ArticleBMC infectious diseases2026
Evaluation of clinical and laboratory manifestations related to the gastrointestinal system and prognosis in hospitalized patients with COVID-19: a prospective cohort study.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe prognostic implications of gastrointestinal symptoms and abnormal liver enzymes in COVID-19 patients have shown significant variability. This study aimed to describe the incidence of these manifestations and their correlation with disease severity in a Brazilian population during the early phase of the pandemic, a context with limited published data.
methodsThis was a prospective cohort study of 253 consecutive patients with SARS-CoV-2 conducted in a tertiary hospital in João Pessoa, Brazil. Patients were evaluated for the presence of gastrointestinal symptoms, elevated liver enzymes, and clinical outcomes (ICU admission, mortality). Statistical analysis included Mann-Whitney, chi-square, or Fisher tests, and logistic regression. Inclusion criteria were a positive rRT-qPCR for SARS-CoV-2 or clinical-radiological findings (CO-RADS 5) with positive serology. Patients were classified as severe or critical based on respiratory rate, oxygen saturation, and organ failure requiring mechanical ventilation or ICU care.
resultsForty-nine (19.37%) patients presented with gastrointestinal symptoms. No significant differences were found in ICU admission (20.4% vs. 24.2%, p = 0.707) or mortality (16.2% vs. 18.3%, p = 0.674) between groups with and without these symptoms. Elevation of liver enzymes during hospitalization was associated with a longer hospital stay (median 7 days vs. 5 days, p = 0.0016) but not with ICU admission or mortality.
conclusionsIn this cohort, gastrointestinal symptoms and elevated liver enzymes at admission were not predictors of mortality. However, in-hospital liver enzyme elevation was associated with a longer hospital stay, highlighting its importance as a marker for resource management rather than mortality risk. CLINICAL TRIAL NUMBER: Not applicable.
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