Clin Trans Gastroenterology:新冠病毒感染者胃肠道症状与疾病预后存在相关性

2021-01-10 MedSci原创 MedSci原创

新冠病毒COVID-19是一种属于冠状病毒家族的RNA病毒,目前全球新冠疫情并没有得到明显控制,并造成了大量患者的死亡。

      新冠病毒COVID-19是一种属于β冠状病毒家族的RNA病毒,目前全球新冠疫情并没有得到明显控制,并造成了大量患者的死亡。新冠病毒通过跨膜丝氨酸蛋白酶和血管紧张素受体2(ACE2)受体进入宿主细胞,ACE2受体不仅在肺上皮细胞中表达,而且在食管,小肠和结肠上皮细胞中表达。此外,约50%的COVID-19患者的粪便中也会排出病毒,来自我国的一项研究表明,存在溃疡的胃肠道(GI)表面和胃肠道活检中均存在病毒。因此,COVID-19感染不仅影响呼吸道,还影响胃肠道,一项研究报告称,即使在没有呼吸道症状的情况下,也有28%的患者出现胃肠道症状。因此,本项研究旨在对以下项目进行前瞻性研究:(i)COVID-19感染患者中胃肠道症状的频率和范围,(ii)与胃肠道症状相关的因素以及(iii)胃肠道之间的关系COVID-19的症状,严重程度和预后关系。

 

      研究人员在印度北部的一家大学医院实验室中,对患有COVID-19感染的患者进行了临床表现评估,包括胃肠道症状,其预测因素以及这些症状的存在,疾病严重程度以及单因素和多因素分析结果之间的关系。

 

      结果显示在2020年4月至2020年5月期间,在16317名受试者的口咽和鼻咽拭子中检测到了COVID-19的RNA,其中252名(1.5%)有阳性症状。其中208例(82.5%)无症状。在44例有症状的患者中,有18名(40.9%)有非胃肠道症状,有15名(34.1%)有胃肠道和非胃肠道症状合并症状,有11名(25.0%)仅有胃肠道症状。33例患有轻度至中度疾病,8例严重和5例严重。五名患者出现(1.98%)死亡。在多变量分析中,与胃肠道症状相关的因素包括接触史,非胃肠道症状的合并症。与没有胃肠道症状的患者相比,有胃肠道症状的患者更常患有严重的危重病和致命的临床预后。

 

      通过本项研究研究人员发现有88%的患者是无症状COVID-19感染患者,有10.3%的人存在胃肠道症状。重症和致命性的病情分别仅占5%和2%。胃肠道症状的存在与严重疾病和多因素分析的致命结果有关。

 

 

原始出处 :

Ghoshal, Uday C. et al. The Spectrum of Gastrointestinal Symptoms in Patients With Coronavirus Disease-19: Predictors, Relationship With Disease Severity, and Outcome. Clinical and Translational Gastroenterology.2021.

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    2021-09-03 许安
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    2021-04-02 bsmagic9140
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  5. 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GetPortalCommentsPageByObjectIdResponse(id=1568204, encodeId=361d15682040f, content=<a href='/topic/show?id=40de83346a3' target=_blank style='color:#2F92EE;'>#胃肠道症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83346, encryptionId=40de83346a3, topicName=胃肠道症状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eede15326817, createdName=yinhl1983, createdTime=Tue Jan 12 04:26:11 CST 2021, time=2021-01-12, status=1, ipAttribution=)]
  6. 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GetPortalCommentsPageByObjectIdResponse(id=1568204, encodeId=361d15682040f, content=<a href='/topic/show?id=40de83346a3' target=_blank style='color:#2F92EE;'>#胃肠道症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83346, encryptionId=40de83346a3, topicName=胃肠道症状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eede15326817, createdName=yinhl1983, createdTime=Tue Jan 12 04:26:11 CST 2021, time=2021-01-12, status=1, ipAttribution=)]
  7. 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style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Mon Aug 09 17:26:11 CST 2021, time=2021-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=916796, encodeId=65a8916e9695, content=太危险了⚠️, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ac05452674, createdName=ms4000001796205693, createdTime=Fri Jan 15 09:05:07 CST 2021, time=2021-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346337, encodeId=6e69134633e0c, content=<a href='/topic/show?id=339e8332035' target=_blank 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GetPortalCommentsPageByObjectIdResponse(id=1568204, encodeId=361d15682040f, content=<a href='/topic/show?id=40de83346a3' target=_blank style='color:#2F92EE;'>#胃肠道症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83346, encryptionId=40de83346a3, topicName=胃肠道症状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eede15326817, createdName=yinhl1983, createdTime=Tue Jan 12 04:26:11 CST 2021, time=2021-01-12, status=1, ipAttribution=)]
    2021-01-15 ms4000001796205693

    太危险了⚠️

    0

  8. 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GetPortalCommentsPageByObjectIdResponse(id=1568204, encodeId=361d15682040f, content=<a href='/topic/show?id=40de83346a3' target=_blank style='color:#2F92EE;'>#胃肠道症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83346, encryptionId=40de83346a3, topicName=胃肠道症状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eede15326817, createdName=yinhl1983, createdTime=Tue Jan 12 04:26:11 CST 2021, time=2021-01-12, status=1, ipAttribution=)]
  9. 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GetPortalCommentsPageByObjectIdResponse(id=1568204, encodeId=361d15682040f, content=<a href='/topic/show?id=40de83346a3' target=_blank style='color:#2F92EE;'>#胃肠道症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83346, encryptionId=40de83346a3, topicName=胃肠道症状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eede15326817, createdName=yinhl1983, createdTime=Tue Jan 12 04:26:11 CST 2021, time=2021-01-12, status=1, ipAttribution=)]
  10. 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GetPortalCommentsPageByObjectIdResponse(id=1568204, encodeId=361d15682040f, content=<a href='/topic/show?id=40de83346a3' target=_blank style='color:#2F92EE;'>#胃肠道症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83346, encryptionId=40de83346a3, topicName=胃肠道症状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eede15326817, createdName=yinhl1983, createdTime=Tue Jan 12 04:26:11 CST 2021, time=2021-01-12, status=1, ipAttribution=)]