Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 21;26(39):6087-6097.
doi: 10.3748/wjg.v26.i39.6087.

Acute gastrointestinal injury in critically ill patients with COVID-19 in Wuhan, China

Jia-Kui Sun  1 , Ying Liu  1 , Lei Zou  1 , Wen-Hao Zhang  1 , Jing-Jing Li  2 , Yu Wang  1 , Xiao-Hua Kan  1 , Jiu-Dong Chen  1 , Qian-Kun Shi  1 , Shou-Tao Yuan  1
Affiliations

Acute gastrointestinal injury in critically ill patients with COVID-19 in Wuhan, China

Jia-Kui Sun et al. World J Gastroenterol. .

Abstract

Background: The coronavirus disease 2019 (COVID-19) is spreading rapidly around the world. Most critically ill patients have organ injury, including acute respiratory distress syndrome, acute kidney injury, cardiac injury, or liver dysfunction. However, few studies on acute gastrointestinal injury (AGI) have been reported in critically ill patients with COVID-19.

Aim: To investigate the prevalence and outcomes of AGI in critically ill patients with COVID-19.

Methods: In this retrospective study, demographic data, laboratory parameters, AGI grades, clinical severity and outcomes were collected. The primary endpoints were AGI incidence and 28-d mortality.

Results: From February 10 to March 10 2020, 83 critically ill patients out of 1314 patients with COVID-19 were enrolled. Seventy-two (86.7%) patients had AGI during hospital stay, of these patients, 30 had AGI grade I, 35 had AGI grade II, 5 had AGI grade III, and 2 had AGI grade IV. The incidence of AGI grade II and above was 50.6%. Forty (48.2%) patients died within 28 days of admission. Multiple organ dysfunction syndrome developed in 58 (69.9%) patients, and septic shock in 16 (19.3%) patients. Patients with worse AGI grades had worse clinical variables, a higher incidence of septic shock and 28-d mortality. Sequential organ failure assessment (SOFA) scores (95%CI: 1.374-2.860; P < 0.001), white blood cell (WBC) counts (95%CI: 1.037-1.379; P = 0.014), and duration of mechanical ventilation (MV) (95%CI: 1.020-1.340; P = 0.025) were risk factors for the development of AGI grade II and above.

Conclusion: The incidence of AGI was 86.7%, and hospital mortality was 48.2% in critically ill patients with COVID-19. SOFA scores, WBC counts, and duration of MV were risk factors for the development of AGI grade II and above. Patients with worse AGI grades had a higher incidence of septic shock and 28-d mortality.

Keywords: COVID-19; Critically ill; Gastrointestinal injury; Organ dysfunction; Septic shock.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The flow diagram of participants. AGI: Acute gastrointestinal injury.
Figure 2
Figure 2
The areas under the receiver operating characteristic curves. A: Multiple organ dysfunction syndrome (0.659, P = 0.022); B: Septic shock (0.793, P < 0.001); C: 28-d mortality (0.716, P = 0.001).
Figure 3
Figure 3
Cumulative survival. Significant differences in 28-d mortality after admission and 60-d mortality after disease onset were found between the group with acute gastrointestinal injury (AGI) grade I/no AGI (n = 41) and the group with acute gastrointestinal injury grade II to IV (n = 42). A: 28-d mortality after admission (P = 0.037); B: 60-d mortality after disease onset (P = 0.049). AGI: Acute gastrointestinal injury.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382:727–733. - PMC - PubMed
    1. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323:1061–1069. - PMC - PubMed
    1. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R, Leung KSM, Lau EHY, Wong JY, Xing X, Xiang N, Wu Y, Li C, Chen Q, Li D, Liu T, Zhao J, Liu M, Tu W, Chen C, Jin L, Yang R, Wang Q, Zhou S, Wang R, Liu H, Luo Y, Liu Y, Shao G, Li H, Tao Z, Yang Y, Deng Z, Liu B, Ma Z, Zhang Y, Shi G, Lam TTY, Wu JT, Gao GF, Cowling BJ, Yang B, Leung GM, Feng Z. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382:1199–1207. - PMC - PubMed
    1. World Health Organization. Coronavirus disease (COVID-19) outbreak. Available from: URL: https://www.who.int.
    1. National Health Commission of the People’s Republic of China home page. Available from: URL: http://www.nhc.gov.cn. - PMC - PubMed

MeSH terms