case shows challenges faced by clinicians when diagnosing COVID-19 in patients with isolated GIT damages without catarrhal signs. Course of the disease in this patient was characterised by a number of features indicative of a bacterial enteric infection: abdominal pain, diarrhoea, increased CRP, colitis syndrome in stool test, warranting differential diagnosis of acute enteric bacterial infections. Negative bacterial culture, detection of SARS-CoV2 RNA in oropharynx and nasopharynx mucous, fast stool normalisation and dyspeptic events arrest allowed diagnosing that the diarrhoea was associated with COVID-19. One month of metabolic and probiotic therapy normalised stool, arrested abdominal pain, and improved exercise tolerance. Conclusion. GIT damage in paediatric COVID-19 patients is essential and unexplored. COVID-19 should be added to differential diagnosis in case of clinical manifestations of an acute enteric infection. Keywords: children, novel coronavirus infection, COVID-19, GIT.

scholarly journals Acute pancreatitis in pregnancy: A 10-year, multi-center, retrospective study in Beijing

2021 ◽  
Author(s):  
Tingting Zhang ◽  
Guoxing Wang ◽  
Zheng Cao ◽  
Wenyang Huang ◽  
Hongli Xiao ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Common Causes ◽  
High Level ◽  
Tertiary Care Hospitals ◽  
Beijing China ◽  
In Pregnancy

Abstract Objective Acute pancreatitis in pregnancy (APIP) is a rare and serious complication during pregnancy. It has acute onset and is difficult to diagnose and treat. The aim of the present study was to describe the etiology, clinical manifestations, and maternofetal outcomes of APIP. Methods We retrospectively reviewed 32 pregnant women who were treated at three tertiary care hospitals in Beijing, China. The correlation between the causes of APIP, severity, laboratory indices, and outcomes was analyzed. Results The most common causes of APIP were hypertriglyceridemia (56.2%,18/32) and gallstones (28.1%, 9/32). Hypertriglyceridemia-induced APIP was associated with a higher rate of severe acute pancreatitis (P = 0.025). Serum level of triglycerides showed a positive correlation with the severity of APIP (P = 0.039). The most frequent presentation of APIP was abdominal pain (93.7%, 30/32). There were no maternal or fetal deaths in our study. Neonatal asphyxia was correlated with the severity of APIP (P = 0.039). Conclusion High level of triglycerides may serve as a useful marker of the severity of APIP. The severity of APIP was associated with higher risk of neonate asphyxia. Appropriate timing of termination of pregnancy is a key imperative for APIP patients.

scholarly journals GASTROINTESTINAL MANIFESTATIONS OF COVID 19: A BRIEF REVIEW

2020 ◽  
pp. 195-197
Author(s):  
Nikhat Naaz
Keyword(s):  
Abdominal Pain ◽  
Respiratory Symptoms ◽  
Gastrointestinal Symptoms ◽  
Viral Pneumonia ◽  
Google Scholar ◽  
Gastrointestinal Manifestations ◽  
Common Presentation ◽  
Pubmed Database ◽  
Gi Symptoms

Background: In Dec 2019, a series of pneumonia cases were identified in Wuhan, China with presentations similar to viral pneumonia which later spread worldwide and was declared as COVID 19 Pandemic. Most common presentation were fever and respiratory symptoms and less common symptoms include GI symptoms like nausea, vomiting, abdominal pain and diarrhea. Objectives: The objective of this article is to review the gastrointestinal manifestations of COVID 19 patients and to understand its importance while diagnosing patients with COVID 19. Methodology: Pubmed database and Google scholar database were searched between Dec 2019 to June 2020 for studies including COVID 19 confirmed patients with GI symptoms. Findings: Many of these studies observed gastrointestinal symptoms like decreased appetite, diarrhea, nausea, vomiting and abdominal pain to be present in a substantial no of COVID 19 confirmed patients. Conclusions: Failure to recognize COVID 19 patients with predominant digestive symptoms may lead to undue spread of virus for a much longer period and may lead to uncontrollable dissemination of the virus. Recommendation: All COVID 19 confirmed patients should be evaluated for GI symptoms also apart from respiratory symptoms. Patients with predominantly GI symptoms should also be suspected as COVID 19 patients during the current COVID 19 pandemic phase.

scholarly journals COVID-19 and Digestive System in Children: A Retrospective Study

