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Background and aims: Reports indicate that patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection present with gastrointestinal (GI) manifestations and abnormal liver function; however, the impact on clinical findings is unclear. The aim of this study is to report the impact of gastrointestinal and liver injury (LI) associated with coronavirus disease (COVID-19). Material and methods: The authors retrospectively evaluated patients who presented to the emergency department and were diagnosed with COVID-19 by PCR nasopharyngeal swab. Primary outcomes were the impact of GI findings and LI on in-hospital mortality. Secondary outcomes were length of stay in hospital and need for intensive care unit (ICU) level care. Results: Of the entire cohort, 64.0% had LI during hospitalisation. LI was present in 88.7% of those who died. In multivariate analysis, GI manifestations were associated with decreased risk of mortality (odds ratio [OR]: 0.46; 95% confidence interval [CI]: 0.24–0.90; p=0.002). GI symptoms did not impact length of stay, 5.06 days for patients with GI symptoms versus 4.74 in patients without (OR: 1.01; 95% CI: 0.96–1.07; p=0.43), or need for ICU (OR: 0.97; 95% CI: 0.60–1.58; p=0.9076) (Table 1). In multivariate analysis, LI was associated with increased mortality (OR: 8.60; 95% CI: 3.49–21.15; Authors: Michael Makar,1 Carlos D. Minacapelli,2 Kapil Gupta,2 Abhishek Bhurwal,2 You Li,2 Carolyn Catalano,2 Romy Bareket,3 Samuel Jo,1 Abhishek A. Chouthai,3 *Vinod Rustgi2,4 1. Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA 2. Department of Medicine, Division of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA 3. Rutgers Robert Wood Johnson Medical School, New Jersey, USA 4. Center for Liver Diseases and Masses, Rutgers Robert Wood Johnson School of Medicine, New Brunswick New Jersey, USA *Correspondence to vinod.rustgi@rutgers.edu Disclosure: The authors have declared no conflicts of interest. The study was reviewed and approved for publication by the authors’ Institutional Reviewer. Acknowledgements: All authors contributed to all four criteria, concept and design, data acquisition, statistical analysis, and drafting of manuscript. The authors thank data collection assistance by Vinit Palayekar (MD candidate), Daniel Kats (MD candidate), and Robert Gaffey (MD).

Gastrointestinal Manifestations and Liver Injury: Correlation with Mortality and Clinical Outcomes in Patients with COVID-19