GI symptoms tied to lower mortality in COVID-19

Patients with the novel coronavirus disease (COVID-19) are prone to gastrointestinal (GI) symptoms, which appears to predict a better prognosis, suggests a single-centre cohort study in Northern Italy.

“The most typical presentation of COVID-19 is an acute respiratory syndrome whose most common symptoms include fever, cough, and dyspnoea,” the authors said. “However, GI symptoms, such as diarrhoea and nausea/vomiting, are increasingly reported in patients affected by COVID-19.”

This prospective single-centre cohort study recruited patients who received diagnosis of COVID-19 between 23 March 2020 and 5 April 2020. The authors obtained patient demographics and medical history, laboratory data, and clinical outcomes.

A specifically designed questionnaire, administered at time of diagnosis, was used to collect data on the presence and time of onset of fever, typical respiratory symptoms, GI symptoms, and other symptoms (eg, fatigue, headache, myalgia/arthralgia, anosmia, ageusia/dysgeusia, sore throat, and ocular symptoms).

Of the 190 patients identified in this cohort, 138 (69 percent) presented with at least one GI symptom at diagnosis. Excluding hyporexia or anorexia, 93 patients (48.9 percent) had at least one GI symptom. Of note, GI symptoms, particularly diarrhoea, correlated with a lower mortality. Multivariate analysis confirmed diarrhoea as an independent predictor of reduced deaths among patients with COVID-19.

“These data suggest that, in some patients, the GI tract may be more involved than the respiratory system in severe acute respiratory syndrome coronavirus 2 infection, and this could account for the less severe course of disease,” the authors said.