COVID-19-associated nausea and vomiting: Difference between revisions

	WikiDoc Resources for COVID-19-associated nausea and vomiting
Articles
Most recent articles on COVID-19-associated nausea and vomiting Most cited articles on COVID-19-associated nausea and vomiting Review articles on COVID-19-associated nausea and vomiting Articles on COVID-19-associated nausea and vomiting in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on COVID-19-associated nausea and vomiting Images of COVID-19-associated nausea and vomiting Photos of COVID-19-associated nausea and vomiting Podcasts & MP3s on COVID-19-associated nausea and vomiting Videos on COVID-19-associated nausea and vomiting
Evidence Based Medicine
Cochrane Collaboration on COVID-19-associated nausea and vomiting Bandolier on COVID-19-associated nausea and vomiting TRIP on COVID-19-associated nausea and vomiting
Clinical Trials
Ongoing Trials on COVID-19-associated nausea and vomiting at Clinical Trials.gov Trial results on COVID-19-associated nausea and vomiting Clinical Trials on COVID-19-associated nausea and vomiting at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on COVID-19-associated nausea and vomiting NICE Guidance on COVID-19-associated nausea and vomiting NHS PRODIGY Guidance FDA on COVID-19-associated nausea and vomiting CDC on COVID-19-associated nausea and vomiting
Books
Books on COVID-19-associated nausea and vomiting
News
COVID-19-associated nausea and vomiting in the news Be alerted to news on COVID-19-associated nausea and vomiting News trends on COVID-19-associated nausea and vomiting
Commentary
Blogs on COVID-19-associated nausea and vomiting
Definitions
Definitions of COVID-19-associated nausea and vomiting
Patient Resources / Community
Patient resources on COVID-19-associated nausea and vomiting Discussion groups on COVID-19-associated nausea and vomiting Patient Handouts on COVID-19-associated nausea and vomiting Directions to Hospitals Treating COVID-19-associated nausea and vomiting Risk calculators and risk factors for COVID-19-associated nausea and vomiting
Healthcare Provider Resources
Symptoms of COVID-19-associated nausea and vomiting Causes & Risk Factors for COVID-19-associated nausea and vomiting Diagnostic studies for COVID-19-associated nausea and vomiting Treatment of COVID-19-associated nausea and vomiting
Continuing Medical Education (CME)
CME Programs on COVID-19-associated nausea and vomiting
International
COVID-19-associated nausea and vomiting en Espanol COVID-19-associated nausea and vomiting en Francais
Business
COVID-19-associated nausea and vomiting in the Marketplace Patents on COVID-19-associated nausea and vomiting
Experimental / Informatics
List of terms related to COVID-19-associated nausea and vomiting

VisualWikitext

Revision as of 17:13, 28 June 2020

For COVID-19 frequently asked inpatient questions, click here
For COVID-19 frequently asked outpatient questions, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Synonyms and keywords:

Overview

Historical Perspective

The etiological agent is SARS-CoV-2, named for the similarity of its symptoms to those induced by the severe acute respiratory syndrome, causing coronavirus disease 2019 (COVID-19), is a virus identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China.^[1]^[2]
The growing number of patients however, suggest that human-to-human transmission is actively occurring.^[3]^[4]
The outbreak was declared a Public Health Emergency of International Concern on 30 January 2020.
On March 12, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic.

Classification

There is no established system for the classification of nausea and vomiting in COVID-19.

Pathophysiology

SARS-CoV-2 uses the Angiotensin-converting enzyme 2 (ACE2) and the serine protease TMPRSS2 receptors for cell entry. These receptors are presently abundantly not only in the lungs but also in the enterocytes of the small intestine.^[5]^[6] Other sites of expression of the receptors in the gastrointestinal tract are-the upper esophagus, liver, and colon. ^[5]
Entry of the virus causes disruption of the enterocytes and may lead to inflammation and alteration of intestinal permeability.
The gastrointestinal symptoms of COVID-19 are thought to arise due to the invasion of enterocytes. ^[7]

Causes

Disease name] may be caused by [cause1], [cause2], or [cause3].

OR

Common causes of [disease] include [cause1], [cause2], and [cause3].

