Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19

Introduction: Gastrointestinal and hepatic symptoms may be seen before respiratory symptoms in Coronavirus disease 2019 (COVID 19). The purpose of the present study was to evaluate the relationship between liver damage and observed symptoms and laboratoryparameters. Materials and Methods: Patients followed-up with diagnoses of COVID-19 between March and August 2020 were included in thestudy. Clinical characteristics and laboratory parameters were compared according to liver damage status. Results: Four hundred and thirteen COVID-19 cases were included. The prevalence of gastrointestinal symptoms was 19.8%, the mostcommon being nausea/vomiting, abdominal pain, and diarrhea (10.4%, 6.1%, and 2.9%, respectively). CT-confirmed pneumonia,intensive care requirement, and mean length of hospitalization differed significantly depending on liver damage status (p< 0.001, p=0.006, p= 0.002, respectively). Significant differences were determined between the groups with and without liver damage in terms ofall the laboratory parameters examined, apart from white blood cell, neutrophil, lymphocyte, neutrophil:lymphocyte ratio (NLR), totalbilirubin, and partial thromboplastin time (PTT) (p< 0.05). Significant associations were present between alanine aminotransferase lev els and all other laboratory parameters apart from NLR and PTT (p< 0.001). Aspartate aminotransferase (OR: 1.22, CI: 1.16-1.28) andalbumin (OR: 2.28, CI: 1.12-4.63) were identified as significant independent risk factors for liver damage in patients with COVID-19. Conclusion: Gastrointestinal symptoms are not uncommon in COVID-19 patients. Liver damage may be associated with progressionto intensive care and systemic inflammation.

Anahtar Kelime:

COVID-19’lu Hastalarda Gastrointestinal Semptomlar ve Karaciğer Hasarı

Öz:

Giriş: Küresel pandemiye neden olan koronavirüs hastalığı 2019 (COVID-19) sıklıkla ateş, öksürük ve nefes darlığı ile kendini göstermek tedir. Gastrointestinal şikayetler ve hepatik belirtiler solunum belirtilerinden önce görülebilir. Çalışmamızda karaciğer hasarı ile gözlenensemptom ve laboratuvar parametreleri arasındaki ilişkiyi değerlendirmeyi amaçladık. Materyal ve Metod: Mart-Ağustos 2020 tarihleri arasında COVID-19 tanısıyla takip edilen hastalar çalışmaya dahil edildi. Karaciğerhasar durumuna göre klinik özellikleri ve laboratuvar parametreleri karşılaştırıldı. Bulgular: Çalışmaya toplamda 413 COVID-19 vakası dahil edildi. Gastrointestinal semptom sıklığı %19.8 olup; en sık gastrointestinalsemptomlar bulantı/kusma, karın ağrısı ve ishal (sırasıyla %10.4, %6.1 ve %2.9) idi. Karaciğer hasarı olan ve karaciğer hasarı olmayanvakalar arasında karın ağrısı hariç (p= 0.015) diğer semptomların tamamı benzer dağılım gösteriyordu (p> 0.05). CT ile doğrulanmışpnömoni, yoğun bakım gereksinimi ve ortalama hastanede kalış süresi, karaciğer hasar durumuna bağlı olarak anlamlı farklılık gösterdi(sırasıyla p< 0.001, p= 0.006, p= 0.002). Takipleri sırasında karaciğer hasarı olan hastaların %9.6’sında, karaciğer hasarı olmayan ların ise %3.1’inde yoğun bakım ihtiyacı doğmuştu (p= 0.006). Hastaların karaciğer hasarına göre hastanede yatış süresi dağılımlarıarasında anlamlı fark vardı (p= 0.002). Karaciğer hasarı bulunan ve bulunmayan hastalar arasında beyaz kan hücresi, nötrofil, len fosit, nötrofil-lenfosit oranı (NLR), total bilurubin ve parsiyel tromboplastin zamanı (PTT) hariç değerlendirilen diğer tüm laboratuvarparametreleri açısından anlamlı fark bulunuyordu (p< 0.05). Hastalarda alanin aminotransferaz düzeyleri ile NLR ve PTT hariç diğerlaboratuvar parametreleri arasında anlamlı ilişkiler söz konusuydu (p< 0.001). COVID-19’lu hastalarda karaciğer hasarı üzerinde aspar tat aminotransferaz (OR: 1.22, CI: 1.16-1.28) ve albumin (OR: 2.28, CI: 1.12-4.63) anlamlı bağımsız risk faktörleri olarak belirlendi. Sonuç: COVID-19’lu hastalarda gastrointestinal şikayetler nadir değildir. Karaciğer hasarı yoğun bakıma gidişle ve sistemik inflamas yonla ilişkili olabilir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Alay H, CAN F, YILMAZ S, ALBAYRAK A, ÖZKURT Z, OZDEN K, PARLAK E, TEKİN E, KOÇAK A (2021). Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19. , 249 - 256. 10.5578/flora.20219801
Chicago	Alay Handan,CAN Fatma KESMEZ,YILMAZ Sinan,ALBAYRAK AYŞE,ÖZKURT Zülal,OZDEN KEMALETTIN,PARLAK Emine,TEKİN Erdal,KOÇAK Abdullah Osman Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19. (2021): 249 - 256. 10.5578/flora.20219801
MLA	Alay Handan,CAN Fatma KESMEZ,YILMAZ Sinan,ALBAYRAK AYŞE,ÖZKURT Zülal,OZDEN KEMALETTIN,PARLAK Emine,TEKİN Erdal,KOÇAK Abdullah Osman Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19. , 2021, ss.249 - 256. 10.5578/flora.20219801
AMA	Alay H,CAN F,YILMAZ S,ALBAYRAK A,ÖZKURT Z,OZDEN K,PARLAK E,TEKİN E,KOÇAK A Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19. . 2021; 249 - 256. 10.5578/flora.20219801
Vancouver	Alay H,CAN F,YILMAZ S,ALBAYRAK A,ÖZKURT Z,OZDEN K,PARLAK E,TEKİN E,KOÇAK A Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19. . 2021; 249 - 256. 10.5578/flora.20219801
IEEE	Alay H,CAN F,YILMAZ S,ALBAYRAK A,ÖZKURT Z,OZDEN K,PARLAK E,TEKİN E,KOÇAK A "Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19." , ss.249 - 256, 2021. 10.5578/flora.20219801
ISNAD	Alay, Handan vd. "Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19". (2021), 249-256. https://doi.org/10.5578/flora.20219801

