Prevalence of Gastrointestinal Symptoms in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Results of the Prospective Controlled Multinational GI-COVID-19 Study

none66siG.B. contribution to this research was permitted in part by funding from Fondazione Cassa di Risparmio in Bologna; the ItalianMinistry of Education, University and Research; and Fondazione del Monte di Bologna e Ravenna and European Grant H2020, DISCOvERIE, SC1-BHC-01-2019. M.R.B. is a recipient of a grant from the Italian Ministry of Health (Ricerca Finalizzata GR-2018-12367062).Introduction: Gastrointestinal (GI) symptoms in coronavirus-19 disease (COVID-19) have been reported with great variability and without standardization. In hospitalized patients, we aimed to evaluate the prevalence of GI symptoms, factors associated with their occurrence, and variation at 1 month. Methods: The GI-COVID-19 is a prospective, multicenter, controlled study. Patients with and without COVID-19 diagnosis were recruited at hospital admission and asked for GI symptoms at admission and after 1 month, using the validated Gastrointestinal Symptom Rating Scale questionnaire. Results: The study included 2036 hospitalized patients. A total of 871 patients (575 COVID+ and 296 COVID-) were included for the primary analysis. GI symptoms occurred more frequently in patients with COVID-19 (59.7%; 343/575 patients) than in the control group (43.2%; 128/296 patients) (P < 0.001). Patients with COVID-19 complained of higher presence or intensity of nausea, diarrhea, loose stools, and urgency as compared with controls. At a 1-month follow-up, a reduction in the presence or intensity of GI symptoms was found in COVID-19 patients with GI symptoms at hospital admission. Nausea remained increased over controls. Factors significantly associated with nausea persistence in COVID-19 were female sex, high body mass index, the presence of dyspnea, and increased C-reactive protein levels. Discussion: The prevalence of GI symptoms in hospitalized patients with COVID-19 is higher than previously reported. Systemic and respiratory symptoms are often associated with GI complaints. Nausea may persist after the resolution of COVID-19 infection.mixedmixedMarasco, Giovanni; Cremon, Cesare; Barbaro, Maria Raffaella; Salvi, Daniele; Cacciari, Giulia; Kagramanova, Anna; Bordin, Dmitry; Drug, Vasile; Miftode, Edgidia; Fusaroli, Pietro; Mohamed, Salem Youssef; Ricci, Chiara; Bellini, Massimo; Rahman, M Masudur; Melcarne, Luigi; Santos, Javier; Lobo, Beatriz; Bor, Serhat; Yapali, Suna; Akyol, Deniz; Sapmaz, Ferdane Pirincci; Urun, Yonca Yilmaz; Eskazan, Tugce; Celebi, Altay; Kacmaz, Huseyin; Ebik, Berat; Binicier, Hatice Cilem; Bugdayci, Mehmet Sait; Yağcı, Munkhtsetseg Banzragch; Pullukcu, Husnu; Kaya, Berrin Yalınbas; Tureyen, Ali; Hatemi, İbrahim; Koc, Elif Sitre; Sirin, Goktug; Calıskan, Ali Riza; Bengi, Goksel; Alıs, Esra Ergun; Lukic, Snezana; Trajkovska, Meri; Hod, Keren; Dumitrascu, Dan; Pietrangelo, Antonello; Corradini, Elena; Simren, Magnus; Sjolund, Jessica; Tornkvist, Navkiran; Ghoshal, Uday C; Kolokolnikova, Olga; Colecchia, Antonio; Serra, Jordi; Maconi, Giovanni; De Giorgio, Roberto; Danese, Silvio; Portincasa, Pietro; Di Stefano, Michele; Maggio, Marcello; Philippou, Elena; Lee, Yeong Yeh; Venturi, Alessandro; Borghi, Claudio; Zoli, Marco; Gionchetti, Paolo; Viale, Pierluigi; Stanghellini, Vincenzo; Barbara, GiovanniMarasco, Giovanni; Cremon, Cesare; Barbaro, Maria Raffaella; Salvi, Daniele; Cacciari, Giulia; Kagramanova, Anna; Bordin, Dmitry; Drug, Vasile; Miftode, Edgidia; Fusaroli, Pietro; Mohamed, Salem Youssef; Ricci, Chiara; Bellini, Massimo; Rahman, M Masudur; Melcarne, Luigi; Santos, Javier; Lobo, Beatriz; Bor, Serhat; Yapali, Suna; Akyol, Deniz; Sapmaz, Ferdane Pirincci; Urun, Yonca Yilmaz; Eskazan, Tugce; Celebi, Altay; Kacmaz, Huseyin; Ebik, Berat; Binicier, Hatice Cilem; Bugdayci, Mehmet Sait; Yağcı, Munkhtsetseg Banzragch; Pullukcu, Husnu; Kaya, Berrin Yalınbas; Tureyen, Ali; Hatemi, İbrahim; Koc, Elif Sitre; Sirin, Goktug; Calıskan, Ali Riza; Bengi, Goksel; Alıs, Esra Ergun; Lukic, Snezana; Trajkovska, Meri; Hod, Keren; Dumitrascu, Dan; Pietrangelo, Antonello; Corradini, Elena; Simren, Magnus; Sjolund, Jessica; Tornkvist, Navkiran; Ghoshal, Uday C; Kolokolnikova, Olga; Colecchia, Antonio; Serra, Jordi; Maconi, Giovanni; De Giorgio, Roberto; Danese, Silvio; Portincasa, Pietro; Di Stefano, Michele; Maggio, Marcello; Philippou, Elena; Lee, Yeong Yeh; Venturi, Alessandro; Borghi, Claudio; Zoli, Marco; Gionchetti, Paolo; Viale, Pierluigi; Stanghellini, Vincenzo; Barbara, Giovann