Olimba LJ.1, Tawasil A.1, Bonghanoy A.1, Torres J.1, Yasay E.1, Evasan A.2, Salamat S.2, Delos Reyes F.3

1Department of Medicine, Division of Gastroenterology, University of the Philippines – Philippine General Hospital, Philippines,  2Department of Medicine, Division of Infectious Diseases, University of the Philippines – Philippine General Hospital,Philippines,  3University of the Philippines, Diliman, Philippines

Background/Aims: To determine the frequencies of gastrointestinal manifestations and identify associations with short-term health outcomes among COVID-19 patients admitted in a tertiary referral hospital. Furthermore, the study sought to determine conditions and co-morbidities that can be associated with the development of these gastrointestinal symptoms.

Methods: This was a retrospective cohort of 1212 adult patients admitted at the Philippine General Hospital from April to September 2020 for COVID-19 infection. Data were gathered from an established database and chart review. Frequencies of observations were tabulated and expressed in percentages. Analytical statistics via the Fisher’s Exact test was used to determine associations.

Results: A total of 597 observations of gastrointestinal symptoms was noted: diarrhea (16.4%), anorexia (13.3%), ageusia/dysgeusia/hypogeusia (7.7%), vomiting (4.5%), abdominal discomfort (4.7%), nausea (1.7%), and gastrointestinal bleeding (0.7% - [melena 0.5%, hematochezia 0.16%, hematemesis 0.08%]). Most of these patients had moderate COVID infection (38.37%). Gastrointestinal bleeding was significantly associated with the need for oxygen support (p = 0.009), invasive ventilation ( p = 0.002), invasive ventilation (p = 0.001), ICU admission (p = 0.006) and mortality (p = 0.006). Anorexia was significantly associated with the need for oxygen support (p = <0.001), invasive ventilation (p = <0.001), renal replacement therapy (p = 0.003), ICU admission ( p = <0.001) and mortality (p = <0.001). Vomiting was significantly associated with need for invasive ventilation (p = 0.023) and renal replacement therapy (p = 0.003).

Conclusion: Gastrointestinal manifestations can present among patients with COVID-19 infection and can affect overall in-patient prognosis.

Keywords: COVID-19 infection, Gastrointestinal Manifestations, Short-term Health Outcomes