# Extrarespiratory, Digestive, and Hepatic Manifestations of COVID-19 in a Moroccan Series

## TL;DR

This study explores digestive and liver symptoms in Moroccan patients with COVID-19, finding that these symptoms are common and may be linked to diabetes, hypertension, and moderate disease severity.

## Contribution

The study provides new insights into the prevalence and associations of digestive and hepatic symptoms in a Moroccan population with COVID-19.

## Key findings

- Digestive symptoms were present in 28% of patients, with nausea/vomiting and diarrhea being most common.
- Digestive symptoms were significantly associated with diabetes, hypertension, and liver function disturbances.
- Nearly half of patients with digestive symptoms had moderate disease, though the association was not statistically significant.

## Abstract

Background: Coronavirus disease 2019 (COVID-19) has emerged as a global human health threat. While SARS-CoV-2 infection exhibits fever and respiratory symptoms, extrarespiratory manifestations were also reported in many cases.

Objectives: This study aimed to determine the prevalence of digestive and hepatic symptoms at the onset of infection and to assess whether digestive symptoms are associated with severe disease progression.

Patients and Methods: Prospective study was conducted during the first COVID-19 wave (from April to October 2020). It included consenting Moroccan patients diagnosed with COVID-19 based on PCR test and chest computed tomography.

Results: A total of 211 patients participated in the study. The patients mean age was 42.3 years, with a sex ratio (F/M) of 1.7. Digestive symptoms were present in 28% of cases, with the most common being nausea or vomiting (12.8%), diarrhea (11.4%), abdominal pain (5.2%), and anorexia (16.6%). These symptoms were significantly associated with diabetes and hypertension. Patients with digestive symptoms reported a significantly higher frequency of anosmia and headache. Hepatic manifestations were present in 21.3%, and digestive symptoms were significantly associated with higher prevalence of liver function disturbances, particularly cholestasis. Nearly half of the patients with digestive symptoms (49.2%) experienced moderate COVID-19, with a higher percentage observed (61.8%) among those aged 42 years or older. However, this association was not statistically significant.

Conclusion: Healthcare professionals need to recognize the range of gastrointestinal and hepatic symptoms to ensure timely diagnosis and effective patient management.