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Real-World Evidence for COVID-19 Delta Variant’s Effects on the Digestive System and Protection of Inactivated Vaccines from a Medical Center in Yangzhou, China: A Retrospective Observational Study

Background. Coronavirus disease 2019 (COVID-19) is rapidly disseminated worldwide, and it continues to threaten global public health. Recently, the Delta variant has emerged as the most dreaded variant worldwide. COVID-19 predominantly affects the respiratory tract, and studies have reported the tra...

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Published in:International journal of clinical practice (Esher) 2022, Vol.2022, p.7405448-9
Main Authors: Zhao, Wenjing, Li, Yong, Xie, Ruijin, Dong, Yuying, Wei, Yan, Cheng, Ce, Lowe, Scott, Sun, Chenyu, Wang, Cunjin, Gao, Ju
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container_title International journal of clinical practice (Esher)
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creator Zhao, Wenjing
Li, Yong
Xie, Ruijin
Dong, Yuying
Wei, Yan
Cheng, Ce
Lowe, Scott
Sun, Chenyu
Wang, Cunjin
Gao, Ju
description Background. Coronavirus disease 2019 (COVID-19) is rapidly disseminated worldwide, and it continues to threaten global public health. Recently, the Delta variant has emerged as the most dreaded variant worldwide. COVID-19 predominantly affects the respiratory tract, and studies have reported the transient effects of COVID-19 on digestive system function. However, the relationship between the severity of the Delta variant and digestive system function remains to be investigated. Additionally, data on the ability of the inactive Chinese vaccines (Sinovac or Sinopharm) to protect against the Delta variant or COVID-19-induced gastrointestinal symptoms in the real world are insufficient. Thus, the present retrospective observational study first attempted to use the total gastrointestinal symptom rating scale scores (GSRS) to quantify the possible changes in digestive system functions following the Delta variant infection in the early stage. In addition, the study discusses the potential of inactivated vaccines in preventing severe or critical symptoms or Delta variant-induced digestive system dysfunction. Methods. To evaluate the difference between mild illness group, moderate illness group, and severe or critical illness group, analysis of variance (ANOVA) was employed to compare the three groups' total gastrointestinal symptom rating scale scores (GSRS). A chi-squared test was used to compare the differences in the ratio of the abnormal biochemical measurements among the three groups first. Then, the percentage of the vaccinated population was compared among the three groups. Additionally, the ratio of the abnormal serum markers between the vaccinated and nonvaccinated cohorts was compared. A P value 
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Coronavirus disease 2019 (COVID-19) is rapidly disseminated worldwide, and it continues to threaten global public health. Recently, the Delta variant has emerged as the most dreaded variant worldwide. COVID-19 predominantly affects the respiratory tract, and studies have reported the transient effects of COVID-19 on digestive system function. However, the relationship between the severity of the Delta variant and digestive system function remains to be investigated. Additionally, data on the ability of the inactive Chinese vaccines (Sinovac or Sinopharm) to protect against the Delta variant or COVID-19-induced gastrointestinal symptoms in the real world are insufficient. Thus, the present retrospective observational study first attempted to use the total gastrointestinal symptom rating scale scores (GSRS) to quantify the possible changes in digestive system functions following the Delta variant infection in the early stage. In addition, the study discusses the potential of inactivated vaccines in preventing severe or critical symptoms or Delta variant-induced digestive system dysfunction. Methods. To evaluate the difference between mild illness group, moderate illness group, and severe or critical illness group, analysis of variance (ANOVA) was employed to compare the three groups' total gastrointestinal symptom rating scale scores (GSRS). A chi-squared test was used to compare the differences in the ratio of the abnormal biochemical measurements among the three groups first. Then, the percentage of the vaccinated population was compared among the three groups. Additionally, the ratio of the abnormal serum markers between the vaccinated and nonvaccinated cohorts was compared. A P value &lt; 0.05 was considered statistically