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Briciu V, Leucuta DC, Muntean M, Radulescu A, Cismaru C, Topan A, Herbel L, Horvat M, Calin M, Dobrota R, Lupse M. Evolving Clinical Manifestations and Outcomes in COVID-19 Patients: A Comparative Analysis of SARS-CoV-2 Variant Waves in a Romanian Hospital Setting. Pathogens 2023; 12:1453. [PMID: 38133336 PMCID: PMC10871103 DOI: 10.3390/pathogens12121453] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
The aim of this study was to evaluate differences in the clinical manifestations and outcomes in hospitalized patients with COVID-19 in a single Romanian center during four pandemic waves determined by different SARS-CoV-2 variants of concern (VOCs). A retrospective study on 9049 consecutive hospitalized adult patients was performed between 27 February 2020 and 31 March 2023. The study interval was divided into waves based on national data on SARS-CoV-2 VOCs' circulation. Multivariate logistic regression models were built, predicting death and complications as functions of comorbidities, therapy, wave, severity form, and vaccination status, and adjusted for ages ≥65 years. Pulmonary (pneumothorax/pneumomediastinum, pulmonary embolism) and extrapulmonary complications (liver injury, acute kidney injury, ischemic/hemorrhagic stroke, myocardial infarction, and gastrointestinal bleeding) were present, more frequently in ICU hospitalized patients and with differences between waves. The highest in-hospital mortality was found in patients presenting pneumothorax/pneumomediastinum. All of the evaluated risk factors were significantly associated with death, except for obesity and the Omicron wave. Our study highlights the changing nature of COVID-19 and acknowledges the impacts of viral mutations on disease outcomes. For all four waves, COVID-19 was a severe disease with a high risk of poor outcomes.
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Affiliation(s)
- Violeta Briciu
- Department of Infectious Diseases and Epidemiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania; (V.B.); (M.M.); (A.R.); (C.C.); (A.T.); (M.H.); (M.L.)
- The Clinical Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania; (L.H.); (M.C.); (R.D.)
| | - Daniel-Corneliu Leucuta
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Monica Muntean
- Department of Infectious Diseases and Epidemiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania; (V.B.); (M.M.); (A.R.); (C.C.); (A.T.); (M.H.); (M.L.)
- The Clinical Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania; (L.H.); (M.C.); (R.D.)
| | - Amanda Radulescu
- Department of Infectious Diseases and Epidemiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania; (V.B.); (M.M.); (A.R.); (C.C.); (A.T.); (M.H.); (M.L.)
- The Clinical Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania; (L.H.); (M.C.); (R.D.)
| | - Cristina Cismaru
- Department of Infectious Diseases and Epidemiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania; (V.B.); (M.M.); (A.R.); (C.C.); (A.T.); (M.H.); (M.L.)
- The Clinical Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania; (L.H.); (M.C.); (R.D.)
| | - Adriana Topan
- Department of Infectious Diseases and Epidemiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania; (V.B.); (M.M.); (A.R.); (C.C.); (A.T.); (M.H.); (M.L.)
- The Clinical Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania; (L.H.); (M.C.); (R.D.)
| | - Lucia Herbel
- The Clinical Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania; (L.H.); (M.C.); (R.D.)
| | - Melinda Horvat
- Department of Infectious Diseases and Epidemiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania; (V.B.); (M.M.); (A.R.); (C.C.); (A.T.); (M.H.); (M.L.)
- The Clinical Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania; (L.H.); (M.C.); (R.D.)
| | - Mihai Calin
- The Clinical Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania; (L.H.); (M.C.); (R.D.)
| | - Roxana Dobrota
- The Clinical Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania; (L.H.); (M.C.); (R.D.)
| | - Mihaela Lupse
- Department of Infectious Diseases and Epidemiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania; (V.B.); (M.M.); (A.R.); (C.C.); (A.T.); (M.H.); (M.L.)
- The Clinical Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania; (L.H.); (M.C.); (R.D.)
