P3380 - Prolonged COVID-19 Associated Gastrointestinal Manifestations

Ivan Berezowski, MD¹, Adam Jacob, DO², Giancarlo Rosa, MD², Jacob T. Newman, DO³, Justin Canakis, DO¹, Adam Horowitz, MD², Junseo B. Lee, MD¹, Ankit Patel, MD¹, Valeria Martinez Lebron, MD¹, Reid Schalet, DO², Seta Degann, MD¹, Chukwunonyelum Ekwempu, MD¹, Zeina Bani Hani, MBBS¹, Samuel A. Schueler, MD², Marie L. Borum, MD, EdD, MPH^4
1George Washington University School of Medicine and Health Sciences, Washington, DC; ²George Washington University Hospital, Washington, DC; ³George Washington University, Washington, DC; ⁴George Washington University Medical Center, Washington, DC

Introduction: COVID-19 is characterized by respiratory manifestations but often includes gastrointestinal (GI) symptoms. Most available data analyze patients requiring hospitalization. However, patients with less severe initial disease may have prolonged GI symptoms. We aimed to analyze and compare acute and prolonged GI symptoms in patients with COVID-19 who did and did not require initial hospitalization.

Methods: An IRB-approved, retrospective cohort study was performed on patients with persistent symptoms after acute COVID-19 infection. Data were abstracted from clinical history prior to COVID-19 diagnosis, during acute COVID-19, and the post-acute phase. Statistical analyses were conducted for numerical variables by comparing lab values stratified by hospitalization status. Mann-Whitney two-tailed t-tests, and Dunn's multiple comparison tests were completed. Percentages of participants reporting "Yes" or "No" were compared for categorical variables, using the same stratifications as for numerical variables.

Results: Out of approximately 300 patients evaluated in our COVID-19 Recovery Clinic, 209 reported GI symptoms. Of those reporting GI symptoms,126 (60.3%) were female, 108 (51.7%) were White and 22 (10.5%) were African-American. A majority (89%) were not hospitalized during acute infection. Among non-hospitalized patients, 18.18% reported nausea, 6.42% reported vomiting and 12.3% reported abdominal pain during the acute phase, compared to 9.09%, 4.55% and 22.73%, respectively, of hospitalized patients. Hospitalized patients had initially higher levels of aspartate transaminase (AST) and inflammatory marker compared to non-hospitalized patients, but levels were similar in the prolonged phase. In the prolonged phase, non-hospitalized patients had higher rates of nausea (8.02%) and abdominal pain (12.3%) compared to hospitalized patients (4.55% and 4.55%) (Table 1).

Discussion: We identified 209 patients who described GI symptoms during acute COVID-19 infection, or in the prolonged phase up to 15 months after. While hospitalized patients initially had more severe abdominal pain and lab abnormalities, rates of nausea and vomiting were higher initially in non-hospitalized patients. Interestingly, in the prolonged phase, rates of nausea and abdominal pain were higher in the non-hospitalized group. These data emphasize the importance of recognizing history of even mild COVID-19 infections as possibly contributing to chronic gastrointestinal symptoms.


Disclosures:


Ivan Berezowski, MD¹, Adam Jacob, DO², Giancarlo Rosa, MD², Jacob T. Newman, DO³, Justin Canakis, DO¹, Adam Horowitz, MD², Junseo B. Lee, MD¹, Ankit Patel, MD¹, Valeria Martinez Lebron, MD¹, Reid Schalet, DO², Seta Degann, MD¹, Chukwunonyelum Ekwempu, MD¹, Zeina Bani Hani, MBBS¹, Samuel A. Schueler, MD², Marie L. Borum, MD, EdD, MPH⁴. P3380 - Prolonged COVID-19 Associated Gastrointestinal Manifestations, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.