OR

The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].

OR

The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.

Differentiating ((Page name)) from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

Epidemiology and Demographics

According to a study by Redd et al, the prevalence of nausea in COVID-19 patients was 26%. ^[8]

The more common GI symptoms were-

Anorexia- 35 %
Diarrhea- 34 %

Another study by Luo et al reported that 16% of patients presented with GI symptoms like diarrhea, nausea, vomiting without any respiratory symptoms. ^[9]

Risk Factors

There are no established risk factors for [disease name].

OR

The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].

OR

Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

OR

Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.

Screening

There is insufficient evidence to recommend routine screening for [disease/malignancy].

OR

According to the [guideline name], screening for [disease name] is not recommended.

OR

According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].

Natural History, Complications, and Prognosis

If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

OR

Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].

OR

Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.

Diagnosis

Diagnostic Study of Choice

The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].

OR

The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].

OR

The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].

OR

There are no established criteria for the diagnosis of [disease name].

History and Symptoms

The majority of patients with [disease name] are asymptomatic.

OR

The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].

Physical Examination

Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].

OR

Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

The presence of [finding(s)] on physical examination is diagnostic of [disease name].

OR

The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Laboratory Findings

An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].

OR

Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

OR

[Test] is usually normal among patients with [disease name].

OR

Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].

OR

There are no diagnostic laboratory findings associated with [disease name].

Electrocardiogram

There are no ECG findings associated with [disease name].

OR

An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

X-ray

There are no x-ray findings associated with [disease name].

OR

An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with [disease name].

OR

Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

CT scan

There are no CT scan findings associated with [disease name].

OR

[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

MRI

There are no MRI findings associated with [disease name].

OR

[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Other Imaging Findings

There are no other imaging findings associated with [disease name].

OR

[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

There are no other diagnostic studies associated with [disease name].

OR

[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

There is no treatment for [disease name]; the mainstay of therapy is supportive care.

OR

Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].

OR

The majority of cases of [disease name] are self-limited and require only supportive care.

OR

[Disease name] is a medical emergency and requires prompt treatment.

OR

The mainstay of treatment for [disease name] is [therapy].

OR The optimal therapy for [malignancy name] depends on the stage at diagnosis.

OR

[Therapy] is recommended among all patients who develop [disease name].

OR

Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].

OR

Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].

OR

Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].

OR

Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].

Surgery

Surgical intervention is not recommended for the management of [disease name].

OR

Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]

OR

The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].

OR

The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

Surgery is the mainstay of treatment for [disease or malignancy].

Primary Prevention

There are no established measures for the primary prevention of [disease name].

OR

There are no available vaccines against [disease name].

OR

Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].

OR

[Vaccine name] vaccine is recommended for [patient population] to prevent [disease name]. Other primary prevention strategies include [strategy 1], [strategy 2], and [strategy 3].

Secondary Prevention

There are no established measures for the secondary prevention of [disease name].

OR

Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].

