George Washington University School of Medicine and Health Sciences Washington, DC
Hayley Rogers, MD, WonSeok W. Choi, MD, Saadia Nawal, MD, Ronit Dastidar, BS, Eric Heinz, MD, PhD, David Yamane, MD, Marie L. Borum, MD, EdD, MPH; George Washington University School of Medicine and Health Sciences, Washington, DC
Introduction: The novel coronavirus (COVID-19) has had a devastating global impact and is a critical area of study for medical professionals. Characterization of the disease is important to assist in developing screening protocols and diagnostic tools. Studies have shown that similar to SARS and MERS, the COVID-19 virus has a tropism for the gastrointestinal (GI) tract. The mechanism of COVID-induced GI symptoms is unknown, though direct viral infection of enterocytes and immune-mediated injury have been hypothesized. This study evaluated the prevalence of GI symptoms and the frequency at which these symptoms were the initial presentation in hospitalized COVID patients. Methods: A confidential database was created from a registry of patients admitted to an urban university hospital with a diagnosis of COVID-19. Gastrointestinal symptoms, including diarrhea, nausea, vomiting, abdominal pain and loss of appetite were identified. A frequency analysis using SAS was performed to determine prevalence of GI symptoms and timing of presentation. The study was IRB approved. Results: 283 patients were analyzed, with 37.46% having at least one GI symptom prior to admission to the hospital. The most common symptom was nausea / vomiting (33.92%) followed by diarrhea (19.08%), loss of appetite (13.07%), and abdominal pain (3.53%). Two or more symptoms were seen in 13.43% of patients. GI symptoms were cited as the initial presentation in 23.32% of cases. Diarrhea was the most common initial symptom (11.66%) followed by nausea / vomiting (9.19%), loss of appetite (9.19%), and abdominal pain (2.47%). Multiple GI symptoms occurred as the initial presentation in 7.06% of patients. Discussion: Gastrointestinal symptoms are an important presentation of COVID-19 that is often overlooked. Increased awareness and characterization of GI symptoms in COVID-19 infection is needed to improve screening procedures and protect healthcare workers from potential fecal-oral transmission. While diarrhea in COVID-19 infection has become the primary GI focus, this study revealed that nausea / vomiting occurred in one-third of hospitalized patients. These results are important because they offer important information about the spectrum of GI manifestations in a diverse U.S. urban population.
Disclosures: Hayley Rogers indicated no relevant financial relationships. WonSeok Choi indicated no relevant financial relationships. Saadia Nawal indicated no relevant financial relationships. Ronit Dastidar indicated no relevant financial relationships. Eric Heinz indicated no relevant financial relationships. David Yamane indicated no relevant financial relationships. Marie Borum indicated no relevant financial relationships.