Published in:
01-12-2021 | SARS-CoV-2 | Original Article
Prevalence of Clostridioides difficile and Other Gastrointestinal Pathogens in Patients with COVID-19
Published in: Digestive Diseases and Sciences | Issue 12/2021
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Background
Gastrointestinal symptoms are common in patients with COVID-19, but prevalence of co-infection with enteric pathogens is unknown.
Aims
This study assessed the prevalence of enteric infections among hospitalized patients with COVID-19.
Methods
We evaluated 4973 hospitalized patients ≥ 18 years of age tested for COVID-19 from March 11 through April 28, 2020, at two academic hospitals. The primary exposure was a positive COVID-19 test. The primary outcome was detection of a gastrointestinal pathogen by PCR stool testing.
Results
Among 4973 hospitalized individuals, 311 were tested for gastrointestinal infections (204 COVID-19 positive, 107 COVID-19 negative). Patients with COVID-19 were less likely to test positive compared to patients without COVID-19 (10% vs 22%, p < 0.01). This trend was driven by lower rates of non-C.difficile infections (11% vs 22% in COVID-19 positive vs. negative, respectively, p = 0.04), but not C. difficile infection (5.1% vs. 8.2%, p = 0.33). On multivariable analysis, infection with COVID-19 remained significantly associated with lower odds of concurrent GI infection (aOR 0.49, 95% CI 0.24–0.97), again driven by reduced non-C.difficile infection. Testing for both C.difficile and non-C.difficile enteric infection decreased dramatically during the pandemic.
Conclusions
Pathogens aside from C.difficile do not appear to be a significant contributor to diarrhea in COVID-19 positive patients.