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Gastrointestinal symptoms and complications in patients hospitalized due to COVID-19, an international multicentre prospective cohort study (TIVURON project)

Cárdenas-Jaén et al., Gastroenterología y Hepatología (English Edition), doi:10.1016/j.gastre.2023.05.002
Jun 2023  
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Severe case 56% Improvement Relative Risk HCQ for COVID-19  Cárdenas-Jaén et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 829 patients in Spain (May - September 2020) Lower severe cases with HCQ (not stat. sig., p=0.13) c19hcq.org Cárdenas-Jaén et al., Gastroenterologí.., Jun 2023 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 418 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,000+ studies for 104 treatments. c19hcq.org
Retrospective 829 hospitalized COVID-19 patients in Spain focused on gastrointestinal symptoms, showing lower risk of severe COVID-19 with HCQ treatment in bivariate analysis, without statistical significance.
This study is excluded in the after exclusion results of meta analysis: unadjusted for baseline differences with no group details.
risk of severe case, 56.2% lower, RR 0.44, p = 0.13, treatment 3 of 42 (7.1%), control 126 of 787 (16.0%), NNT 11, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Cárdenas-Jaén et al., 20 Jun 2023, retrospective, Spain, peer-reviewed, median age 57.0, 44 authors, study period May 2020 - September 2020, average treatment delay 7.0 days. Contact: emadaria@umh.es.
This PaperHCQAll
Gastrointestinal symptoms and complications in patients hospitalized due to COVID-19, an international multicentre prospective cohort study (TIVURON project)
Karina Cárdenas-Jaén, Sergio A Sánchez-Luna, Alicia Vaillo-Rocamora, Micaela Riat Castro-Zocchi, Laura Guberna-Blanco, Daniel Useros-Brañas, José M Remes-Troche, Antonio Ramos-De La Medina, Bryan A Priego-Parra, José A Velarde-Ruiz Velasco, Pedro Martínez-Ayala, Álvaro Urzúa, Dannette Guiñez-Francois, Katarzyna M Pawlak, Katarzyna Kozłowska-Petriczko, Irati Gorroño-Zamalloa, Clara Urteaga-Casares, Inmaculada Ortiz-Polo, Adolfo Del Val Antoñana, Edgard E Lozada-Hernández, Enrique Obregón-Moreno, Guillermo García-Rayado, María José Domper-Arnal, Diego Casas-Deza, Elena I Esteban-Cabello, Luis A Díaz, Arnoldo Riquelme, Helena Martínez-Lozano, Francisco Navarro-Romero, Ignasi Olivas, Guillem Iborra-Muñoz, Alicia Calero-Amaro, Ibán Caravaca-García, Francisco J Lacueva-Gómez, Rubén Pastor-Mateu, Berta Lapeña-Muñoz, Violeta Sastre-Lozano, Nazaret M Pizarro-Vega, Luigi Melcarne, Marc Pedrosa-Aragón, José J Mira, Aurora Mula Mstat, Irene Carrillo, Enrique De-Madaria
Gastroenterología y Hepatología, doi:10.1016/j.gastrohep.2022.10.007
Background: Retrospective studies suggest that coronavirus disease (COVID-19) commonly involves gastrointestinal (GI) symptoms and complications. Our aim was to prospectively evaluate GI manifestations in patients hospitalized for COVID-19. Methods: This international multicentre prospective cohort study recruited COVID-19 patients hospitalized at 31 centres in Spain, Mexico, Chile, and Poland, between May and September 2020. Patients were followed-up until 15 days post-discharge and completed comprehensive questionnaires assessing GI symptoms and complications. A descriptive analysis as well as a bivariate and multivariate analysis were performer using binary logistic regression. p < 0.05 was considered significant. Results: Eight hundred twenty-nine patients were enrolled; 129 (15.6%) had severe COVID-19, 113 (13.7%) required ICU admission, and 43 (5.2%) died. Upon admission, the most prevalent GI symptoms were anorexia (n = 413; 49.8%), diarrhoea (n = 327; 39.4%), nausea/vomiting (n = 227; 27.4%), and abdominal pain (n = 172; 20.7%), which were mild/moderate throughout the disease and resolved during follow-up. One-third of patients exhibited liver injury. Non-severe COVID-19 was associated with ≥2 GI symptoms upon admission (OR 0.679; 95% CI 0.464---0.995; p = 0.046) or diarrhoea during hospitalization (OR 0.531; 95% CI 0.328---0.860; p = 0.009). Multivariate analysis revealed that worse hospital outcomes were not independently associated with liver injury or GI symptoms. Conclusion: GI symptoms were more common than previously documented, and were mild, rapidly resolved, and not independently associated with COVID-19 severity. Liver injury was a frequent complication in hospitalized patients not independently associated with COVID-19 severity.
Authors' contributions All authors were involved in data acquisition and critical revision of the manuscript. E. de-Madaria and K. Cárdenas-Jaén conceptualized and designed the study. A. Vaillo monitored the study. K. Cárdenas-Jaén, J.J. Mira, A. Mula, I. Carrillo, and E. de-Madaria performed the primary analysis and interpretation of the data. K. Cárdenas-Jaén, S.A. Sánchez-Luna, J.J. Mira, A. Mula, I. Carrillo, and E. de-Madaria prepared the initial draft of the manuscript. All authors have approved the final version of the manuscript. Competing interests The authors declare no conflict of interests for this article. Appendix A. Supplementary data Supplementary data associated with this article can be found, in the online version, at doi:10.1016/j. gastrohep.2022.10.007.
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Late treatment
is less effective
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