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Hu W, Meng L, Wang C, Lu W, Tong X, Lin R, Xu T, Chen L, Cui A, Xu X, Li A, Tang J, Gao H, Pei Z, Zhang R, Wang Y, Wang Y, Han W, Jiang N, Xiong C, Feng Y, Lee K, Chen M. Spatiotemporal observations of host-pathogen interactions in mucosa during SARS-CoV-2 infection indicate a protective role of ILC2s. Microbiol Spectr 2023; 11:e0087823. [PMID: 37937994 PMCID: PMC10714800 DOI: 10.1128/spectrum.00878-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/30/2023] [Indexed: 11/09/2023] Open
Abstract
IMPORTANCE Our study revealed the spatial interaction between humanized ACE2 and pseudovirus expressing Spike, emphasizing the role of type 2 innate lymphoid cells during the initial phase of viral infection. These findings provide a foundation for the development of mucosal vaccines and other treatment approaches for both pre- and post-infection management of coronavirus disease 2019.
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Affiliation(s)
- Wei Hu
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Lu Meng
- The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology and Immunology, Institute Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Chao Wang
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenhan Lu
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Xiaoyu Tong
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Rui Lin
- State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China
| | - Tao Xu
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Liang Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - An Cui
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoqing Xu
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Anni Li
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jia Tang
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongru Gao
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Zhenle Pei
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Ruonan Zhang
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Yicong Wang
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Yu Wang
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Wendong Han
- Biosafety Level 3 Laboratory, Shanghai Medical College Fudan University, Shanghai, China
| | - Ning Jiang
- State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China
| | - Chenglong Xiong
- Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yi Feng
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Kuinyu Lee
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Institute of Acupuncture and Moxibustion, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Mingquan Chen
- Department of Emergency Medicine, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
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Negro A, Villa G, Cardinali M, Gianelle N, Ranzani R, Rolandi S, Maimeri N, Zangrillo A. Is Gastrointestinal Bleeding a Problem for COVID-19 Intensive Care Unit Patients? Gastroenterol Nurs 2023; 46:225-231. [PMID: 37053376 DOI: 10.1097/sga.0000000000000722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 11/08/2022] [Indexed: 04/15/2023] Open
Abstract
The objective of this study was to describe the COVID-19 intensive care unit population and analyze the characteristics and outcomes of gastrointestinal bleeding patients. An observational prospective study design was used following the STROBE checklist. All patients admitted between February and April 2020 to the intensive care unit were included. Main outcome measures were first bleeding event timing, sociodemographic and clinical data before admission, and gastrointestinal symptoms. A total of 116 COVID-19 patients were included; 16 (13.8%) developed gastrointestinal bleeding, 15 were males (93.7%), and the median age was 65.64 ± 7.33 years. All 16 patients were mechanically ventilated, one (6.3%) already had gastrointestinal symptoms, 13 (81.3%) had at least one concomitant disease, and six (37.5%) died. Bleeding episodes occurred on a mean of 16.9 ± 9.5 days after admission. Nine cases (56.3%) had effects on their hemodynamics, hemoglobin levels, or transfusion requirements; six (37.5%) required diagnostic imaging; and two (12.5%) underwent endoscopy procedures. The Mann-Whitney test showed statistically significant differences between the two groups of patients concerning comorbidities. Gastrointestinal bleeding can occur in critically ill patients with COVID-19. Having a solid tumor or chronic liver disease seems to increase that risk. Nurses caring for COVID-19 patients are urged to individualize patients at higher risk in order to improve safety.
