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▎Editor of WuXi AppTec's content team Earlier this year, The Lancet published an important study by the Chinese team, reporting that patients discharged from Jinyintan Hospital with new crowns have long-term symptoms.
Although the new coronavirus mainly affects the lungs, many other organs are also affected, including the digestive tract.
Gastrointestinal symptoms are very common in patients with new coronary disease, and may be the only symptom, or they may appear before respiratory symptoms.
The latest issue of "The Lancet-Gastroenterology and Hepatology" published a study from the team of Professor Lan Ping of Colorectal Surgery of the Sixth Affiliated Hospital of Sun Yat-sen University, focusing on the digestive tract symptoms of patients with new coronary disease 90 days after discharge .
Screenshot source: The Lancet Gastroenterology & Hepatology This study included patients admitted to 12 hospitals in Hubei and Guangdong from January 16 to March 7, 2020 due to the new crown.
A total of 117 discharged patients (53 [45%] age ≥60 years) completed a follow-up visit (usually 1 month after discharge) and completed a telephone follow-up visit approximately 90 days after discharge.
The most common symptoms of these patients upon admission were fever (69%) and cough (66%); 17% of patients experienced dyspnea.
Gastrointestinal symptoms were recorded in 13% of patients upon admission and 42% during hospitalization.
The median time of hospitalization was 19 days.
During the hospitalization, most patients (87%) needed supplemental oxygen, 22% had reduced blood oxygen saturation, 28% were severely ill, and 24% needed ICU monitoring.
The research team defined gastrointestinal sequelae as gastrointestinal symptoms that appeared after discharge but did not appear within one month before the onset of COVID-19.
Among the 117 patients included in the study, 44% (52 cases) reported having gastrointestinal symptoms after discharge in the 90-day follow-up visit.
Of these, 51 people still had gastrointestinal symptoms 90 days after discharge, and only 1 had gastrointestinal symptoms.
Alleviated.
Among 117 patients, the most common gastrointestinal sequelae were loss of appetite (28 cases [24%]), nausea (21 cases [18%]), acid reflux (21 cases [18%]) and diarrhea (17 cases [ 15%]); less common gastrointestinal sequelae include abdominal distension (16 cases [14%]), hiccups (12 cases [10%]), vomiting (11 cases [9%]), abdominal pain (8 cases [7 %]) and bloody stools (2 cases [2%]).
65 patients with no gastrointestinal sequelae at 90 days had no gastrointestinal symptoms at the time of admission or during hospitalization.
Of the 52 patients with gastrointestinal sequelae after discharge, 15 (29%) had gastrointestinal symptoms on admission and during hospitalization, 34 (65%) had gastrointestinal symptoms during hospitalization, and 3 cases (6 %) Such symptoms only appear after discharge from the hospital.
Photo source: 123RF research team analyzed the characteristics of patients and pointed out that patients with or without gastrointestinal sequelae at 90 days of discharge are similar in age, gender, body mass index and comorbidities, and the length of hospital stay is also similar.
However, patients with gastrointestinal sequelae have higher levels of white blood cell count, neutrophil count, procalcitonin concentration, and C-reactive protein level on blood examination upon admission; blood alanine aminotransferase detected at 90 days after discharge is higher.
From the perspective of symptoms, patients with gastrointestinal sequelae also have more dyspnea (23% vs 12%) and myalgia (17% vs 11%) when admitted, but fewer severely ill patients (17% vs 37%) .
In terms of treatment, patients with gastrointestinal sequelae received less supplemental oxygen therapy during hospitalization (79% vs 94%), received more proton pump inhibitor (PPI) and corticosteroid therapy, and less received enteral nutrition therapy .
Decreased blood oxygen saturation (closely related to severe pneumonia) has been found to be associated with gastrointestinal sequelae, and this association may involve multiple organ damage mediated by hypoxia.
It should be noted that hypoxia does not only occur in patients who have difficulty breathing.
Asymptomatic hypoxemia can explain the obvious differences observed in the study.
Patients with gastrointestinal sequelae have reduced blood oxygen saturation, but they are not necessarily severe.
In terms of treatment, acid reflux is the expected result of PPI treatment.
Nutritional support during hospitalization helps to maintain life, and the reduction of gastrointestinal sequelae may also be part of the benefit.
Overall, the research team pointed out that persistent gastrointestinal symptoms emphasized that patients with new coronary disease need proper gastrointestinal management and medical resource support after they are discharged from the hospital.
Since this study is a retrospective study and lacks some blood biochemical test data, only 71% of discharged patients have enough data to be included in this analysis, and the analysis depends on the symptoms reported by patients.
Follow-up prospective studies will help better Understand the long-term gastrointestinal sequelae caused by the new coronavirus infection.
New crown research related reading "The Lancet": Six months after Jinyintan's new crown patients were discharged, 76% still had symptoms.
JAMA: "Awe" the new crown, even if it is mild, 10% of patients still have long-term symptoms after 8 months.
1/3 of new crown infections The brain health of patients is affected.
The "Lancet" sub-published 230,000 patient data "This virus is unusual".
.
.
"Nature-Medical" reviewed the new coronavirus attack on nearly 10 organ systems other than the lung among internationally renowned virologists Recruiting new crowns, facing the reflection of death: "I am more in awe of the virus" Reference materials: [1] Jingrong Weng, et al.
, (2021).
Gastrointestinal sequelae 90 days after discharge for COVID-19.
The Lancet Gastroenterology & Hepatology, DOI : https://doi.
org/10.
1016/S2468-1253(21)00076-5 Note: This article aims to introduce the progress of medical and health research, and is not a treatment plan recommendation.
