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Introduction <p>Patients with coronavirus disease 2019 (COVID-19) can present with gastrointestinal symptoms and abnormal liver biochemical tests, but their prevalence and impact on outcomes remain controversial among studies. Importantly, the relevant data are very scarce after the end of the zero-COVID policy in China.</p> Methods <p>In this single-center retrospective cohort study, all patients with COVID-19 pneumonia who were consecutively admitted to the Department of Gastroenterology of a tertiary hospital from December 20, 2022 to January 20, 2023 were collected. Differences in gastrointestinal symptoms and abnormal liver biochemical tests were evaluated between patients with moderate and severe/critical COVID-19 pneumonia. Their association with the composite endpoint, defined as transfer to intensive care unit, mechanical ventilation, and/or death, was evaluated by logistic regression analyses.</p> Results <p>Overall, 78 patients with COVID-19 pneumonia were included, of whom 49 (63%) had gastrointestinal symptoms, but 13 of them did not have any obvious respiratory symptoms, while 67 (86%) patients had abnormal liver biochemical tests. Compared with patients with moderate COVID-19 pneumonia, patients with severe/critical COVID-19 pneumonia had significantly higher proportions of anorexia (<i>P</i> = 0.041), serum albumin level &lt; 40 g/L (<i>P</i> = 0.010), alanine transaminase level &gt; 40 U/L (<i>P</i> = 0.037), and γ-glutamyl transferase level &gt; 45 U/L (<i>P</i> = 0.038). Constipation [odds ratios (OR) = 23.833, <i>P</i> = 0.019] and aspartate transaminase (AST) level &gt; 35 U/L (OR = 31.085, <i>P</i> = 0.015) were independently associated with a higher risk of composite endpoint among patients with COVID-19 pneumonia.</p> Conclusions <p>Gastrointestinal symptoms and abnormal liver biochemical tests are very common in patients with COVID-19 pneumonia who were admitted to the department of gastroenterology, and constipation and AST level &gt; 35 U/L can independently predict worse outcome.</p>

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Gastrointestinal Symptoms and Abnormal Liver Biochemistry in Patients with COVID-19 Pneumonia Admitted to the Department of Gastroenterology After Ending Zero-COVID Policy in China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月18日

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  • Xiaojie Zheng,
  • Sai Guan,
  • Yuhang Yin,
  • Beilei Zhang,
  • Wen Ning,
  • Wenxiu Zhang,
  • Haonan Zhao,
  • Zhendong Liang,
  • Deli Zou,
  • Xingshun Qi

摘要

Introduction

Patients with coronavirus disease 2019 (COVID-19) can present with gastrointestinal symptoms and abnormal liver biochemical tests, but their prevalence and impact on outcomes remain controversial among studies. Importantly, the relevant data are very scarce after the end of the zero-COVID policy in China.

Methods

In this single-center retrospective cohort study, all patients with COVID-19 pneumonia who were consecutively admitted to the Department of Gastroenterology of a tertiary hospital from December 20, 2022 to January 20, 2023 were collected. Differences in gastrointestinal symptoms and abnormal liver biochemical tests were evaluated between patients with moderate and severe/critical COVID-19 pneumonia. Their association with the composite endpoint, defined as transfer to intensive care unit, mechanical ventilation, and/or death, was evaluated by logistic regression analyses.

Results

Overall, 78 patients with COVID-19 pneumonia were included, of whom 49 (63%) had gastrointestinal symptoms, but 13 of them did not have any obvious respiratory symptoms, while 67 (86%) patients had abnormal liver biochemical tests. Compared with patients with moderate COVID-19 pneumonia, patients with severe/critical COVID-19 pneumonia had significantly higher proportions of anorexia (P = 0.041), serum albumin level < 40 g/L (P = 0.010), alanine transaminase level > 40 U/L (P = 0.037), and γ-glutamyl transferase level > 45 U/L (P = 0.038). Constipation [odds ratios (OR) = 23.833, P = 0.019] and aspartate transaminase (AST) level > 35 U/L (OR = 31.085, P = 0.015) were independently associated with a higher risk of composite endpoint among patients with COVID-19 pneumonia.

Conclusions

Gastrointestinal symptoms and abnormal liver biochemical tests are very common in patients with COVID-19 pneumonia who were admitted to the department of gastroenterology, and constipation and AST level > 35 U/L can independently predict worse outcome.