Keerthiga Sivakumar, MD, Aaron Douen, MD, Justin Wagner, DO, Nikolas St. Cyr, MD, John Trillo, MD Coney Island Hospital, Brooklyn, NY
Introduction: The Covid-19 virus has been postulated to interact with Angiotensin-converting enzyme 2 (ACE2) receptors in the gut and possibly cause malabsorption. Our study aimed to determine the incidence of diarrhea in patients hospitalized with Covid-19 and determine if there is any association in clinical outcomes.
Methods: This retrospective study included 2711 patients ages 18 years or older that were hospitalized and tested positive for SARS-COV2 from 3/1/ 2020 through 4/1/ 2021 at a public hospital in New York City. We examined baseline characteristics and comorbidities. T-test for age and Pearson’s Chi squared test for statistical analysis were used for the primary outcome of mortality and secondary outcomes of mechanical ventilation, vasopressor use and acute kidney injury.
Results: Clinical outcomes of 279 Covid-19 hospitalized patients with diarrhea was compared to 2432 patients without diarrhea. 279/2711 Covid-19 patients were positive for diarrhea (incidence of 10.3%). Overall sample characteristics included mean age in years (62.81, SD 18.40) and 64.09 (SD 19.25) (p< 0.293) for diarrhea and non-diarrhea groups, respectively. Males comprised 143 (51.3%) in the diarrhea group and 1324 (54.4%) in the non-diarrhea group (p< 0.312). Baseline characteristics and multiple comorbidities (Diabetes, Chronic Kidney Disease, Chronic Obstructive Pulmonary Disease, Heart Failure, Hypertension, and Coronary Artery Disease) were not statistically different (p >0.063) between groups. Overall mortality in the diarrhea group was 71(25.4%) and in the non-diarrhea group was 608 (25%) with odds ratio of 1.024 (0.770–1.36, p< 0.870). For secondary outcomes, we found acute kidney injury odds ratio of 1.131 (0.882 – 1.452, p< 0.332), shock requiring vasopressors odds ratio of 1.010 (0.751–1.358, p< 0.948), and mechanical ventilation odds ratio of 1.150 (0.849 – 1.556, (p< 0.366).
Discussion: Baseline characteristics and comorbidities were not different in patients with and without diarrhea. Even though diarrhea is prevalent in Covid-19 patients, our data suggests that there is no statistically significant difference in primary outcome of mortality and secondary outcomes of AKI, Vasopressor use, and Mechanical ventilation. These findings could be due to small sample size and future research with a larger population is needed. However, patients should still be treated with supportive care for symptomatic relief.
Keerthiga Sivakumar indicated no relevant financial relationships.
Aaron Douen indicated no relevant financial relationships.
Justin Wagner indicated no relevant financial relationships.
Nikolas St. Cyr indicated no relevant financial relationships.
John Trillo indicated no relevant financial relationships.
Keerthiga Sivakumar, MD, Aaron Douen, MD, Justin Wagner, DO, Nikolas St. Cyr, MD, John Trillo, MD. P0149 - The Unusual COVID-19 Symptom: Diarrhea in Hospitalized Patients, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.