PECULIARITIES OF LEVEL OF THE GASTROINTESTINAL TRACT IN CORONAVIRUS DISEASE (COVID-19) IN DIFFERENT WAVES OF THE PANDEMIC

Abstract

ABSTRACT. Today, patients with COVID-19 perform not only respiratory symptoms. One of the most common atypical symptoms are gastrointestinal.

The aim of the study was to evaluate the frequency of gastrointestinal symptoms in patients with coronavirus disease (COVID-19) in different waves of the pandemic in the Dnieper region.

Materials and methods. 68 patients with verified coronavirus disease (COVID-19) were examined. All of them formed the main group, which was divided into three subgroups depending on the period in which the disease developed: subgroup 1 included 19 patients (mean age – 53,1 ± 3,3 years; men - 10 (52,6%) , women - 9 (47,4%)) who were hospitalized in the period from October 2020 to January 2021; to subgroup 2 - 27 patients (average age – 57,3 ± 2,5 years, men - 12 (44,4%), women - 15 (55,6%)), who were hospitalized in the period from March to May 2021 year; to subgroup 3 - 22 patients (average age - 56.2 ± 4.7 years, men - 9 (40.9%), women - 13 (59.1%)), who were hospitalized in the period from September to November 2021 year. Examination of patients included evaluation of physical status  by clinical methods.

Results. Manifestation of gastroenterological symptoms in all patients was on average 5,3 ± 2,9 days from the onset of the disease and did not differ by subgroup (p > 0,05). Nausea was observed in almost every sixth patient and in most cases was accompanied by vomiting, with no significant difference between subgroups (p > 0,05). 6 (27,3%) patients of the 3rd subgroup complained of vomiting, which was significantly more often than in the 2nd subgroup (1 (3,7%) patients) (p = 0,020). All patients of the 1st and 2nd subgroups reported single vomiting, which brought relief and did not require medical intervention, while four patients of the 3rd subgroup (66,7%) had vomiting more than once (mean 2,5 ± 0,5 times). Abdominal pain was almost non-existent in the cohort of subjects and the frequency of symptoms did not differ significantly between subgroups (p > 0,05), it was quite strong, which disrupted the daily activities of patients. Diarrhea in subgroup 3 bothered patients significantly more often than in subgroup 2 (p = 0,013). Prolonged diarrhea was detected in patients of subgroup 3 (3,4 ± 0,7 days) than in patients of subgroup 1 (1,2 ± 0,3 days) (p < 0.0001), which required the appointment of rehydration therapy. Analysis of the combination of gastroenterological symptoms in patients with COVID-19 showed that the most common symptom was nausea or diarrhea, no difference between subgroups was found (p > 0,05).

Conclusions. Nausea, vomiting, abdominal pain and diarrhea are the most common gastrointestinal symptoms of COVID-19, and in the Dnieper region, vomiting and diarrhea were significantly more common in autumn 2021 than in spring 2021. In the presence of gastroenterological symptoms in a COVID-19 pandemic, patients must be excluded from SARS-CoV-2 infection.