RESUMO
INTRODUCTION: The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has greatly challenged public health worldwide. A growing number of studies have reported gastrointestinal (GI) symptoms. We performed a systematic review of GI symptoms associated with coronavirus disease 2019 (COVID-19) as well as of the serum levels of biomarkers related to liver function and lesion in SARS-CoV-2-infected individuals. METHODS: We surveyed relevant articles published in English, Spanish, and Portuguese up to July, 2020 in the PubMed, MEDLINE, SciELO, LILACS, and BVS databases. Moreover, we surveyed potentially important articles in journals such as the NEJM, JAMA, BMJ, Gut, and AJG. RESULTS: This systematic review included 43 studies, including 18,246 patients. Diarrhea was the most common GI symptom, affecting 11.5% of the patients, followed by nausea and vomiting (6.3%) and abdominal pain (2.3%). With regard to clinical severity, 17.5% of the patients were classified as severely ill, whereas 9.8% of them were considered to have a non-severe disease. Some studies showed increased aspartate transaminase and alanine aminotransferase levels in a portion of the 209 analyzed patients and two studies. CONCLUSIONS: Our results suggest that digestive symptoms are common in COVID-19 patients. In addition, alterations in cytolysis biomarkers could also be observed in a lesser proportion, calling attention to the possibility of hepatic involvement in SARS-CoV-2-infected individuals.
Assuntos
COVID-19/patologia , Gastroenteropatias/virologia , Dor Abdominal/virologia , Diarreia/virologia , Humanos , Náusea/virologia , Pandemias , Vômito/virologiaRESUMO
Abstract INTRODUCTION: The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has greatly challenged public health worldwide. A growing number of studies have reported gastrointestinal (GI) symptoms. We performed a systematic review of GI symptoms associated with coronavirus disease 2019 (COVID-19) as well as of the serum levels of biomarkers related to liver function and lesion in SARS-CoV-2-infected individuals. METHODS: We surveyed relevant articles published in English, Spanish, and Portuguese up to July, 2020 in the PubMed, MEDLINE, SciELO, LILACS, and BVS databases. Moreover, we surveyed potentially important articles in journals such as the NEJM, JAMA, BMJ, Gut, and AJG. RESULTS: This systematic review included 43 studies, including 18,246 patients. Diarrhea was the most common GI symptom, affecting 11.5% of the patients, followed by nausea and vomiting (6.3%) and abdominal pain (2.3%). With regard to clinical severity, 17.5% of the patients were classified as severely ill, whereas 9.8% of them were considered to have a non-severe disease. Some studies showed increased aspartate transaminase and alanine aminotransferase levels in a portion of the 209 analyzed patients and two studies. CONCLUSIONS: Our results suggest that digestive symptoms are common in COVID-19 patients. In addition, alterations in cytolysis biomarkers could also be observed in a lesser proportion, calling attention to the possibility of hepatic involvement in SARS-CoV-2-infected individuals.
Assuntos
Humanos , Infecções por Coronavirus/patologia , Gastroenteropatias/virologia , Vômito/virologia , Dor Abdominal/virologia , Diarreia/virologia , Pandemias , Náusea/virologiaRESUMO
During a dengue epidemic in Rio de Janeiro in 2007-2008 the Instituto de Puericultura e Pediatria Martagão Gesteira Hospital was a reference for admitted children. The World Health Organization (WHO) considered several manifestations as warning signs of severe dengue This is a retrospective cohort study of all children admitted with dengue fever. Clinical variables considered warning signs by WHO were evaluated in the multivariate analysis, to investigate if they were independently associated with severe dengue. One hundred and eighty one children were admitted, aged from 4 months to 15 years; 30 were classified as severe dengue. Abdominal pain (OR=2.63, 95% CI 1.06-6.53) and lethargy (OR=3.40, 95% CI 1.45-7.99) were independently associated with severe dengue.
Assuntos
Vírus da Dengue/patogenicidade , Dengue/epidemiologia , Surtos de Doenças , Hospitalização , Dor Abdominal/virologia , Adolescente , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Incidência , Lactente , Letargia/virologia , Masculino , Análise Multivariada , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
As manifestações hepáticas são descritas como não usuais no dengue e podem evoluir com quadros graves e potencialmente letais. Avaliamos as alterações hepáticas em 41 pacientes com dengue hemorrágico com confirmação laboratorial (ELISA IgM positivo) em Campo Grande, Mato Grosso do Sul, Brasil e observamos 61 por cento (25/41) de alteração na alanina aminotransferase e 80,5 por cento (33/41) na aspartato aminotransferase, sendo que não houve diferenças estatisticamente significativas quando comparamos as várias formas clínicas. A variação nos valores de ALT foi de 14-547U/l, nos valores da AST foi de 11-298U/l. Náuseas e/ou vômitos foram referidos por 90 por cento (37/41) dos pacientes, 46,3 por cento (19/41) referiram dor abdominal e 10 por cento (3/29) apresentavam hepatomegalia ao exame físico. A idade variou de 18 a 88 anos, 23 (56 por cento) eram mulheres e 18 (44 por cento) homens.
Hepatic manifestations are described as unusual complications of dengue and may lead to severe and potentially lethal conditions. Liver abnormalities in 41 patients diagnosed with dengue hemorrhagic fever in Campo Grande, Mato Grosso do Sul, Brazil, between January 1 and March 31, 2002, were evaluated. All were serologically positive for dengue in laboratory tests (IgM ELISA). ALT alterations were observed in 61 percent (25/41) and AST alterations in 80.5 percent (33/41), but there were no statistically significant differences between the various clinical forms. The range in ALT levels was 14-547U/l and in AST levels was 11-298U/l. Nausea and/or vomiting were reported by 90 percent (37/41) of the patients; 46.3 percent (19/41) had abdominal pain and 10 percent (3/29) presented hepatomegaly at clinical examination. The patients' ages ranged from 18 to 88 years; 23 (56 percent) were female and 18 (44 percent) were male.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Dengue Grave/complicações , Fígado/fisiopatologia , Dor Abdominal/virologia , Albuminas/análise , Fosfatase Alcalina/análise , Dengue Grave/fisiopatologia , Hepatomegalia/virologia , Testes de Função Hepática , Fígado/enzimologia , Fígado/virologia , Náusea/virologia , Índice de Gravidade de Doença , Transferases/análise , Vômito/virologiaRESUMO
Hepatic manifestations are described as unusual complications of dengue and may lead to severe and potentially lethal conditions. Liver abnormalities in 41 patients diagnosed with dengue hemorrhagic fever in Campo Grande, Mato Grosso do Sul, Brazil, between January 1 and March 31, 2002, were evaluated. All were serologically positive for dengue in laboratory tests (IgM ELISA). ALT alterations were observed in 61% (25/41) and AST alterations in 80.5% (33/41), but there were no statistically significant differences between the various clinical forms. The range in ALT levels was 14-547 U/l and in AST levels was 11-298 U/l. Nausea and/or vomiting were reported by 90% (37/41) of the patients; 46.3% (19/41) had abdominal pain and 10% (3/29) presented hepatomegaly at clinical examination. The patients' ages ranged from 18 to 88 years; 23 (56%) were female and 18 (44%) were male.