Objectives: To determine the frequencies of gastrointestinal manifestations and identity associations with outcomes among COVID-19 patients admitted in a tertiary hospital. Furthermore, it sought to determine conditions and risk factors that can be attributed to the development of these gastrointestinal symptoms. Materials and Methods: This was a retrospective cohort of 1212 adult patients admitted at the Philippine General Hospital from April to September 2020 for COVID-19 infection. Data were gathered from an established database and chart review. Frequencies of observations were tabulated and expressed in percentages. Analytical statistics via the Fisher's Exact test was used to determine associations. Results: A total of 597 observations of gastrointestinal symptoms was noted: diarrhea (16.4%), anorexia (13.3%), ageusia/dysgeusia/hypogeusia (7.7%), vomiting (4.5%), abdominal discomfort (4.7%), nausea (1.7%), and gastrointestinal bleeding (0.7% - [melena 0.5%, hematochezia 0.16%, hematemesis 0.08%]). Most of these patients had moderate COVID infection (38.37%). Gastrointestinal bleeding was significantly associated with the need for oxygen support (p = 0.009), invasive ventilation (p = 0.002), invasive ventilation (p= 0.001), ICU admission (p = 0.006) and mortality (p= 0.006). Anorexia was significantly associated with the need for oxygen support (p = <0.001), invasive ventilation (p= <0.001), renal replacement therapy (p = 0.003), ICU admission (p = <0.001) and mortality (p = <0.001). Vomiting was significantly associated with need for invasive ventilation (p = 0.023) and renal replacement therapy (p = 0.003). Conclusion Gastrointestinal manifestations can present among patients with COVID-19 infection and can affect overall prognosis.
Gastrointestinal Tract ; COVID-19 ; Tertiary Care Centers

Background and Objective: Convalescent plasma therapy (CPT) may reduce the risk of disease progression among patients with COVID-19. This study was undertaken to evaluate the efficacy and safety of CPT in preventing ICU admission among hospitalized COVID-19 patients. Methods: In this open-label randomized controlled trial, we randomly assigned hospitalized adult patients with COVID-19 in a 1:1 ratio to receive convalescent plasma as an adjunct to standard of care or standard of care alone. The primary endpoint was ICU admission within first 28 days of enrolment. Primary safety endpoints include rapid deterioration of respiratory or clinical status within four hours of convalescent plasma transfusion and cumulative incidence of serious adverse events during the study period including transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), severe allergic reactions, and transfusion-related infections. Results: A total of 22 patients were assigned to receive convalescent plasma as an adjunct to standard of care and 22 to receive standard of care alone. The median time from onset of COVID-19 symptoms to study enrolment was eight days (IQR, 4 to 10). Two patients (9.1%) in the CPT group and one patient (4.5%) in the control group were admitted to the ICU. The primary outcome measure, ICU admission, was not different between the two groups (q-value >0.9). No patient who received convalescent plasma had rapid deterioration of respiratory/clinical status within four hours of transfusion and none developed TRALI, TACO, anaphylaxis, severe allergic reactions, or transfusion-related infections. There was also no significant difference in the secondary outcomes of 28-day mortality (two patients in the CPT group and none in the control group, q-value >0.90), dialysis-free days, vasopressor-free days, and ICU-free days. Conclusions Among hospitalized COVID-19 patients, no significant differences were observed in the need for ICU admission between patients given CPT as adjunct to standard of care and those who received standard of care alone. Interpretation is limited by early termination of the trial which may have been underpowered to detect a clinically important difference.
COVID-19 ; COVID-19 Serotherapy