APA	Alay H, CAN F, YILMAZ S, ALBAYRAK A, ÖZKURT Z, OZDEN K, PARLAK E, TEKİN E, KOÇAK A (2021). Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 26(2), 249 - 256. 10.5578/flora.20219801
Chicago	Alay Handan,CAN Fatma KESMEZ,YILMAZ Sinan,ALBAYRAK AYŞE,ÖZKURT Zülal,OZDEN KEMALETTIN,PARLAK Emine,TEKİN Erdal,KOÇAK Abdullah Osman Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi 26, no.2 (2021): 249 - 256. 10.5578/flora.20219801
MLA	Alay Handan,CAN Fatma KESMEZ,YILMAZ Sinan,ALBAYRAK AYŞE,ÖZKURT Zülal,OZDEN KEMALETTIN,PARLAK Emine,TEKİN Erdal,KOÇAK Abdullah Osman Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, vol.26, no.2, 2021, ss.249 - 256. 10.5578/flora.20219801
AMA	Alay H,CAN F,YILMAZ S,ALBAYRAK A,ÖZKURT Z,OZDEN K,PARLAK E,TEKİN E,KOÇAK A Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi. 2021; 26(2): 249 - 256. 10.5578/flora.20219801
Vancouver	Alay H,CAN F,YILMAZ S,ALBAYRAK A,ÖZKURT Z,OZDEN K,PARLAK E,TEKİN E,KOÇAK A Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi. 2021; 26(2): 249 - 256. 10.5578/flora.20219801
IEEE	Alay H,CAN F,YILMAZ S,ALBAYRAK A,ÖZKURT Z,OZDEN K,PARLAK E,TEKİN E,KOÇAK A "Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19." Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 26, ss.249 - 256, 2021. 10.5578/flora.20219801
ISNAD	Alay, Handan vd. "Gastrointestinal Symptoms and Liver Damage inPatients with COVID-19". Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi 26/2 (2021), 249-256. https://doi.org/10.5578/flora.20219801