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Papa A, Covino M, De Lucia SS, Del Gaudio A, Fiorani M, Polito G, Settanni CR, Piccioni A, Franceschi F, Gasbarrini A. Impact of COVID-19 in individuals with and without pre-existent digestive disorders with a particular focus on elderly patients. World J Gastroenterol 2023; 29:4099-4119. [PMID: 37475841 PMCID: PMC10354572 DOI: 10.3748/wjg.v29.i26.4099] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/10/2023] [Accepted: 03/20/2023] [Indexed: 07/10/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has several extrapulmonary symptoms. Gastrointestinal (GI) symptoms are among the most frequent clinical manifestations of COVID-19, with severe consequences reported in elderly patients. Furthermore, the impact of COVID-19 on patients with pre-existing digestive diseases still needs to be fully elucidated, particularly in the older population. This review aimed to investigate the impact of COVID-19 on the GI tract, liver, and pancreas in individuals with and without previous digestive diseases, with a particular focus on the elderly, highlighting the distinctive characteristics observed in this population. Finally, the effectiveness and adverse events of the anti-COVID-19 vaccination in patients with digestive disorders and the peculiarities found in the elderly are discussed.
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Affiliation(s)
- Alfredo Papa
- CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
- CEMAD, Università Cattolica del Sacro Cuore, Roma 00168, Italy
| | - Marcello Covino
- Department of Emergency, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome 00168, Italy
- Emergency Medicine, Università Cattolica del Sacro Cuore, Roma 00168, Italy
| | - Sara Sofia De Lucia
- CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
| | - Angelo Del Gaudio
- CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
| | - Marcello Fiorani
- CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
| | - Giorgia Polito
- CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
| | - Carlo Romano Settanni
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Andrea Piccioni
- Department of Emergency, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
| | - Francesco Franceschi
- Department of Emergency, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
- Department of Emergency, Università Cattolica del Sacro Cuore, Roma 00168, Italy
| | - Antonio Gasbarrini
- CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
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Asfuroğlu Kalkan E, Kalkan Ç, Kaçar S, Barutçu S, Yüksel M, Güçbey Türker Ö, Göre B, Canlı T, Asfuroğlu U, Barutçu Asfuroğlu B, Hamamcı M, Kılıç V, Köseoğlu T, Özaslan E, Ödemiş B, Kılıç M, Yüksel İ, Ersoy O, Altıparmak E, Ateş İ, Soykan İ. Similarities and Differences Between Gerontal and Young Patients with Acute Pancreatitis: Evaluation of Clinical Characteristics and Outcomes. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2022; 33:874-884. [PMID: 36205509 PMCID: PMC9623137 DOI: 10.5152/tjg.2022.22227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: Acute pancreatitis is an abrupt inflammatory disease of the exocrine pancreas and it can occur in different severities. It is becoming more common and more mortal in the gerontal population. The aim of our study was to explore the similarities and differences between young and gerontal patients with acute pancreatitis, with a special emphasis on patients over 80 years of age. Methods: Medical records of patients (n = 1150) with acute pancreatitis were analyzed retrospectively. Several scoring systems including Bedside index for severity in acute pancreatitis, Ranson’s score, Harmless acute pancreatitis score, Acute Physiology and Chronic Health Evaluation, Balthazar Grade, Glasgow score, and Japanese severity score were applied at admission. Patients were divided into 3 groups; group I, young group (n = 706), if they were aged <65 years; group II, older group (n = 338), if they were aged ≥65 years to <80 years; group III, octogenarian group (n = 106), if they were aged ≥ 0 years. Results: In total, 1150 patients with acute pancreatitis were analyzed. Octogenarian group (n = 42, 39.6%) showed a more severe acute pancreatitis compared to patients in group I (n = 15, 2.1%) and II (n = 50, 14.8%, P < .001). Complications were more common in patients in group III (P < .001). Mortality rate was higher in patients in group III (n = 53, 50%) compared to group I (n = 8, 1.1%) and group II (n = 53, 15.7%) (P < .001). Conclusion: Gerontal patients with acute pancreatitis tend to have more severe disease and systemic and local complications. Mortality rates were higher in older patients compared to younger patients.
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Affiliation(s)
- Emra Asfuroğlu Kalkan
- Department of Internal Medicine, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Çağdaş Kalkan
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Sabite Kaçar
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Sezgin Barutçu
- Department of Gastroenterology, Gaziantep University Hospital, Gaziantep, Turkey
| | - Mahmut Yüksel
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Özge Güçbey Türker
- Department of Internal Medicine, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Burak Göre
- Department of Internal Medicine, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Tolga Canlı
- Department of Internal Medicine, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Umut Asfuroğlu
- Department of Radiology, Ministry of Health, Abdulkadir Yüksel Hospital, Gaziantep, Turkey
| | | | - Mevlüt Hamamcı
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Vedat Kılıç
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Tankut Köseoğlu
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Ersan Özaslan
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Bülent Ödemiş
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Mesut Kılıç
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - İlhami Yüksel
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Osman Ersoy
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - Emin Altıparmak
- Department of Gastroenterology, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - İhsan Ateş
- Department of Internal Medicine, Ankara City Hospital, Ministry of Health, Ankara, Turkey
| | - İrfan Soykan
- Department of Gastroenterology, Ankara University Faculty of Medicine, İbni-Sina Hospital, Ankara, Turkey,Corresponding author: İrfan Soykan, e-mail:
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Acute pancreatitis and the weekend effect: does weekend admission affect patient outcome? GASTROENTEROLOGY REVIEW 2020; 15:241-246. [PMID: 33005270 PMCID: PMC7509903 DOI: 10.5114/pg.2020.95039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/01/2019] [Indexed: 11/20/2022]
Abstract
Introduction When a patient is admitted to a hospital for acute pancreatitis (AP), the day of the week on which the admission occurs may influence the outcome of care. The link between reduced weekend staffing practices and outcomes for patients hospitalised for AP, however, has been inadequately studied. Aim To evaluate the relationship between weekend admission and AP outcome. Material and methods One hundred and twenty-six patients were prospectively included, assessed according to the revised Atlanta criteria, and observed until discharge or death. Weekend and weekday admissions were compared in terms of severity, aetiology, length of hospital stay, and in-hospital mortality. Results Patients were divided into two groups according to the timing of admission (weekday, n = 99, 78.6%; or weekend, n = 27, 21.4%). AP was considered severe in 33 (26.2%) patients, moderately severe AP in 37 (29.4%) patients, and mild in 56 (44.4%) patients. No significant differences were found with regard to the distribution of AP severity between the two groups. The impact of weekend admission was not significant for aetiology or for the length of hospital stay (median of 9 vs. 10 days). In-hospital mortality rates were not significantly different for weekday and weekend admissions. Conclusions Patients admitted for hospitalisation during a weekend received the same level and quality of care at the facility under study as AP patients admitted during the week. Additionally, the rate of favourable outcomes for patients admitted during the weekend was found to be similar to the outcomes of patients admitted on a weekday.
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