Be Vigilant for GI and Hepatic Symptoms in Patients Who Could Have Been Exposed to COVID-19

Gastrointestinal complaints and hepatic symptoms are more common in patients ultimately diagnosed with COVID-19 than previously thought, according to a paper to be published in the journal Gastroenterology. The research, based on retrospective study of 1,059 patients at two hospitals in New York City, reveals that 33% of patients who went on to test positive for COVID-19 had at least one GI symptom at presentation; 22% had diarrhea, 7% had abdominal pain, 16% were nauseous, and 9% reported vomiting. Patients had a mean ALT of 50 and a mean AST of 60 U/L. Further, 62% had biochemical evidence of liver injury, indicated by having at least one liver enzyme elevated. While patients with GI and liver symptoms had higher rates of hospitalization than COVID-19 patients without those symptoms (78% vs 70% for patients with GI symptoms and 87% vs 76% with liver injury), they also showed a lower risk of death (8.5% vs 16.5%). The data suggest that urgent care providers should probe patients presenting with GI symptoms for possible exposure to the virus.