Louisiana State University Health Sciences Center Shreveport, LA
Shazia Rashid, MD1, Meher Sindhoora Mavuram, MD, MS1, Hrishikesh Samant, MD2; 1Louisiana State University Health Sciences Center, Shreveport, LA; 2Louisiana State University Health Shreveport, Shreveport, LA
Introduction: The novel SARS-coronavirus (COVID-19) causing the current pandemic has been a threat to human life. According to Johns Hopkins Database, as of June 15, 2020, there have been about 8million cases worldwide with almost 450,000 deaths. Although it presents with fever and respiratory symptoms, gastrointestinal (GI) symptoms have also been reported. We will study the manifestation of GI symptoms in patients with COVID-19 in our tertiary care center in Shreveport, Louisiana. Methods: An IRB protocol highlighting a retrospective study was approved. Using electronic health records (EPIC EMR) and the slicer/dicer feature, data from March 1-May 15, 2020 was collected on patient demographics, geography, number of patients with GI symptoms such as nausea, abdominal pain, diarrhea and liver abnormalities. Inclusion criteria involved adult patients >18yrs of age who were hospitalized and tested positive for COVID-19 with RT-PCR nasopharyngeal swab. Exclusion criteria involved patients < 18yrs and prisoners. Results: There were 302 adult patients admitted to our hospital who were tested positive for COVID-19 virus. Of all the patients, 57% were female, 43% male; 85% were African American and 11% were Caucasian. About 5.6% of patients had nausea, 11.6% had diarrhea, 8% had vomiting, 8% had constipation and 11.3% had abdominal pain. Liver abnormalities were found in 65.6% of patients. Approximately 26% of the cases were within a 6-mile radius of the hospital. Discussion: It is postulated that like the epithelial cells in the airways, the enterocytes in GI tract express ACE2 receptors. This allows for providing entry of the virus in the GI tract, thereby proliferating and excreting in the stool. This study analyzed data from tertiary care center over 6 weeks and found majority of the patients presented with diarrhea and abdominal pain. Racial variation also was highlighted and confirmed the finding of prior studies regarding increased prevalence of COVID-19 in African American populations. Furthermore, approximately a quarter of the cases were found to be in African American populated areas that are within proximity to the hospital. This is likely secondary to poverty, residing in population-dense areas, lack of insurance or access to healthcare and presence of co-morbidities such as hypertension, diabetes and obesity. Understanding the manifestation of GI symptoms in COVID-19, especially in our population has become increasingly important and for clinicians to remain mindful of such presentation.
Disclosures: Shazia Rashid indicated no relevant financial relationships. Meher Sindhoora Mavuram indicated no relevant financial relationships. Hrishikesh Samant indicated no relevant financial relationships.