scholarly journals Association between gastrointestinal symptoms and disease severity in patients with COVID-19 in Tehran City, Iran

2021 ◽  
Author(s):  
Elena Lak ◽  
Seyed Sheikholeslami ◽  
Mahmoud Ghorbi ◽  
Mostafa Shafei ◽  
Homayon Yosefi
Keyword(s):  
Disease Severity ◽  
Gastrointestinal Symptoms

scholarly journals The Spectrum of Gastrointestinal Symptoms in Patients With Coronavirus Disease-19: Predictors, Relationship With Disease Severity, and Outcome

2020 ◽  
Vol 11 (12) ◽  
pp. e00259
Author(s):  
Uday C. Ghoshal ◽  
Ujjala Ghoshal ◽  
Akash Mathur ◽  
Ratender K. Singh ◽  
Alok Nath ◽  
...  
Keyword(s):  
Disease Severity ◽  
Gastrointestinal Symptoms

scholarly journals Impairments in Protein Digestion and Absorption Attenuate the Anabolic Response to Feeding in Patients with Congestive Heart Failure (FS09-03-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sarah Kirschner ◽  
Nicolaas E P Deutz ◽  
Iris Rijnaarts ◽  
Steven W M Olde Damink ◽  
Marielle P K J Engelen
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Disease Severity ◽  
Glucose Transport ◽  
Membrane Integrity ◽  
Gastrointestinal Symptoms ◽  
Protein Digestion ◽  
Anabolic Response ◽  
Intestinal Membrane ◽  
Small Intestinal

Abstract Objectives Gastrointestinal symptoms are prevalent extracardiac systemic manifestations of Congestive Heart Failure (CHF). We developed a comprehensive panel of methods to unravel gut dysfunction in CHF and its impact on the anabolic response to feeding. Methods We recruited 14 clinically stable CHF patients (ejection fraction: 33.9 ± 2.1, NYHA class: 2.3 ± 0.2) and 17 healthy controls matched for age and gender. Stable tracers of L-phenylalanine (PHE)-[ring-2H5] and L-tyrosine (TYR)-[13C9,15 N] were administered intravenously for 5 hours via primed constant and continuous infusion. After 2 hours, participants ingested a complete high protein meal containing L-PHE-[1–13C] and spirulina-[U-15 N]. We sampled blood throughout the study to analyze enrichments by LC-MS/MS. We calculated the anabolic response to feeding before and after correction for changes in protein digestion and absorption, assessed by spirulina degradation ratio (L-PHE-[15 N]/[1–13C]). Moreover, we measured small intestinal membrane integrity and active carrier-mediated glucose transport by urinary recovery of the orally ingested inert sugars lactulose, rhamnose, and 3-O-methyl-glucose. Disease severity was assessed by medical chart and history. Statistical analysis was performed by unpaired t-tests. Data are expressed as mean ± SEM. Results In CHF patients, protein digestion and absorption were reduced (0.66 ± 0.04 vs. 0.82 ± 0.04, P < 0.01), which further attenuated the anabolic response to feeding (28.3 ± 3.8 vs. 54.0 ±5.5 μmol/kg FFM/meal, P < 0.001). Disturbances in protein digestion and absorption as well as anabolic response in CHF were independent of disease severity. Small intestinal permeability and active carrier-mediated glucose transport did not differ between the groups indicating a preserved enterocyte function in CHF patients. Conclusions We hypothesize that enhancing protein digestion and absorption in patients with CHF can improve the availability of nutrients and protein anabolism. Funding Sources National Institutes of Health

scholarly journals Clinical Characteristics of COVID-19 Patients with Gastrointestinal Symptoms

2021 ◽  
Vol 24 (2) ◽  
pp. 131-138
Author(s):  
Mahnaz Montazeri ◽  
Nastaran Maghbouli ◽  
Raika Jamali ◽  
Alireza Sharifi ◽  
Marzieh Pazoki ◽  
...  
Keyword(s):  
Disease Severity ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Gastrointestinal Symptoms ◽  
Chi Square ◽  
Increased Risk ◽  
Gi Symptoms ◽  
Significant Difference ◽  
Treatment Data ◽  
Risk Of Disease

Background: We aimed to assess the gastrointestinal (GI) manifestations of patients with severe acute respiratory syndrome coronavirus 2 infection and determine factors predicting disease prognosis and severity among patients with GI symptoms. Methods: In this retrospective study, we evaluated laboratory confirmed (by real-time polymerase chain reaction) inpatient cases of coronavirus-associated disease 2019 (COVID-19), referred to Sina hospital, a tertiary educational hospital of Tehran University of Medical Sciences, from March 10 to May 20, 2020. Demographic and clinical characteristics, laboratory data, outcomes and treatment data were extracted and analyzed using SPSS version 20. Results: A total of 611 patients (234 women and 377 men) were included with 155 patients having GI symptoms. The most prevalent reported GI symptom was nausea/vomiting in 115 (18.8%) of patients. A total of 20 patients (3.2%) only had GI symptoms (without respiratory symptoms). There was no statistically significant difference in the clinical outcomes, disease severity, intensive care unit (ICU) admission and mortality between patients with and without GI symptoms. Aspartate Aminotransferase level was associated with 446% increased risk of disease severity (adjusted odds ratio: 5.46, 95% CI: 2.01 to 14.81) (P=0.040) among patients with GI symptoms. Additionally, we found that treatment with antibiotics in addition to mechanical ventilation was associated with increased survival among patients with GI symptoms (Pearson Chi square: 6.22; P value: 0.013). Conclusion: More attention should be paid to patients with only GI symptoms for early patient detection and isolation. Moreover, patients with GI manifestations are not exposed to higher rates of disease severity or mortality.

