The Commonest Medical, Surgical, and Oncological Causes of Acute Abdomen in Adults With COVID-19. A Prospective Observational Study.

Coronaviruses are a large family of viruses that can cause mild to severe respiratory infections. 2019-nCoV is a novel coronavirus that was discovered in Wuhan, China. Since its discovery in humans in late 2019, it has had a global, rapid spread. Dry cough, fever, and fatigue are the most common symptoms in the first two to 14 days after exposure.

At the moment, it is unknown how common gastrointestinal symptoms are. However, COVID-19's initial clinical presentations have become more evident as the pandemic has progressed and case data has been gathered, and literature suggests that digestive symptoms are prevalent .

In a recent systematic review and meta-analysis of 47 studies involving 10,890 patients with COVID-19, the pooled prevalence of gastrointestinal symptoms were 7.7 % for diarrhea, 7.8% for nausea/vomiting, and 2.7% for abdominal pain. Only a few cases of isolated abdominal pain have been reported.

A wide range of diseases can cause acute abdominal pain, and diagnosing them can be difficult. The examining physician should prioritize life-threatening conditions that may necessitate immediate surgical intervention with such a broad differential diagnosis to avoid further mortality or morbidity. The objective of this study was to determine the characteristics, incidence, severity and of acute abdominal pain (medical and surgical causes) during the COVID-19 pandemic.

Study Overview

• Status: Completed
• Conditions: Acute Abdomen
• Intervention / Treatment: Other: medical ,oncological and surgical treatment of cases of acute abdomen

Detailed Description

Coronaviruses are a large family of viruses that can cause mild to severe respiratory infections. 2019-nCoV is a novel coronavirus that was discovered in Wuhan, China. Since its discovery in humans in late 2019, it has had a global, rapid spread. Dry cough, fever, and fatigue are the most common symptoms in the first two to 14 days after exposure.

At the moment, it is unknown how common gastrointestinal symptoms are. However, COVID-19's initial clinical presentations have become more evident as the pandemic has progressed and case data has been gathered, and literature suggests that digestive symptoms are prevalent .

In a recent systematic review and meta-analysis of 47 studies involving 10,890 patients with COVID-19, the pooled prevalence of gastrointestinal symptoms were 7.7 % for diarrhea, 7.8% for nausea/vomiting, and 2.7% for abdominal pain. Only a few cases of isolated abdominal pain have been reported.

A wide range of diseases can cause acute abdominal pain, and diagnosing them can be difficult. The examining physician should prioritize life-threatening conditions that may necessitate immediate surgical intervention with such a broad differential diagnosis to avoid further mortality or morbidity. The objective of this study was to determine the characteristics, incidence, severity and of acute abdominal pain (medical and surgical causes) during the COVID-19 pandemic.

Acute abdominal pain in COVID-19 patients poses a diagnostic quandary for clinicians. Delays in treating an acute abdomen can lead to severe complications and even death. In contrast, performing unnecessary surgery on COVID-19 patients results in increased morbidity and mortality, increased strain on healthcare resources, and an increased risk of exposure for healthcare workers in operative fields. This study aimed to determine the characteristics, incidence and severity, and of various medical and surgical causes of acute abdomen in COVID-19. According to our study, gastritis is the most common medical cause of acute abdomen (19.2%). While acute appendicitis (42.4%), acute cholecystitis (11%), and biliary colic (9.8%) are the most frequently encountered surgical causes of acute abdomen, acute pancreatitis occurred in (3%) of cases and mainly was benign in course. Except for acute appendicitis, intestinal ischemia and liver abscesses, the severity of all causes of acute abdomen did not worsen.

Abdominal pain is a less frequent symptom of COVID-19 infection than anorexia, nausea/vomiting, or diarrhea. Abdominal pain is prevalent in 3.9-6.8% of the population .

• Study Type: Observational
• Enrollment (Actual): 910

Contacts and Locations

Study Locations

• Egypt
  • Sharkia
    • Zagazig, Sharkia, Egypt, 1234
      • Tamer Alnaimy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Adult patients > 18 years of age, both sexes, admitted to the emergency department or already admitted but complaining of an acute abdomen, and diagnosed with COVID-19 using a thoracic computed tomography (CT) scan and/or reverse transcription polymerase chain reaction (RT-PCR) of SARS-CoV-2 RNA, as per the Institute Pasteur protocol and WHO technical guidelines [8]. Patients younger than 18 years of age and those who were not confirmed to be COVID-19 positive were excluded from the study. All patients who underwent chest computed tomography (CT) and a comprehensive panel of routine laboratory tests, which included a complete blood count, urinalysis, blood biochemistry, and blood coagulation function.

Description

Inclusion Criteria:

• >18 years
• male and female
• covid-19 positive
• acute abdomen

Exclusion Criteria:

• < 18 years
• unsure diagnosis of covid-19

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
characteristic, severity and incidence of acute abdomen	incidence in %	2 years

Collaborators and Investigators

• Sponsor: Zagazig University
• Investigators: Principal Investigator: Alnaimy A alnaimy, Phd, Zagazig University

Study record dates

Study Major Dates

• Study Start (ACTUAL): May 1, 2020
• Primary Completion (ACTUAL): February 28, 2022
• Study Completion (ACTUAL): February 28, 2022

Study Registration Dates

• First Submitted: March 24, 2022
• First Submitted That Met QC Criteria: March 24, 2022
• First Posted (ACTUAL): March 25, 2022

Study Record Updates

• Last Update Posted (ACTUAL): September 7, 2022
• Last Update Submitted That Met QC Criteria: September 5, 2022
• Last Verified: September 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Signs and Symptoms, Digestive; Abdominal Pain; Abdomen, Acute
• Other Study ID Numbers: acute abdomen in covid

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No