Prevalence of Gastrointestinal Symptoms in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Results of the Prospective Controlled Multinational GI-COVID-19 Study

Marasco, G.; Cremon, C.; Barbaro, M. R.; Salvi, D.; Cacciari, G.; Kagramanova, A.; Bordin, D.; Drug, V.; Miftode, E.; Fusaroli, P.; Mohamed, S. Y.; Ricci, C.; Bellini, M.; Rahman, M. M.; Melcarne, L.; Santos, J.; Lobo, B.; Bor, S.; Yapali, S.; Akyol, D.; Sapmaz, F. P.; Urun, Y. Y.; Eskazan, T.; Celebi, A.; Kacmaz, H.; Ebik, B.; Binicier, H. C.; Bugdayci, M. S.; Yagci, M. B.; Pullukcu, H.; Kaya, B. Y.; Tureyen, A.; Hatemi, I.; Koc, E. S.; Sirin, G.; Caliskan, A. R.; Bengi, G.; Alis, E. E.; Lukic, S.; Trajkovska, M.; Hod, K.; Dumitrascu, D.; Pietrangelo, A.; Corradini, E.; Simren, M.; Sjolund, J.; Tornkvist, N.; Ghoshal, U. C.; Kolokolnikova, O.; Colecchia, A.; Serra, J.; Maconi, G.; De Giorgio, R.; Danese, S.; Portincasa, P.; Di Stefano, M.; Maggio, M.; Philippou, E.; Lee, Y. Y.; Venturi, A.; Borghi, C.; Zoli, M.; Gionchetti, P.; Viale, P.; Stanghellini, V.; Barbara, G.; Piacentini, A.; Shengelia, M.; Vechorko, V.; Cardamone, C.; Rosei, C. A.; Pancetti, A.; Rettura, F.; Pedrosa, M.; Campoli, C.; Mijac, D.; Korac, M.; Karic, U.; Markovic, A.; Najdeski, A.; Nikolova, D.; Dimzova, M.; Lior, O.; Shinhar, N.; Perelmutter, O.; Ringel, Y.; Sabo, C. M.; Chis, A.; Bonucchi, G.; Caio, G. P. I.; Ghirardi, C.; Marziani, B.; Rizzello, B.; Aguilar, A.; Capogreco, A.; Aghemo, A.; Di Paolo, D. M.; Marconi, G.; Di Sabatino, A.; Tagliaferri, S.; Naves, J. E.; Galli, A.; Dragoni, G.; Nedelcu, L.; Mauloni, P. A.; Del Vecchio, S.; Rotondo, L.; Capuani, F.; Montanari, D.; Palombo, F.; Paone, C.; Mastel, G.; Fontana, C.; Bellacosa, L.; Cogliandro, R. F.

doi:10.14309/ajg.0000000000001541

INTRODUCTION: Gastrointestinal (GI) symptoms in coronavirus-19 disease (COVID-19) have been reported with great variability and without standardization. In hospitalized patients, we aimed to evaluate the prevalence of GI symptoms, factors associated with their occurrence, and variation at 1 month. METHODS: TheGI-COVID-19 is a prospective,multicenter, controlled study. Patientswith and without COVID-19 diagnosis were recruited at hospital admission and asked for GI symptoms at admission and after 1 month, using the validated Gastrointestinal Symptom Rating Scale questionnaire. RESULTS: The study included 2036 hospitalized patients. A total of 871 patients (575 COVID1and 296 COVID2) were included for the primary analysis. GI symptoms occurred more frequently in patients with COVID-19 (59.7%; 343/575 patients) than in the control group (43.2%; 128/296 patients) (P < 0.001). Patients with COVID-19 complained of higher presence or intensity of nausea, diarrhea, loose stools, and urgency as compared with controls. At a 1-month follow-up, a reduction in the presence or intensity of GI symptoms was found in COVID-19 patients with GI symptoms at hospital admission. Nausea remained increased over controls. Factors significantly associated with nausea persistence in COVID-19 were female sex, high body mass index, the presence of dyspnea, and increased C-reactive protein levels. DISCUSSION: The prevalence of GI symptoms in hospitalized patients with COVID-19 is higher than previously reported. Systemic and respiratory symptoms are often associated with GI complaints. Nausea may persist after the resolution of COVID-19 infection.