Gastrointestinal Manifestations and Liver Abnormalities in COVID-19: A Real-World Experience and a Novel COVID-19 Prognostic Index
Introduction: Gastrointestinal (GI) manifestations and liver function abnormalities have been reported in Coronavirus Disease-2019 (COVID-19). However, data is variable and lacking from the Indian Population. Moreover, the prognostic implication of these manifestations has not been well-defined...
Main Authors: | , , , , , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2023-07-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://www.jcdr.net/articles/PDF/18170/61458_CE[Ra1]_F(IS)_PF1_(HB_OM)_PFA(HB_KM)_PN(KM).pdf |
Summary: | Introduction: Gastrointestinal (GI) manifestations and liver
function abnormalities have been reported in Coronavirus
Disease-2019 (COVID-19). However, data is variable and lacking
from the Indian Population. Moreover, the prognostic implication
of these manifestations has not been well-defined
Aim: To determine the impact of COVID-19, on the gastrointestinal
tract and Liver Function Test (LFT) and develop a prognostic
model for mortality
Materials and Methods: An observational descriptive study
was conducted in the Department of Internal Medicine
at a temporary dedicated COVID-19 centre in a Tertiary
Care Cardiothoracic Centre, Western Maharashtra, India.
The hospital records of all the patients admitted from July
2020 to September 2020 were analysed. Clinical details
and laboratory details were obtained from 589 Reverse
Transcription– Polymerase Chain Reaction (RT-PCR) confirmed
patients. The data was analysed and a prognostic scoring
system was developed. Patients with positive Severe Acute
Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RT-PCR
on nasopharyngeal or oropharyngeal swabs. The data was
entered in Microsoft Excel 2010 worksheet and t-test or
Mann-Whitney test was also applied to compare the mean of
variables being studied by separation of living and deceased
patients based on the normality of the quantitative data.
Results: The mean age±SD of the study participants was
44.74±19.61 years. The majority {127/589 (21.56 %)} of the
patients were in the age group of 51-60 years. A total of 5 (0.84%)
out of 589 patients had diarrhoea, and 3 (0.51%) had vomiting
at the time of admission. Elevated Aspartate Aminotransferase
(AST), Alanine Transaminase (AST), Alkaline Phosphatase (ALP),
Gamma-glutamyl Transferase (GGT), Lactate Dehydrogenase
(LDH), Creatine Kinase Myocardial Band (CK-MB) was reported
in non survivors in 45 (90%), 39 (78%), 15 (30%), 28 (56%), 48
(96%) and 49 (98%) out of 50 cases, respectively. The prognostic
scoring system was developed with the following variables: age,
Diabetes Mellitus (DM), symptomatic, breathlessness, albumin,
AST, ALP, LDH, Prothrombin Time (PT), D-Dimer. The area under
the curve, came out to be 0.91 and a cut-off value of three in
the scoring system was able to predict death at a sensitivity of
85.5% and specificity of 79.6%.
Conclusion: Gastrointestinal manifestations and abnormalities
in LFTs are important extrapulmonary manifestations of COVID19. Patients with abnormal liver tests had higher risks of
progressing to severe disease. Hence, LFT should be monitored
and evaluated frequently during hospitalisation for COVID-19. |
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ISSN: | 2249-782X 0973-709X |