Gastro-intestinal symptoms are associated with a lower in-hospital mortality rate in frail older patients hospitalized for COVID-19

In the previous issue of Acta Gastro-Enterologica Belgica, a meta-analysis on the presence of gastrointestinal (GI) symptoms in patients with COVID-19 was published. (1). The pooled prevalence of GI manifestations was 12% with diarrhea being the most frequent digestive symptom (8%). Other reports show an incidence rate of diarrhea ranging from 2% to 50%. A question emerges after reading this systematic review : is the presence of these GI symptoms associated with a particular prognosis? At Cliniques universitaires Saint-Luc, we analyzed the first cohort of geriatric patients admitted for COVID-19. (2). The study population consisted of 50 consecutive patients admitted between March 11 and April 17, 2020 to the geriatric COVID-19 units of our Belgian academic hospital, with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection confirmed by reverse-transcriptase-polymerase-chainreaction (RT-PCR) (2). Another inclusion criteria was the presence of vulnerability/frailty defined by a clinical frailty scale equal or higher than 4 (2). In this cohort, GI symptoms were present in 30% of the patients at the time of COVID-19 diagnosis. We then compared the patients on the basis of intra hospital mortality (IHM), with a total IHM of 52%, and assessed the factors associated with it (2). Interestingly, GI symptoms were significantly more frequent in the patients alive at discharge than in those who died in the hospital (45.8% vs. 15.4%, p=0.02)

Keywords: COVID-19, diarrhea, coronavirus, digestive symptoms, liver, mortality prognosis.