Association of Digestive Symptoms and Hospitalization in Patients With SARS-CoV-2 Infection

  1. George Cholankeril
  2. Alexander Podboy
  3. Vasiliki Irene Aivaliotis
  4. Edward A. Pham
  5. Sean P. Spencer
  6. Donghee Kim
  7. Aijaz Ahmed

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Abstract

High rates of concurrent gastrointestinal manifestations have been noted in patients with corona virus disease 2019 (COVID-19); however, the association between these digestive manifestations and need for hospitalization has not been established.

METHODS:

This is a retrospective review of consecutive patients diagnosed with COVID-19. A total of 207 patients were identified; 34.5% of patients noted concurrent gastrointestinal symptoms, with 90% of gastrointestinal symptoms being mild.

RESULTS:

In a multivariate regression model controlled for demographics and disease severity, an increased risk of hospitalization was noted in patients with any digestive symptom (adjusted odds ratio 4.84, 95% confidence interval: 1.68–13.94).

DISCUSSION:

The presence of digestive symptoms in COVID-19 is associated with a need for hospitalization.

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  1. ScreenIT

    SciScore for 10.1101/2020.04.23.20076935: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Following expedited approval from our Institutional Review Board, we analyzed retrospectively collected data from consecutive patients with confirmed COVID-19 based on a positive polymerase chain reaction testing at our institution from March 03, 2020 to April 7, 2020.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are several limitations to our findings. As this is a retrospective single institution study, our findings may not be broadly generalizable. Also, as this series represents our initial experience treating COVID-19, it is unclear if these results should be viewed on a continuum with changing demographic and clinical information with time. Additionally, due to the short study duration, we were unable to further assess hospitalization outcomes. In conclusion, while analyzing our initial clinical and demographic data in patients with COVID-19 we identified the presence of gastrointestinal symptoms as a risk factor for higher severity of overall illness and need for hospitalization. With the current focus on streamlining triaging efforts, first responders and frontline providers should consider assessing for digestive symptoms in their initial clinical evaluation and decision-making. Larger prospective studies are needed to validate these observations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  2. Version published to 10.14309/ajg.0000000000000712
  3. Version published to 10.1101/2020.04.23.20076935v1 on medRxiv