[Skip to Content]
[Skip to Content Landing]

Gastrointestinal Complications in Critically Ill Patients With and Without COVID-19

Educational Objective
To understand the gastrointestinal complications in critically ill patients with and without COVID-19
1 Credit CME

Coronavirus disease 2019 (COVID-19) appears to have significant extrapulmonary complications affecting multiple organ systems.13 Critically ill patients with COVID-19 often develop gastrointestinal complications during their hospital stay, including bowel ischemia, transaminitis, gastrointestinal bleeding, pancreatitis, Ogilvie syndrome, and severe ileus.3 Whether the high incidence of gastrointestinal complications is a manifestation of critical illness in general or is specific to COVID-19 remains unclear. We compared the incidence of gastrointestinal complications of critically ill patients with COVID-19–induced acute respiratory distress syndrome (ARDS) vs comparably ill patients with non–COVID-19 ARDS using propensity score analysis.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Haytham M. A. Kaafarani, MD, MPH, Harvard Medical School, Division of Trauma, Emergency Surgery, and Surgical Critical Care, 165 Cambridge St, Ste 810, Boston, MA 02114 (hkaafarani@mgh.harvard.edu).

Accepted for Publication: September 14, 2020.

Published Online: September 24, 2020. doi:10.1001/jama.2020.19400

Correction: This article was corrected on March 16, 2021, to fix the median (interquartile range) days on opioid drip reported in the Table for patients with acute respiratory distress syndrome with and without COVID-19.

Author Contributions: Dr Kaafarani had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: El Moheb, Naar, Christensen, Maurer, Kaafarani.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: El Moheb, Farhat, Kaafarani.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: El Moheb, Naar, Christensen, Maurer, Farhat, Kaafarani.

Administrative, technical, or material support: Kaafarani.

Supervision: Maurer, Farhat, Kaafarani.

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank George Velmahos, MD, PhD, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, for his clinical expertise and advice. Dr Velmahos was not compensated for his contributions.

References
1.
Hirsch  JS , Ng  JH , Ross  DW ,  et al; Northwell COVID-19 Research Consortium; Northwell Nephrology COVID-19 Research Consortium.  Acute kidney injury in patients hospitalized with COVID-19.   Kidney Int. 2020;98(1):209-218. doi:10.1016/j.kint.2020.05.006PubMedGoogle ScholarCrossref
2.
Levi  M , Thachil  J , Iba  T , Levy  JH .  Coagulation abnormalities and thrombosis in patients with COVID-19.   Lancet Haematol. 2020;7(6):e438-e440. doi:10.1016/S2352-3026(20)30145-9PubMedGoogle ScholarCrossref
3.
Kaafarani  HMA , El Moheb  M , Hwabejire  JO ,  et al.  Gastrointestinal complications in critically ill patients with COVID-19.   Ann Surg. 2020;272(2):e61-e62. doi:10.1097/SLA.0000000000004004PubMedGoogle ScholarCrossref
4.
Ranieri  VM , Rubenfeld  GD , Thompson  BT ,  et al; ARDS Definition Task Force.  Acute respiratory distress syndrome: the Berlin Definition.   JAMA. 2012;307(23):2526-2533.PubMedGoogle Scholar
5.
Qi  F , Qian  S , Zhang  S , Zhang  Z .  Single cell RNA sequencing of 13 human tissues identify cell types and receptors of human coronaviruses.   Biochem Biophys Res Commun. 2020;526(1):135-140. doi:10.1016/j.bbrc.2020.03.044PubMedGoogle ScholarCrossref
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Close
Close

Lookup An Activity

or

My Saved Searches

You currently have no searches saved.

Close

My Saved Courses

You currently have no courses saved.

Close