Epidemiological features and consequences of COVID-19 in patients with and without gastrointestinal symptoms in southwestern Iran. A retrospective observational study

Habibollah Azarbakhsh; Leila Moftakhar; Aliasghar Valipour; Alireza Mirahmadizadeh; Hekmat Allah Moradi; Elahe Piraee

doi:10.1002/hsr2.1499

Epidemiological features and consequences of COVID-19 in patients with and without gastrointestinal symptoms in southwestern Iran. A retrospective observational study

Health Sci Rep. 2023 Sep 18;6(9):e1499. doi: 10.1002/hsr2.1499. eCollection 2023 Sep.

Authors

Habibollah Azarbakhsh¹, Leila Moftakhar², Aliasghar Valipour³, Alireza Mirahmadizadeh⁴, Hekmat Allah Moradi⁵, Elahe Piraee⁶

Affiliations

¹ Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran.
² Department of Public Health, Student Research Committee Shiraz University of Medical Sciences Shiraz Iran.
³ Department of Public Health Abadan Faculty of Medical Sciences Abadan Iran.
⁴ Department of Epidemiology, Non-communicable Diseases Research Center Shiraz University of Medical Sciences Shiraz Iran.
⁵ Department of Disaster and Emergency Health, Health Human Resources Research Center, School of Health Management and Information Sciences Shiraz University of Medical Sciences Shiraz Iran.
⁶ Department of Public Health Social Determinants of Health Research Center, Yasuj University of Medical Sciences Yasuj Iran.

Abstract

Background and aims: Some studies have shown that in addition to respiratory symptoms, gastrointestinal (GI) manifestations reported in patients with coronavirus disease 2019 (COVID-19). The aim of this study was to compare the epidemiological features and consequences of COVID-19 in patients with and without GI symptoms.

Methods: This retrospective observational study concluded on 15,323 COVID-19 patients with GI symptoms and 95,724 patients without symptoms. All symptoms and comorbidities of the patients collected. To investigate the differences between qualitative variables in the two groups, χ ² test was used. Logistic regression analysis also used to identify determinants of mortality in patients with COVID-19.

Results: During the course of the study, 111,047 cases of COVID-19 occurred. Of these, 13.8% of patients had GI symptoms, and 9.9% of deaths due to COVID-19 occurred in these patients. The most common reported GI symptoms among COVID-19 patients were nausea, vomiting, and diarrhea. In addition, comorbidities, such as diabetes, cardiovascular disease, and thyroid disease were significantly higher in patients with GI symptoms. The result of multiple logistic regression showed that the chance of mortality is higher in a patient with COVID-19 who have dyspnea, fever, cough, hypertension, cardiovascular disease, diabetes, immunodeficiency, chronic kidney disease, thyroid disease, chronic pulmonary disease, and male gender. The chance of death was lower in people with GI symptoms.

Conclusion: According to the findings of this study, nausea, vomiting, and diarrhea were the most common GI symptoms. Also, the chance of death is higher in people with co-morbidities such as cardiovascular diseases, diabetes, and high blood pressure. Therefore, it is necessary to follow these people closely.

Keywords: COVID‐19; Iran; epidemiology; gastrointestinal symptoms; mortality.