P1228 (S0582). - Prevalence of GI Symptoms in COVID-19 Patients and Their Impact on Clinical Outcomes, from the Epicenter of COVID-19: Multicenter Study of Academic Centers in Brooklyn

Award: Fellows-in-Training Award (General Endoscopy Category)

Award: Presidential Poster Award

Muhammad H. Bashir, MD¹, Mohammad Nawaz, MD², Melis Celdir, MD³, Daria Yunina, MD⁴, Firas Al-Ani, MD³, Brooks R. Crowe, MD², Benjamin S. Silver, MD⁵, Nealansh E. Gupta, DO⁶, Malav P. Parikh, MD¹, Tanuj Chokshi, DO⁶, Evan B. Grossman, MD⁶, Cherif El Younis, MD⁷, Yuriy Tsirlin, MD, FACG⁴, Rajesh Veluvolu, MS, MD⁸, Shivakumar Vignesh, MD¹; ¹SUNY Downstate Health Sciences University, Brooklyn, NY; ²State University of New York Downstate, Brooklyn, NY; ³State University of New York Downstate Medical Center, Brooklyn, NY; ⁴Maimonides Medical Center, Brooklyn, NY; ⁵State University of New York Health Sciences University Hospital, Brooklyn, NY; ⁶SUNY Downstate Medical Center, Brooklyn, NY; ⁷Brookdale University Hospital, Brooklyn, NY; ⁸Kings County Hospital Center, Brooklyn, NY

Introduction: SARS-CoV-2 has infected more than 2.12 million people in United States. GI symptoms have frequently been reported in association with COVID-19. Studies have reported prevalence and impact of GI symptoms on COVID-19 outcomes with marked variability in different regions of the world. We investigated the association of GI symptoms with clinical characteristics and mortality in COVID-19 in a diverse multiethnic population in Brooklyn, NY.

Methods: We performed a retrospective study of patients who were positive for SARS-CoV2 and were admitted from 04/01/20 through 04/15/20 at four academic medical centers in Brooklyn. We collected data on COVID-19 symptoms, medical comorbidities, clinical outcomes and GI symptoms at presentation including nausea, vomiting, diarrhea, abdominal pain, anorexia, and GI bleeding (table 1). We compared length of hospital stay, ICU admission rate, and all-cause mortality in patients with GI symptoms at presentation (Group A) with patients who did not have any GI symptoms (Group B). Charlson Comorbidity Index (CCI) was used to account for comorbid conditions and CURB65 score for pneumonia severity. Groups were compared with Wilcoxon Rank Sum, Chi-Square and Fisher’s exact test. Logistic regression was used to evaluate the association of GI symptom at presentation with all-cause mortality.

Results: Of the total of 680 patients included, 48.9% were black, average age was 66.8 years, no significant difference in gender distribution, and mean BMI for the cohort was 30.27 kg/m² Table 1). 36.02% of patients had at least one GI symptom at presentation. Most common presenting GI symptom was anorexia (19.7%) followed by diarrhea (13%) and nausea (7.2%). Baseline mean CCI score for group A and B were 3.50 and 3.85 respectively (p=0.11). CURB65 score at presentation was lower in Group A (mean 1.61) compared to Group B (mean 1.83) (p = 0.028). There was no significant difference in ICU care requirements between the groups (17.6% (A) vs. 21.8% (B), p=0.18). Group A had slightly longer mean length of hospital stay 8.85 vs. 8.30 days (group B), (p=0.07).  When adjusted for age, BMI, ethnicity, sex and pneumonia severity index, presence of a GI symptom at presentation was not associated with mortality (OR 0.8; 95% CI: 0.55, 1.16; p = 0.24

Discussion: In hospitalized COVID-19 patients, presence of GI symptoms at presentation was not associated with higher mortality. Patients without a GI symptom presented with higher pneumonia severity.


Table 1. Demographic and baseline characteristics of the patients


Table 2. GI symptom prevalence at presentation


Graph 1. GI specific symptoms at presentation

Disclosures:
Muhammad Bashir indicated no relevant financial relationships.
Mohammad Nawaz indicated no relevant financial relationships.
Melis Celdir indicated no relevant financial relationships.
Daria Yunina indicated no relevant financial relationships.
Firas Al-Ani indicated no relevant financial relationships.
Brooks Crowe indicated no relevant financial relationships.
Benjamin Silver indicated no relevant financial relationships.
Nealansh Gupta indicated no relevant financial relationships.
Malav Parikh indicated no relevant financial relationships.
Tanuj Chokshi indicated no relevant financial relationships.
Evan Grossman indicated no relevant financial relationships.
Cherif El Younis indicated no relevant financial relationships.
Yuriy Tsirlin indicated no relevant financial relationships.
Rajesh Veluvolu indicated no relevant financial relationships.
Shivakumar Vignesh indicated no relevant financial relationships.