scholarly journals Correlation between gastrointestinal symptoms and disease severity in patients with COVID-19: a systematic review and meta-analysis

2020 ◽  
Vol 7 (1) ◽  
pp. e000437 ◽  
Author(s):  
Jing Liu ◽  
Min Cui ◽  
Tao Yang ◽  
Ping Yao
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Disease Severity ◽  
Meta Analysis ◽  
Severe Disease ◽  
Gastrointestinal Symptoms ◽  
Exclusion Criteria ◽  
Funnel Plot ◽  
Gi Symptoms ◽  
Significant Difference

ObjectiveTo study the correlation between gastrointestinal (GI) symptoms and disease severity in patients with COVID-19.DesignWe searched six databases including three Chinese and three English databases for all the published articles on COVID-19. Studies were screened according to inclusion and exclusion criteria. The relevant data were extracted and all the statistical analyses were performed using Revman5.3.ResultIn a meta-analysis of 9 studies, comprising 3022 patients, 479 patients (13.7%, 95% CI 0.125 to 0.149) had severe disease and 624 patients (14.7%, 95% CI 0.136 to 0.159) had GI symptoms. Of 624 patients with GI symptoms, 118 patients had severe disease (20.5%, 95% CI 0.133 to 0.276) and of 2397 cases without GI symptoms, 361 patients had severe disease (18.2%, 95% CI 0.129 to 0.235). Comparing disease severity of patients with and without GI symptoms, the results indicated: I²=62%, OR=1.21, 95% CI 0.94 to 1.56, p=0.13; there was no statistically significant difference between the two groups. The funnel plot was symmetrical with no publication bias.ConclusionCurrent results are not sufficient to demonstrate a significant correlation between GI symptoms and disease severity in patients with COVID-19.

scholarly journals Elevated transaminases and hypoalbuminemia in Covid-19 are prognostic factors for disease severity

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jason Wagner ◽  
Victor Garcia-Rodriguez ◽  
Abraham Yu ◽  
Barbara Dutra ◽  
Scott Larson ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Disease Severity ◽  
Liver Enzymes ◽  
Prognostic Markers ◽  
Laboratory Data ◽  
Gastrointestinal Symptoms ◽  
Academic Hospital ◽  
Single Institution ◽  
Elevated Transaminases ◽  
Time Of Admission

AbstractPrognostic markers are needed to understand the disease course and severity in patients with Covid-19. There is evidence that Covid-19 causes gastrointestinal symptoms and abnormalities in liver enzymes. We aimed to determine if hepatobiliary laboratory data could predict disease severity in patients with Covid-19. In this retrospective, single institution, cohort study that analyzed patients admitted to a community academic hospital with the diagnosis of Covid-19, we found that elevations of Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) and Alkaline Phosphatase (AP) at any time during hospital admission increased the odds of ICU admission by 5.12 (95% CI: 1.55–16.89; p = 0.007), 4.71 (95% CI: 1.51–14.69; p = 0.01) and 4.12 (95% CI: 1.21–14.06, p = 0.02), respectively. Hypoalbuminemia found at the time of admission to the hospital was associated with increased mortality (p = 0.02), hypotension (p = 0.03), and need for vasopressors (p = 0.02), intubation (p = 0.01) and hemodialysis (p = 0.002). Additionally, there was evidence of liver injury: AST was significantly elevated above baseline in patients admitted to the ICU (54.2 ± 15.70 U/L) relative to those who were not (9.2 ± 4.89 U/L; p = 0.01). Taken together, this study found that hypoalbuminemia and abnormalities in hepatobiliary laboratory data may be prognostic factors for disease severity in patients admitted to the hospital with Covid-19.

Discordance between Patient and Physician Assessments of Disease Severity in Systemic Sclerosis

2010 ◽  
Vol 37 (11) ◽  
pp. 2307-2312 ◽  
Author(s):  
MARIE HUDSON ◽  
ANN IMPENS ◽  
MURRAY BARON ◽  
JAMES R. SEIBOLD ◽  
BRETT D. THOMBS ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Disease Severity ◽  
Disease Duration ◽  
Intraclass Correlation ◽  
Gastrointestinal Symptoms ◽  
The United States ◽  
Relative Importance ◽  
Shortness Of Breath ◽  
Future Studies ◽  
The Us

Objective.To describe the magnitude and correlates of discordance between patient and physician assessments of disease severity in patients with systemic sclerosis (SSc).Methods.Subjects were patients enrolled in the Canadian Scleroderma Research Group Registry. The outcomes of interest were patient and physician global assessments of disease severity (scales ranging from 0–10). Predictors of disease severity represented the spectrum of disease in SSc (skin involvement, severity of Raynaud’s phenomenon, shortness of breath, gastrointestinal symptoms and pain, number of fingertip ulcers, tender and swollen joints, creatinine, and fatigue). The results of the analysis were validated in an independent sample of patients with SSc from the United States.Results.Patients perceived greater disease severity than physicians (mean difference 0.78 ± 2.65). The agreement between patient and physician assessments of disease severity was, at best, modest (intraclass correlation 0.3774; weighted κ 0.3771). Although both patients and physicians were influenced by skin scores, breathlessness, and pain, the relative importance of these predictors differed. Patients were also influenced by other subjective symptoms, while physicians were also influenced by disease duration and creatinine. The predictors explained 56% of the deviance in the patient global assessments and 29% in the physician assessments. These findings were confirmed in the US dataset.Conclusion.Patients and physicians rate SSc disease severity differently in magnitude and are influenced by different factors. Patient-assessed and physician-assessed measures of severity should be considered as complementary and used together in future studies of SSc.

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