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GASTROINTESTINAL MANIFESTATIONS IN COVID-19: A PROSPECTIVE STUDY

Introduction: Gastrointestinal manifestations are common during coronavirus disease (COVID-19) infection. They can occur before respiratory symptoms, resulting in a diagnostic delay and an increased risk of disease transmission. Aims & Methods: The current study reports major gastrointestinal manifestations as initial symptoms of COVID-19. This prospective, descriptive, cross-sectional, and single-center study of 713 cases was conducted in a field hospital over a 5-week period from June 21 to July 25, 2020. Result(s): The average age of our patients was 31.95 years. Clinically, on admission, anorexia was the main symptom, present in 32.3% of patients. Gastrointestinal manifestations were present in 14.9% of patients, including watery diarrhea in 8.6% of cases, nausea and/or vomiting in 4.6% of cases, and abdominal pain in 1.6% of cases. Six hundred thirty-two patients were treated in accordance with one of the two therapeutic protocols recommended by the National Ministry of Health. The treatment-related effects that occurred in 61.4% of patients were primarily digestive in 55.3% of cases. In multivariate analysis, following adjustment of the studied parameters, only the presence of gastroin- testinal manifestations (odds ratio [OR]: 1.478 confidence interval [CI]: 1.286-1.698;p < 0.001) and treat- ment side effects (OR = 1.069, CI: 1.020-1.119, p = 0.005) altered the rate of negative polymerase chain reaction (PCR) tests on day 10. Conclusion(s): Gastrointestinal manifestations are common during COVID- 19 and seem to be linked to a longer duration of disease. SARS-CoV-2 (the causative virus of COVID-19) can persist in the digestive tract, with the possibility of fecal-oral transmission. Therefore, hygiene is extremely important, espe- cially handwashing and strict precautions when performing gastrointestinal endoscopy and handling stools from infected patients.