2020 ◽  
Vol 23 (11) ◽  
pp. 782-786
Author(s):  
Mohammadreza Esmaeili Dooki ◽  
Sanaz Mehrabani ◽  
Hadi Sorkhi ◽  
Maryam Nikpour ◽  
Mohamadreza Tabatabaie ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Retrospective Study ◽  
Digestive System ◽  
Liver Enzymes ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Liver Function Tests ◽  
Pulmonary Lesions ◽  
Respiratory Involvement ◽  
Gi Symptoms

Background: The aim of this study was to identify gastrointestinal (GI) and liver injury presentations in children admitted with COVID-19 infection. Methods: In this retrospective study, we studied all children with suspected symptoms of COVID-19, referred to Amirkola Children’s Hospital. Clinical manifestations of the digestive and respiratory systems and liver function tests were evaluated for all cases. Results: Eighteen children were studied. The most common clinical symptoms were fever, anorexia, weakness, nausea and vomiting, cough, diarrhea, and abdominal pain, respectively. Also, 5/18 (27.8%) and 7/18 (38.9%) of cases had abnormally high alanine aminotransferase (ALT), aspartate aminotransferase (AST), respectively. Additionally, in icteric cases, direct bilirubin was raised. There was no significant relationship between pulmonary lesions and abnormal excess in ALT (P = 0.59) and AST (P = 0.62). Conclusion: The findings showed that there were no severe clinical GI symptoms in children with COVID-19 infection. Besides, children with increased liver enzymes did not have more respiratory involvement than those without a rise in liver enzymes.

Enterogastric Reflux: an Uncommon Diagnosis Analyzed by Hepatobiliary Imaging

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Peter Wang
Keyword(s):  
Abdominal Pain ◽  
Digestive Enzymes ◽  
Gallbladder Disease ◽  
Hepatobiliary Scintigraphy ◽  
Hepatobiliary Imaging ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Upper Abdominal ◽  
Enterogastric Reflux

Enterogastric reflux (EGR) is the reflux of bile and digestive enzymes from the small bowel into the stomach. While it is a normal physiologic process in small amounts, excessive reflux and chronic EGR can cause upper GI symptoms often mimicking more common diseases such as gallbladder disease and GERD that often leads to its underdiagnosis. Identifying EGR is significant as it has been associated with the development of gastroesophogeal pathology including gastritis, esophagitis, ulcers, and mucosal metaplasia. This article presents a 22-year-old male with enterogastric reflux causing upper abdominal pain and will discuss the role of hepatobiliary scintigraphy in its diagnosis.

scholarly journals Non-Celiac Gluten Sensitivity: A Challenging Diagnosis in Children with Abdominal Pain

2018 ◽  
Vol 73 (Suppl. 4) ◽  
pp. 39-46 ◽  
Author(s):  
Frank M. Ruemmele
Keyword(s):  
Abdominal Pain ◽  
Celiac Disease ◽  
Clinical Symptoms ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Clear Cut ◽  
Clinical Presentations ◽  
New Findings ◽  
Three Phase ◽  
Gi Symptoms

Several disorders related to the ingestion of gluten are well recognized despite overlapping clinical presentations: celiac disease, an autoimmune enteropathy triggered by gluten ingestions in susceptible individuals, allergy to wheat, and more recently non-celiac gluten sensitivity (NCGS). While celiac disease and wheat allergy are well-known disorders with a clear-cut diagnosis based on clinical tests and biological parameters, NCGS is a more difficult diagnosis, especially in children with functional gastrointestinal (GI) complaints. NCGS is considered a syndrome of intestinal but also extraintestinal symptoms occurring within hours, but sometimes even after several days of gluten ingestion. In children, the leading symptoms of NCGS are abdominal pain and diarrhea, while extraintestinal symptoms are rare, in contrast to adult patients. No precise diagnostic test nor specific biomarkers exist, except a rather cumbersome three-phase gluten-exposure, gluten-free diet, followed by a blinded placebo-controlled gluten challenge with crossover to provoke symptoms elicited by gluten in a reproducible manner that disappear on gluten-free alimentation. Recent data indicate that the peptide part of wheat proteins is not necessarily the sole trigger of clinical symptoms. Mono- or oligosaccharides, such as fructan and other constituents of wheat, were able to provoke GI symptoms in clinical trials. These new findings indicate that the term gluten sensitivity is probably too restrictive. The incidence of NCGS was reported in the range of 1–10% in the general population and to increase steadily; however, most data are based on patients’ self-reported gluten intolerance or avoidance without a medically confirmed diagnosis. Treatment consists of gluten avoidance for at least several weeks or months. Patients with NCGS require regular reassessment for gluten tolerance allowing with time the reintroduction of increasing amounts of gluten.

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