Published online Jun 26, 2021. doi: 10.12998/wjcc.v9.i18.4654
Peer-review started: January 5, 2021
First decision: January 27, 2021
Revised: February 4, 2021
Accepted: March 29, 2021
Article in press: March 29, 2021
Published online: June 26, 2021
Processing time: 156 Days and 10.4 Hours
Coronavirus disease 2019 (COVID-19) and associated gastrointestinal symptoms (GI) in patients from different regions of Iran have not been reported, and this has major implications for GI related health and comorbidities.
The key issues are whether the outcome of COVID-19 and GI manifestations is different across regions of Iran.
To obtain a full understanding of GI manifestations in COVID-19 patients.
We analyzed data from severe acute respiratory syndrome coronavirus 2 positive patients admitted at four hospitals in Iran (n = 91), including South, Southeast, North, and Northwest, between April and September 2020. Demographics, comorbidities, and clinical findings including GI symptoms were collected.
The average age of COVID-19 patients was 51.1 years, and 56% were male. Mortality rate was 17%. Cough with 84.6%, shortness of breath with 71.4%, fever with 52.7%, and loss of appetite with 43.9% were the main symptoms. Overall, cardiac disease was the most common comorbidity with an average of 28.5%, followed by hypertension (28.5%) and diabetes (25.2%). The highest comorbidity in North (Rasht) was diabetes (30%) and in South was (Dezful) hypertension (37%). Shiraz leads cardiac disease with 43.4%. The most reported GI symptoms included nausea, diarrhea, vomiting, and abdominal pain, with 42.8%, 31.8%, 26.8%, and 12% prevalence, respectively. In addition, albumin, alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase were elevated in 26.3%.
Our results show hypertension and diabetes as the most common comorbidities, but their distribution was different in COVID-19 patients in the four studied regions of Iran. Nausea, diarrhea, and elevated liver enzymes were the most common GI findings. There was also a high mortality rate that was associated with high infection rates in Iran at the beginning of the pandemic. GI manifestations and liver function markers should be monitored in COVID-19 patients.
Larger long-term prospective studies and predictive factors for duration and follow-up of GI symptoms in COVID-19 should be performed in future studies.