Sintomas gastrointestinais, perda ponderal e hospitalização por COVID-19: um estudo multicêntrico no nordeste brasileiro

Abstract

Introduction: The clinical manifestations of COVID-19 in people infected with SARS-CoV-2 wide variability, encompassing not only respiratory symptoms but also extrapulmonary symptoms. Signs and symptoms of gastrointestinal tract have been frequently reported in people infected with SARS-CoV-2, and may occur alone or in association with classic symptoms of the disease. Little is known about how gastrointestinal involvement relates to hospitalization for COVID-19. Objective: To evaluate the association between the occurrence of gastrointestinal symptoms, weight loss, and hospitalization for COVID-19 in people of different age groups in the Northeast region of Brazil. Methods: This is a cross-sectional, multicenter study with a non-probability sample composed of people of different age groups (children/adolescents and adults/elderly) with a laboratory diagnosis of COVID-19. Demographic, socioeconomic, and clinical data were collected, including the occurrence of gastrointestinal symptoms related to the viral infection and reports of unintentional weight loss in the last 6 months (independent variables). The need for hospitalization for COVID-19 (dependent variable) was also assessed. Data were analyzed using JAMOVI software, version 2.4. Results: The study population consisted of 205 children and adolescents and 1089 adults and elderly individuals. Gastrointestinal symptoms (1) occurred in 132 (64.4%) children and adolescents and in 589 (54.1%) adults and elderly individuals evaluated in the study, being similar in those hospitalized and not hospitalized (p0.05). In the univariate analysis, a higher frequency of vomiting, loss of appetite, and weight loss was observed in hospitalized children and adolescents (p<0.05). In the analysis adjusted for age, sex, and presence of comorbidities, it was found that loss of appetite/anorexia (OR=4.36; 95% CI: 1.71–11.11; p=0.002) and previous weight loss (OR=3.06; 95% CI: 1.37–6.80; p=0.006) were associated with a higher risk of hospitalization for COVID-19 in this subgroup; and loss of smell was associated with a lower chance of hospitalization (OR=0.26; 95% CI: 0.07–0.91; p=0.035). In adults and the elderly, no association was found between gastrointestinal symptoms or previous weight loss and hospitalization for COVID-19. Conclusion: The frequency of gastrointestinal symptoms was high in people of different age groups infected with SARS-CoV-2. Loss of appetite/anorexia and previous weight loss increased the chances of hospitalization due to COVID-19 in children and adolescents.