If you need guidance on treatment plans, please go to a regular hospital for treatment.
Although the new coronavirus mainly affects the lungs, many other organs are also affected, including the digestive tract.
Gastrointestinal symptoms are very common in patients with new coronary disease, and may be the only symptom, or they may appear before respiratory symptoms.
The latest issue of "The Lancet-Gastroenterology and Hepatology" published a study from the team of Professor Lan Ping of Colorectal Surgery of the Sixth Affiliated Hospital of Sun Yat-sen University, focusing on the digestive tract symptoms of patients with new coronary disease 90 days after discharge .
Screenshot source: The Lancet Gastroenterology & Hepatology This study included patients admitted to 12 hospitals in Hubei and Guangdong from January 16 to March 7, 2020 due to the new crown.
A total of 117 discharged patients (53 [45%] age ≥60 years) completed a follow-up visit (usually 1 month after discharge) and completed a telephone follow-up visit approximately 90 days after discharge.
The most common symptoms of these patients upon admission were fever (69%) and cough (66%); 17% of patients experienced dyspnea.
Gastrointestinal symptoms were recorded in 13% of patients upon admission and 42% during hospitalization.
The median time of hospitalization was 19 days.
During the hospitalization, most patients (87%) needed supplemental oxygen, 22% had reduced blood oxygen saturation, 28% were severely ill, and 24% needed ICU monitoring.
The research team defined gastrointestinal sequelae as gastrointestinal symptoms that appeared after discharge but did not appear within one month before the onset of COVID-19.
Among the 117 patients included in the study, 44% (52 cases) reported having gastrointestinal symptoms after discharge in the 90-day follow-up visit.
Of these, 51 people still had gastrointestinal symptoms 90 days after discharge, and only 1 had gastrointestinal symptoms.
Alleviated.
Among 117 patients, the most common gastrointestinal sequelae were loss of appetite (28 cases [24%]), nausea (21 cases [18%]), acid reflux (21 cases [18%]) and diarrhea (17 cases [ 15%]); less common gastrointestinal sequelae include abdominal distension (16 cases [14%]), hiccups (12 cases [10%]), vomiting (11 cases [9%]), abdominal pain (8 cases [7 %]) and bloody stools (2 cases [2%]).
65 patients with no gastrointestinal sequelae at 90 days had no gastrointestinal symptoms at the time of admission or during hospitalization.
Of the 52 patients with gastrointestinal sequelae after discharge, 15 (29%) had gastrointestinal symptoms on admission and during hospitalization, 34 (65%) had gastrointestinal symptoms during hospitalization, and 3 cases (6 %) Such symptoms only appear after discharge from the hospital.
Photo source: 123RF research team analyzed the characteristics of patients and pointed out that patients with or without gastrointestinal sequelae at 90 days of discharge are similar in age, gender, body mass index and comorbidities, and the length of hospital stay is also similar.
However, patients with gastrointestinal sequelae have higher levels of white blood cell count, neutrophil count, procalcitonin concentration, and C-reactive protein level on blood examination upon admission; blood alanine aminotransferase detected at 90 days after discharge is higher.
From the perspective of symptoms, patients with gastrointestinal sequelae also have more dyspnea (23% vs 12%) and myalgia (17% vs 11%) when admitted, but fewer severely ill patients (17% vs 37%) .
In terms of treatment, patients with gastrointestinal sequelae received less supplemental oxygen therapy during hospitalization (79% vs 94%), received more proton pump inhibitor (PPI) and corticosteroid therapy, and less received enteral nutrition therapy .
Decreased blood oxygen saturation (closely related to severe pneumonia) has been found to be associated with gastrointestinal sequelae, and this association may involve multiple organ damage mediated by hypoxia.
It should be noted that hypoxia does not only occur in patients who have difficulty breathing.
Asymptomatic hypoxemia can explain the obvious differences observed in the study.
Patients with gastrointestinal sequelae have reduced blood oxygen saturation, but they are not necessarily severe.
In terms of treatment, acid reflux is the expected result of PPI treatment.
Nutritional support during hospitalization helps to maintain life, and the reduction of gastrointestinal sequelae may also be part of the benefit.
Overall, the research team pointed out that persistent gastrointestinal symptoms emphasized that patients with new coronary disease need proper gastrointestinal management and medical resource support after they are discharged from the hospital.
Since this study is a retrospective study and lacks some blood biochemical test data, only 71% of discharged patients have enough data to be included in this analysis, and the analysis depends on the symptoms reported by patients.
Follow-up prospective studies will help better Understand the long-term gastrointestinal sequelae caused by the new coronavirus infection.
New crown research related reading "The Lancet": Six months after Jinyintan's new crown patients were discharged, 76% still had symptoms.
JAMA: "Awe" the new crown, even if it is mild, 10% of patients still have long-term symptoms after 8 months.
1/3 of new crown infections The brain health of patients is affected.
The "Lancet" sub-published 230,000 patient data "This virus is unusual".
.
.
"Nature-Medical" reviewed the new coronavirus attack on nearly 10 organ systems other than the lung among internationally renowned virologists Recruiting new crowns, facing the reflection of death: "I am more in awe of the virus" Reference materials: [1] Jingrong Weng, et al.
, (2021).
Gastrointestinal sequelae 90 days after discharge for COVID-19.
The Lancet Gastroenterology & Hepatology, DOI : https://doi.
org/10.
1016/S2468-1253(21)00076-5 Note: This article aims to introduce the progress of medical and health research, and is not a treatment plan recommendation.
If you need guidance on treatment plans, please go to a regular hospital for treatment.
