Do Gastrointestinal Symptoms in COVID-19 Patients Correlate with Disease Severity?

Background: Apart from the respiratory tract symptoms, patients with COVID-19 infection may be either asymptomatic or present with Gastrointestinal (GI) symptoms. However, it is not known whether the presence of GI symptoms has any prognostic value or their presence is associated with poor disease outcomes in COVID-19 patients. Objective: To determine the prevalence of GI symptoms and their correlation with disease severity and outcome in patients with COVID-19. Methods: A hospital-based controlled study. Results: The number of valid cases was 444 with a mean age of 46 ± 18.6 (range, 18-80 years). One hundred and twenty (27%) patients presented with GI symptoms alone and 12% of patients were asymptomatic. Throughout illness, 304 (68.4%) patients developed GI symptoms. Diarrhea was the most common GI symptom (34.2%), followed by loss of appetite (33%) and loss of taste (28.8%), and tongue ulcers (14.6%). There was a significant difference (Chi-square tests, p=0.006) in COVID-19 severity between patients with and without GI symptoms. Oxygen supplementation was required in 174 (39.2%) patients, mechanical ventilation was required in 34 (7.7%). The mean stay in the Intensive Care Unit (ICU) was 13.5 ± 7.4days. The mean duration of oxygen therapy was 10.4 ± 6.4 days and the mean duration of mechanical ventilation was 10.8±4.7days. There was a significant difference in outcome between patients with and without GI symptoms (Chi-square tests, p=0.033). Conclusion: The presence of GI symptoms does correlate with COVID-19 disease severity. However, their impact on clinical outcome and mortality needs further evaluation.