Disease Course and Outcomes of COVID-19 Among Hospitalized Patients With Gastrointestinal Manifestations |
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Authors: | Monika Laszkowska Adam S. Faye Judith Kim Han Truong Elisabeth R. Silver Myles Ingram Benjamin May Benjamin Ascherman Logan Bartram Jason Zucker Magdalena E. Sobieszczyk Julian A. Abrams Benjamin Lebwohl Daniel E. Freedberg Chin Hur |
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Affiliation: | 1. Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York;3. Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York;4. Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York;5. Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York;7. Department of Medicine, Henry D. Janowitz Division of Gastroenterology, Mount Sinai Hospital, New York, New York |
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Abstract: | Background & AimsOur understanding of outcomes and disease time course of COVID-19 in patients with gastrointestinal (GI) symptoms remains limited. In this study we characterize the disease course and severity of COVID-19 among hospitalized patients with gastrointestinal manifestations in a large, diverse cohort from the Unites States.MethodsThis retrospective study evaluated hospitalized individuals with COVID-19 between March 11 and April 28, 2020 at two affiliated hospitals in New York City. We evaluated the association between GI symptoms and death, and also explored disease duration, from symptom onset to death or discharge.ResultsOf 2804 patients hospitalized with COVID-19, the 1,084 (38.7%) patients with GI symptoms were younger (aOR for age ≥75, 0.59; 95% CI, 0.45-0.77) and had more co-morbidities (aOR for modified Charlson comorbidity score ≥2, 1.22; 95% CI, 1.01-1.48) compared to those without GI symptoms. Individuals with GI symptoms had better outcomes, with a lower likelihood of intubation (aHR, 0.66; 95% CI, 0.55-0.79) and death (aHR, 0.71; 95% CI, 0.59-0.87), after adjusting for clinical factors. These patients had a longer median disease course from symptom onset to discharge (13.8 vs 10.8 days, log-rank p = .048; among 769 survivors with available symptom onset time), which was driven by longer time from symptom onset to hospitalization (7.4 vs 5.4 days, log-rank P < .01).ConclusionHospitalized patients with GI manifestations of COVID-19 have a reduced risk of intubation and death, but may have a longer overall disease course driven by duration of symptoms prior to hospitalization. |
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Keywords: | COVID-19 Mortality Gastrointestinal Disease Course aOR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0035" }," $$" :[{" #name" :" text" ," _" :" adjusted odds ratio BMI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0045" }," $$" :[{" #name" :" text" ," _" :" body mass index COVID-19" },{" #name" :" keyword" ," $" :{" id" :" kwrd0055" }," $$" :[{" #name" :" text" ," _" :" coronavirus disease 2019 GI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0065" }," $$" :[{" #name" :" text" ," _" :" gastrointestinal SARS-CoV-2" },{" #name" :" keyword" ," $" :{" id" :" kwrd0075" }," $$" :[{" #name" :" text" ," _" :" severe acute respiratory syndrome coronavirus 2 |
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