References

↑ https://www.cdc.gov/coronavirus/2019-ncov/about/index.html. Missing or empty |title= (help)
↑ Lu, Jian; Cui, Jie; Qian, Zhaohui; Wang, Yirong; Zhang, Hong; Duan, Yuange; Wu, Xinkai; Yao, Xinmin; Song, Yuhe; Li, Xiang; Wu, Changcheng; Tang, Xiaolu (2020). "On the origin and continuing evolution of SARS-CoV-2". National Science Review. doi:10.1093/nsr/nwaa036. ISSN 2095-5138.
↑ Huang, Chaolin; Wang, Yeming; Li, Xingwang; Ren, Lili; Zhao, Jianping; Hu, Yi; Zhang, Li; Fan, Guohui; Xu, Jiuyang; Gu, Xiaoying; Cheng, Zhenshun; Yu, Ting; Xia, Jiaan; Wei, Yuan; Wu, Wenjuan; Xie, Xuelei; Yin, Wen; Li, Hui; Liu, Min; Xiao, Yan; Gao, Hong; Guo, Li; Xie, Jungang; Wang, Guangfa; Jiang, Rongmeng; Gao, Zhancheng; Jin, Qi; Wang, Jianwei; Cao, Bin (2020). "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China". The Lancet. 395 (10223): 497–506. doi:10.1016/S0140-6736(20)30183-5. ISSN 0140-6736.
↑ https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html. Missing or empty |title= (help)
↑ ^5.0 ^5.1 D'Amico F, Baumgart DC, Danese S, Peyrin-Biroulet L (2020). "Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management". Clin Gastroenterol Hepatol. doi:10.1016/j.cgh.2020.04.001. PMC 7141637 Check |pmc= value (help). PMID 32278065 Check |pmid= value (help).
↑ Liang W, Feng Z, Rao S, Xiao C, Xue X, Lin Z; et al. (2020). "Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus". Gut. 69 (6): 1141–1143. doi:10.1136/gutjnl-2020-320832. PMID 32102928 Check |pmid= value (help).
↑ Wahba L, Jain N, Fire AZ, Shoura MJ, Artiles KL, McCoy MJ; et al. (2020). "An Extensive Meta-Metagenomic Search Identifies SARS-CoV-2-Homologous Sequences in Pangolin Lung Viromes". mSphere. 5 (3). doi:10.1128/mSphere.00160-20. PMC 7203451 Check |pmc= value (help). PMID 32376697 Check |pmid= value (help).
↑ Redd WD, Zhou JC, Hathorn KE, McCarty TR, Bazarbashi AN, Thompson CC; et al. (2020). "Prevalence and Characteristics of Gastrointestinal Symptoms in Patients with SARS-CoV-2 Infection in the United States: A Multicenter Cohort Study". Gastroenterology. doi:10.1053/j.gastro.2020.04.045. PMC 7195377 Check |pmc= value (help). PMID 32333911 Check |pmid= value (help).
↑ Luo S, Zhang X, Xu H (2020). "Don't Overlook Digestive Symptoms in Patients With 2019 Novel Coronavirus Disease (COVID-19)". Clin Gastroenterol Hepatol. 18 (7): 1636–1637. doi:10.1016/j.cgh.2020.03.043. PMC 7154217 Check |pmc= value (help). PMID 32205220 Check |pmid= value (help).

Template:WikiDoc Sources

[1] ttps://www.cdc.gov/coronavirus/2019-ncov/about/index.html. Missing or empty |title= (help)

[LuCui2020-2] Lu, Jian; Cui, Jie; Qian, Zhaohui; Wang, Yirong; Zhang, Hong; Duan, Yuange; Wu, Xinkai; Yao, Xinmin; Song, Yuhe; Li, Xiang; Wu, Changcheng; Tang, Xiaolu (2020). "On the origin and continuing evolution of SARS-CoV-2". National Science Review. doi:10.1093/nsr/nwaa036. ISSN 2095-5138.

[HuangWang2020-3] Huang, Chaolin; Wang, Yeming; Li, Xingwang; Ren, Lili; Zhao, Jianping; Hu, Yi; Zhang, Li; Fan, Guohui; Xu, Jiuyang; Gu, Xiaoying; Cheng, Zhenshun; Yu, Ting; Xia, Jiaan; Wei, Yuan; Wu, Wenjuan; Xie, Xuelei; Yin, Wen; Li, Hui; Liu, Min; Xiao, Yan; Gao, Hong; Guo, Li; Xie, Jungang; Wang, Guangfa; Jiang, Rongmeng; Gao, Zhancheng; Jin, Qi; Wang, Jianwei; Cao, Bin (2020). "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China". The Lancet. 395 (10223): 497–506. doi:10.1016/S0140-6736(20)30183-5. ISSN 0140-6736.

[4] ttps://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html. Missing or empty |title= (help)

[pmid32278065-5] 5.0 ^5.1 D'Amico F, Baumgart DC, Danese S, Peyrin-Biroulet L (2020). "Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management". Clin Gastroenterol Hepatol. doi:10.1016/j.cgh.2020.04.001. PMC 7141637 Check |pmc= value (help). PMID 32278065 Check |pmid= value (help).

[pmid32102928-6] Liang W, Feng Z, Rao S, Xiao C, Xue X, Lin Z; et al. (2020). "Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus". Gut. 69 (6): 1141–1143. doi:10.1136/gutjnl-2020-320832. PMID 32102928 Check |pmid= value (help).