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Affiliation(s)
- Alessandra Negro
- Alessandra Negro, RN, is Nursing, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Giulia Villa, PhD, MSN, RN, is Assistant Professor, Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
- Matteo Cardinali, MScN, RN, is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicola Gianelle, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Roberta Ranzani, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Stefano Rolandi, MScN, RN, is Nurse Manager, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicolò Maimeri, MD, is Anesthesiologist Resident, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Alberto Zangrillo, MD, is Full Professor, IRCCS San Raffaele Scientific Institute, Milan, Italy; Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Giulia Villa
- Alessandra Negro, RN, is Nursing, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Giulia Villa, PhD, MSN, RN, is Assistant Professor, Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
- Matteo Cardinali, MScN, RN, is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicola Gianelle, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Roberta Ranzani, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Stefano Rolandi, MScN, RN, is Nurse Manager, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicolò Maimeri, MD, is Anesthesiologist Resident, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Alberto Zangrillo, MD, is Full Professor, IRCCS San Raffaele Scientific Institute, Milan, Italy; Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Matteo Cardinali
- Alessandra Negro, RN, is Nursing, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Giulia Villa, PhD, MSN, RN, is Assistant Professor, Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
- Matteo Cardinali, MScN, RN, is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicola Gianelle, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Roberta Ranzani, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Stefano Rolandi, MScN, RN, is Nurse Manager, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicolò Maimeri, MD, is Anesthesiologist Resident, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Alberto Zangrillo, MD, is Full Professor, IRCCS San Raffaele Scientific Institute, Milan, Italy; Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicola Gianelle
- Alessandra Negro, RN, is Nursing, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Giulia Villa, PhD, MSN, RN, is Assistant Professor, Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
- Matteo Cardinali, MScN, RN, is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicola Gianelle, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Roberta Ranzani, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Stefano Rolandi, MScN, RN, is Nurse Manager, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicolò Maimeri, MD, is Anesthesiologist Resident, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Alberto Zangrillo, MD, is Full Professor, IRCCS San Raffaele Scientific Institute, Milan, Italy; Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberta Ranzani
- Alessandra Negro, RN, is Nursing, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Giulia Villa, PhD, MSN, RN, is Assistant Professor, Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
- Matteo Cardinali, MScN, RN, is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicola Gianelle, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Roberta Ranzani, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Stefano Rolandi, MScN, RN, is Nurse Manager, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicolò Maimeri, MD, is Anesthesiologist Resident, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Alberto Zangrillo, MD, is Full Professor, IRCCS San Raffaele Scientific Institute, Milan, Italy; Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Stefano Rolandi
- Alessandra Negro, RN, is Nursing, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Giulia Villa, PhD, MSN, RN, is Assistant Professor, Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
- Matteo Cardinali, MScN, RN, is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicola Gianelle, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Roberta Ranzani, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Stefano Rolandi, MScN, RN, is Nurse Manager, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicolò Maimeri, MD, is Anesthesiologist Resident, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Alberto Zangrillo, MD, is Full Professor, IRCCS San Raffaele Scientific Institute, Milan, Italy; Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicolò Maimeri
- Alessandra Negro, RN, is Nursing, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Giulia Villa, PhD, MSN, RN, is Assistant Professor, Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
- Matteo Cardinali, MScN, RN, is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicola Gianelle, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Roberta Ranzani, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Stefano Rolandi, MScN, RN, is Nurse Manager, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicolò Maimeri, MD, is Anesthesiologist Resident, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Alberto Zangrillo, MD, is Full Professor, IRCCS San Raffaele Scientific Institute, Milan, Italy; Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Zangrillo
