未经证实:胃肠道(GI)症状是2019年冠状病毒病(COVID-19)的公认表现。我们的主要目标是评估胃肠道症状与COVID-19严重程度之间的关系。
未经授权:在这个全国性的美国退伍军人队伍中,我们评估了SARS-CoV-2检测阳性前30天报告的胃肠道症状(恶心/呕吐/腹泻),包括检测阳性日期(2020年3月1日至2021年2月20日).所有患者均有≥1年的基线数据和≥60天的随访相对于测试日期。我们使用倾向评分(PS)加权来平衡具有与没有胃肠道症状的患者的协变量。主要复合结局是严重的COVID-19,定义为住院,重症监护室入院,机械通气,或在阳性检测60天内死亡。
未经批准:在218,045名SARS-CoV-2阳性患者中,29,257(13.4%)有胃肠道症状。PS加权后,所有协变量均平衡.在PS加权队列中,有胃肠道症状的患者与无胃肠道症状的患者发生严重COVID-19的频率更高(29.0%vs17.1%;P<.001).仅限于住院患者(14.9%;n=32,430),与没有症状的患者相比,有胃肠道症状的患者接受重症监护病房和机械通气的频率相似.存在显著的年龄交互作用;在70岁以上的住院患者中,与无胃肠道症状的患者相比,COVID-19相关死亡率较低,即使在考虑了COVID-19特定的药物治疗之后。
UNASSIGNED:在美国最大的综合医疗保健系统中,有胃肠道症状的SARS-CoV-2阳性患者比没有症状的患者更容易出现严重的COVID-19结果。关于COVID-19相关胃肠道症状的其他研究可能会为减少严重COVID-19的预防工作和干预提供信息。
UNASSIGNED: Gastrointestinal (GI) symptoms are well-recognized manifestations of coronavirus disease 2019 (COVID-19). Our primary objective was to evaluate the association between GI symptoms and COVID-19 severity.
UNASSIGNED: In this nationwide cohort of US veterans, we evaluated GI symptoms (nausea/vomiting/diarrhea) reported 30 days before and including the date of positive SARS-CoV-2 testing (March 1, 2020, to February 20, 2021). All patients had ≥1 year of prior baseline data and ≥60 days follow-up relative to the test date. We used propensity score (PS)-weighting to balance covariates in patients with vs without GI symptoms. The primary composite outcome was severe COVID-19, defined as hospital admission, intensive care unit admission, mechanical ventilation, or death within 60 days of positive testing.
UNASSIGNED: Of 218,045 SARS-CoV-2 positive patients, 29,257 (13.4%) had GI symptoms. After PS weighting, all covariates were balanced. In the PS-weighted cohort, patients with vs without GI symptoms had severe COVID-19 more often (29.0% vs 17.1%; P < .001). When restricted to hospitalized patients (14.9%; n=32,430), patients with GI symptoms had similar frequencies of intensive care unit admission and mechanical ventilation compared with patients without symptoms. There was a significant age interaction; among hospitalized patients aged ≥70 years, lower COVID-19-associated mortality was observed in patients with vs without GI symptoms, even after accounting for COVID-19-specific medical treatments.
UNASSIGNED: In the largest integrated US health care system, SARS-CoV-2-positive patients with GI symptoms experienced severe COVID-19 outcomes more often than those without symptoms. Additional research on COVID-19-associated GI symptoms may inform preventive efforts and interventions to reduce severe COVID-19.