[pmid32376697-7] Wahba L, Jain N, Fire AZ, Shoura MJ, Artiles KL, McCoy MJ; et al. (2020). "An Extensive Meta-Metagenomic Search Identifies SARS-CoV-2-Homologous Sequences in Pangolin Lung Viromes". mSphere. 5 (3). doi:10.1128/mSphere.00160-20. PMC 7203451 Check |pmc= value (help). PMID 32376697 Check |pmid= value (help).

[pmid32333911-8] Redd WD, Zhou JC, Hathorn KE, McCarty TR, Bazarbashi AN, Thompson CC; et al. (2020). "Prevalence and Characteristics of Gastrointestinal Symptoms in Patients with SARS-CoV-2 Infection in the United States: A Multicenter Cohort Study". Gastroenterology. doi:10.1053/j.gastro.2020.04.045. PMC 7195377 Check |pmc= value (help). PMID 32333911 Check |pmid= value (help).

[pmid32205220-9] Luo S, Zhang X, Xu H (2020). "Don't Overlook Digestive Symptoms in Patients With 2019 Novel Coronavirus Disease (COVID-19)". Clin Gastroenterol Hepatol. 18 (7): 1636–1637. doi:10.1016/j.cgh.2020.03.043. PMC 7154217 Check |pmc= value (help). PMID 32205220 Check |pmid= value (help).

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

@@ Line 21: / Line 21: @@
 ==Pathophysiology==
-The exact pathogenesis of [disease name] is not fully understood.
+*SARS-CoV-2 uses the [[Angiotensin-converting enzyme 2]] (ACE2) and the [[serine protease]] [[TMPRSS2]] receptors for cell entry. These receptors are presently abundantly not only in the [[Lung|lungs]] but also in the [[Enterocyte|enterocytes]] of the [[small intestine]].<ref name="pmid32278065">{{cite journal| author=D'Amico F, Baumgart DC, Danese S, Peyrin-Biroulet L| title=Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management. | journal=Clin Gastroenterol Hepatol | year= 2020 | volume=  | issue=  | pages=  | pmid=32278065 | doi=10.1016/j.cgh.2020.04.001 | pmc=7141637 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32278065  }} </ref><ref name="pmid32102928">{{cite journal| author=Liang W, Feng Z, Rao S, Xiao C, Xue X, Lin Z | display-authors=etal| title=Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus. | journal=Gut | year= 2020 | volume= 69 | issue= 6 | pages= 1141-1143 | pmid=32102928 | doi=10.1136/gutjnl-2020-320832 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32102928  }} </ref> Other sites of expression of the receptors in the gastrointestinal tract are-the upper [[esophagus]], [[liver]], and [[Colon (anatomy)|colon]]. <ref name="pmid32278065">{{cite journal| author=D'Amico F, Baumgart DC, Danese S, Peyrin-Biroulet L| title=Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management. | journal=Clin Gastroenterol Hepatol | year= 2020 | volume=  | issue=  | pages=  | pmid=32278065 | doi=10.1016/j.cgh.2020.04.001 | pmc=7141637 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32278065  }} </ref>
+*Entry of the virus causes disruption of the [[Enterocyte|enterocytes]] and may lead to inflammation and alteration of [[Intestine|intestinal]] [[permeability]].
-OR
+* The gastrointestinal symptoms of COVID-19 are thought to arise due to the invasion of enterocytes. <ref name="pmid32376697">{{cite journal| author=Wahba L, Jain N, Fire AZ, Shoura MJ, Artiles KL, McCoy MJ | display-authors=etal| title=An Extensive Meta-Metagenomic Search Identifies SARS-CoV-2-Homologous Sequences in Pangolin Lung Viromes. | journal=mSphere | year= 2020 | volume= 5 | issue= 3 | pages=  | pmid=32376697 | doi=10.1128/mSphere.00160-20 | pmc=7203451 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32376697  }} </ref>
-It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
-OR
-[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
-OR
-Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
-OR
-[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
-OR
-The progression to [disease name] usually involves the [molecular pathway].
-OR
-The pathophysiology of [disease/malignancy] depends on the histological subtype.
 ==Causes==