Abstract
Background: Gastrointestinal symptoms are common in patients with COVID-19, but prevalence of co-infection with enteric pathogens is unknown.
Aims: This study assessed the prevalence of enteric infections among hospitalized patients with COVID-19.
Methods: We evaluated 4973 hospitalized patients ≥ 18 years of age tested for COVID-19 from March 11 through April 28, 2020, at two academic hospitals. The primary exposure was a positive COVID-19 test. The primary outcome was detection of a gastrointestinal pathogen by PCR stool testing.
Results: Among 4973 hospitalized individuals, 311 were tested for gastrointestinal infections (204 COVID-19 positive, 107 COVID-19 negative). Patients with COVID-19 were less likely to test positive compared to patients without COVID-19 (10% vs 22%, p < 0.01). This trend was driven by lower rates of non-C.difficile infections (11% vs 22% in COVID-19 positive vs. negative, respectively, p = 0.04), but not C. difficile infection (5.1% vs. 8.2%, p = 0.33). On multivariable analysis, infection with COVID-19 remained significantly associated with lower odds of concurrent GI infection (aOR 0.49, 95% CI 0.24-0.97), again driven by reduced non-C.difficile infection. Testing for both C.difficile and non-C.difficile enteric infection decreased dramatically during the pandemic.
Conclusions: Pathogens aside from C.difficile do not appear to be a significant contributor to diarrhea in COVID-19 positive patients.
Keywords: COVID-19; Clostridioides difficile; Diarrhea; Enteric infection; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2, diarrhea, Clostridioides difficile, Enteric infection, 【초록키워드】 SARS-CoV-2, pandemic, Hospitalized, Infection, Symptom, hospitals, Prevalence, Stool, Testing, PCR, pathogen, Co-infection, Gastrointestinal, age, Gastrointestinal infection, Primary outcome, 95% CI, multivariable analysis, positive, COVID-19 positive patients, positive COVID-19, enteric, tested, significantly, remained, evaluated, reduced, less, hospitalized patient, individuals, driven by, Clostridioide, COVID-19 negative, infection with COVID-19, patients with COVID-19, patients without COVID-19, with COVID-19, 【제목키워드】 Gastrointestinal, Other, Clostridioide, with COVID-19,