Sanjeev Kumar, K (2023) A Cross Sectional Study of Gastrointestinal and Hepatic Manifestations and Its Outcome in Covid 19 Patients of Tertiary Health Center. Masters thesis, Stanley Medical College, Chennai.
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Abstract
BACKGROUND: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that causes coronavirus disease-2019 (COVID-19) is a global pandemic, manifested by an infectious bronchopneumonia. Patients primarily present with fever, cough and breathing difficulty, some patients also develop gastrointestinal (GI) manifestations and hepatic enzyme Elevations. The most common GI symptoms reported are diarrhea, nausea, vomiting, and abdominal discomfort etc. • The digestive symptoms of COVID-19 likely occur because the virus enters the target cells through ACE 2 (angiotensin converting enzyme 2), a receptor found in both upper and lower gastrointestinal tract. Receptor is expressed at nearly 100-fold higher levels than in respiratory organs. SARS CoV-2 viral components found in the stool sample,which originated from infected intestinal cells particularly patient’s ileum and colon. • The ACE 2 expression on intestinal enterocytes makes both the small and large intestines susceptible to SARS CoV-2 infection. In addition, viral nucleic acid is detected in feces in over half of the patients infected with COVID-19 and in nearly one-quarter of cases stool samples test positive when respiratory samples are negative. Digestive symptoms indicate viral load and replication within the gastrointestinal tract. • Liver biochemistry abnormalities are Elevation of aspartate transferase, alanine transferase, and total bilirubin. Direct assault of SARS-CoV-2 on hepatocytes, leading to abnormal liver enzyme level, SARS-COV-2 can invade the human body by binding to the human angiotensin converting enzyme 2 (ACE2) receptor, which causes liver tissue injury by the up regulation of ACE-2 expression in liver tissue caused by compensatory proliferation of hepatocytes derived from bile duct epithelial cells. Preliminary study revealed a high level of ACE2 expression in cholangiocyte, also which suggesting an indirect cause of elevated liver enzymes as cholangiocyte dysfunction. Another possibility in covid patients with extra pulmonary symptoms reported later for care because they did not initially have typical respiratory symptoms, and thus presented at a later and less curable stage of disease. OBJECTIVES: 1. To determine the prevalence of gastrointestinal and hepatic manifestations in SARS-Cov-2 patients. 2. To investigate the gastrointestinal and hepatic manifestations and its outcome in SARS-CoV-2 patients. MATERIALS AND METHODS: This is the Descriptive Cross – Sectional Study,which was conducted over a period of 1 year from april 2021 to january 2022.Patients selected for this study from COVID OP and COVID Ward in Government Stanley Medical college and hospital, Chennai. Patients were selected based on inclusion and exclusion criteria. Sampling was done by SIMPLE RANDOM SAMPLING technique. Relevant data were collected and analysed. RESULTS: Primary symptoms distribution were 84.0% is Fever, 6.0% is Sore throat, 37.7% is Dry Cough, 41.9% is Expectoration, 25.7% is Chest Tightness, 14.1% is Shortness of Breath, 14.1% is Dizziness, 10.9% is Headache, 33.8% is Myalgia. GI symptoms distribution were 18.0% is Diarrhea, 7.7% is Nausea, 6.0% is Vomiting, 9.9% is Abdominal Pain, 15.8% is Loss Appetite, 19.7% is Loss of Taste. Hepatic enzyme Elevation distribution were 23.9% is SGPT, 23.9% is SGOT. Complications distribution were 81.7% is Pneumonia, 1.8% is Acute Respiratory Distress Syndrome, 2.8% is Arrythmias, 2.8% is Shock, 1.8% is Acute Heart Failure. Outcomes distribution were 19.7% is Outpatient Recovered, 53.5% is Discharge From Hospital, 19.7% is Staying in Hospital, 6.7% is Death. CONCLUSION: Patient affected with Gastrointestinal symptoms are mostly recovered completely, They are usually mild cases. Mild covid affected patients showed mild hepatic enzyme Elevation. Although, Patients with more than 3 to 4 fold raise of hepatic enzyme Elevation had mild to moderate covid disease, but their outcome was good.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.200120101026 |
| Uncontrolled Keywords: | Gastrointestinal and Hepatic Manifestations, Outcome, Covid 19 Patients, Tertiary Health Center. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 02 May 2021 15:04 |
| Last Modified: | 20 Mar 2024 06:27 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/15597 |
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