- Alessandra Negro, RN, is Nursing, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Giulia Villa, PhD, MSN, RN, is Assistant Professor, Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
- Matteo Cardinali, MScN, RN, is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicola Gianelle, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Roberta Ranzani, RN; is Critical Care Nurse, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Stefano Rolandi, MScN, RN, is Nurse Manager, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nicolò Maimeri, MD, is Anesthesiologist Resident, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Alberto Zangrillo, MD, is Full Professor, IRCCS San Raffaele Scientific Institute, Milan, Italy; Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
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6
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Maruyama S, Wada D, Oishi T, Saito F, Yoshiya K, Nakamori Y, Kuwagata Y. A descriptive study of abdominal complications in patients with mild COVID-19 presenting to the emergency department: a single-center experience in Japan during the omicron variant phase. BMC Gastroenterol 2023; 23:43. [PMID: 36800938 PMCID: PMC9938954 DOI: 10.1186/s12876-023-02681-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/15/2023] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND COVID-19 is widely known to induce a variety of extrapulmonary manifestations. Gastrointestinal symptoms have been identified as the most common extra-pulmonary manifestations of COVID-19, with an incidence reported to range from 3 to 61%. Although previous reports have addressed abdominal complications with COVID-19, these have not been adequately elucidated for the omicron variant. The aim of our study was to clarify the diagnosis of concomitant abdominal diseases in patients with mild COVID-19 who presented to hospital with abdominal symptoms during the sixth and seventh waves of the pandemic of the omicron variant in Japan. METHODS This study was a retrospective, single-center, descriptive study. In total, 2291 consecutive patients with COVID-19 who visited the Department of Emergency and Critical Care Medicine, Kansai Medical University Medical Center, Osaka, Japan, between January 2022 and September 2022 were potentially eligible for the study. Patients delivered by ambulance or transferred from other hospitals were not included. We collected and described physical examination results, medical history, laboratory data, computed tomography findings and treatments. Data collected included diagnostic characteristics, abdominal symptoms, extra-abdominal symptoms and complicated diagnosis other than that of COVID-19 for abdominal symptoms. RESULTS Abdominal symptoms were present in 183 patients with COVID-19. The number of patients with each abdominal symptom were as follows: nausea and vomiting (86/183, 47%), abdominal pain (63/183, 34%), diarrhea (61/183, 33%), gastrointestinal bleeding (20/183, 11%) and anorexia (6/183, 3.3%). Of these patients, 17 were diagnosed as having acute hemorrhagic colitis, five had drug-induced adverse events, two had retroperitoneal hemorrhage, two had appendicitis, two had choledocholithiasis, two had constipation, and two had anuresis, among others. The localization of acute hemorrhagic colitis was the left-sided colon in all cases. CONCLUSIONS Our study showed that acute hemorrhagic colitis was characteristic in mild cases of the omicron variant of COVID-19 with gastrointestinal bleeding. When examining patients with mild COVID-19 with gastrointestinal bleeding, the potential for acute hemorrhagic colitis should be kept in mind.
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Affiliation(s)
- Shuhei Maruyama
- Department of Emergency and Critical Care Medicine, Kansai Medical University Medical Center, 10-15 Fumizono-cho, Moriguchi, Osaka, 570-8507, Japan.
| | - Daiki Wada
- grid.410783.90000 0001 2172 5041Department of Emergency and Critical Care Medicine, Kansai Medical University Medical Center, 10-15 Fumizono-cho, Moriguchi, Osaka 570-8507 Japan
| | - Takahiro Oishi
- grid.410783.90000 0001 2172 5041Department of Emergency and Critical Care Medicine, Kansai Medical University Medical Center, 10-15 Fumizono-cho, Moriguchi, Osaka 570-8507 Japan
| | - Fukuki Saito
- grid.410783.90000 0001 2172 5041Department of Emergency and Critical Care Medicine, Kansai Medical University Medical Center, 10-15 Fumizono-cho, Moriguchi, Osaka 570-8507 Japan
| | - Kazuhisa Yoshiya
- grid.410783.90000 0001 2172 5041Department of Emergency and Critical Care Medicine, Kansai Medical University Medical Center, 10-15 Fumizono-cho, Moriguchi, Osaka 570-8507 Japan
| | - Yasushi Nakamori
- grid.410783.90000 0001 2172 5041Department of Emergency and Critical Care Medicine, Kansai Medical University Medical Center, 10-15 Fumizono-cho, Moriguchi, Osaka 570-8507 Japan
| | - Yasuyuki Kuwagata
- grid.410783.90000 0001 2172 5041Department of Emergency and Critical Care Medicine, Kansai Medical University Hospital, 2-3-1 Shinmachi, Hirakata, Osaka 573-1191 Japan
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