Clinical Characteristics of COVID-19 Patients with Digestive Symptoms: A Retrospective Study from Dakar, Senegal

Abstract

Introduction: As of February 2022, coronavirus disease 2019 (COVID-19) has caused a pandemic affecting all countries, with a total of 399 million patients and 5 million deaths. The lungs are the major organs involved in COVID-19. COVID-19 infection is not limited to the respiratory system but can affect multiple organs including the gastrointestinal tract. The aim of our study was to assess the prevalence of gastrointestinal (GI) symptoms on admission in patients with COVID-19 and their association with adverse outcomes, including mortality. Methods: In a retrospective study, we examined medical record data from patients with SARS-CoV-2 infection admitted to epidemic treatment center of hospital Aristide Le Dantec, Dakar (Senegal) between May 1, 2020, and June 31, 2021. SARS-CoV-2 infection was diagnosed by real-time polymerase chain reaction on nasopharyngeal and throat swabs. We included all patients with SARS-CoV-2 infection and GI symptoms. Result: The study identified 472 hospitalized patients with confirmed SARS-CoV-2 infection during the study period. We recruited 222 patients with gastrointestinal symptoms. The mean age of patients with GI symptoms was 56 years [17 - 90 years], and 54.9% were male. Patients with GI symptoms had comorbidities in 66.2% of cases. Hypertension, diabetes mellitus and chronic kidney disease were the most common comorbidities at 29.3%, 23.9%, and 6.7%, respectively. Patients with GI had cough in 69.4%, shortness of breath in 61.7%, ageusia in 57.6%, and fever in 53.1%. At presentation among patients with GI symptoms, 32.4% had mild disease, 27.5% had moderate disease, and 40.1% had severe disease. The prevalence of digestive manifestations was 47%, and the main digestive manifestations were nausea (27%), diarrhea (17.1%), abdominal pain (17.1%) and vomiting (14.4%). GI symptoms such as abdominal pain, diarrhea, and vomiting were more common in those with hypertension (45%) and those with diabetes (43%). Conclusion: Gastrointestinal symptoms are common in patients with COVID-19. During a pandemic, patients with GI symptoms should be considered for SARS-CoV-2 infection.