significant. Results. Significant differences were observed in the abnormal ratio of alanine aminotransferase (ALT), total bilirubin (TBIL), direct bilirubin (DBIL), lactate dehydrogenase (LDH), and Interleukin 6 (IL-6) ratio among the three groups (P&lt;0.05). Additionally, no significant difference was observed in the abnormal serum markers ratio between day 14 and day 21 after treatment (P&gt;0.05). A significant difference was observed in the total GSRS scores among the three groups and the ratio of the vaccinated population among the three groups (P&lt;0.05). A significant difference was observed in the ratio of the abnormal serum ALT and AST levels between the vaccinated and nonvaccinated cohorts (P&lt;0.05). Conclusions. In summary, serum AST, DBIL, LDH, and IL-6 levels are potential markers for distinguishing severe or critical patients in the early stage of the Delta variant infection. Additionally, changes in the levels of these serum makers are transient, and the levels can return to normal after treatment. Furthermore, severe gastrointestinal discomfort was significantly more prevalent in patients with severe or critical diseases and should thus be considered in patients diagnosed with Delta variant infection. Finally, inactivated vaccines may prevent severe or critical symptoms and Delta variant-induced liver dysfunction. Vaccination programs must be promoted to protect public health.</description><identifier>ISSN: 1368-5031</identifier><identifier>ISSN: 1742-1241</identifier><identifier>EISSN: 1742-1241</identifier><identifier>DOI: 10.1155/2022/7405448</identifier><identifier>PMID: 36052305</identifier><language>eng</language><publisher>India: Hindawi</publisher><subject>Alanine transaminase ; Bilirubin ; Biomarkers ; Cardiovascular disease ; China - epidemiology ; Chronic obstructive pulmonary disease ; Coronaviruses ; COVID-19 ; COVID-19 - prevention &amp; control ; COVID-19 vaccines ; Cytokines ; Diarrhea ; Digestive System ; Gastrointestinal Diseases - diagnosis ; Hospitals ; Humans ; Illnesses ; Infections ; Interleukin 6 ; Kinases ; L-Lactate dehydrogenase ; Liver diseases ; Medical records ; Observational studies ; Patients ; Public health ; Respiratory tract ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Statistical analysis ; Vaccines ; Vaccines, Inactivated - therapeutic use ; Variance analysis</subject><ispartof>International journal of clinical practice (Esher), 2022, Vol.2022, p.7405448-9</ispartof><rights>Copyright © 2022 Wenjing Zhao et al.</rights><rights>Copyright © 2022 Wenjing Zhao et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0</rights><rights>Copyright © 2022 Wenjing Zhao et al. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-62bb292cd703a464ea63403e42324e9812f5223520648ab13eab177c1674e30d3</citedby><cites>FETCH-LOGICAL-c448t-62bb292cd703a464ea63403e42324e9812f5223520648ab13eab177c1674e30d3</cites><orcidid>0000-0002-8223-389X ; 0000-0003-3812-3164 ; 0000-0002-3035-7786 ; 0000-0001-7063-7574</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9417746/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9417746/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,27923,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36052305$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Cui, Dawei</contributor><contributor>Dawei Cui</contributor><creatorcontrib>Zhao, Wenjing</creatorcontrib><creatorcontrib>Li, Yong</creatorcontrib><creatorcontrib>Xie, Ruijin</creatorcontrib><creatorcontrib>Dong, Yuying</creatorcontrib><creatorcontrib>Wei, Yan</creatorcontrib><creatorcontrib>Cheng, Ce</creatorcontrib><creatorcontrib>Lowe, Scott</creatorcontrib><creatorcontrib>Sun, Chenyu</creatorcontrib><creatorcontrib>Wang, Cunjin</creatorcontrib><creatorcontrib>Gao, Ju</creatorcontrib><title>Real-World Evidence for COVID-19 Delta Variant’s Effects on the Digestive System and Protection of Inactivated Vaccines from a Medical Center in Yangzhou, China: A Retrospective Observational Study</title><title>International journal of clinical practice (Esher)</title><addtitle>Int J Clin Pract</addtitle><description>Background. Coronavirus disease 2019 (COVID-19) is rapidly disseminated worldwide, and it continues to threaten global public health. Recently, the Delta variant has emerged as the most dreaded variant worldwide. COVID-19 predominantly affects the respiratory tract, and studies have reported the transient effects of COVID-19 on digestive system function. However, the relationship between the severity of the Delta variant and digestive system function remains to be investigated. Additionally, data on the ability of the inactive Chinese vaccines (Sinovac or Sinopharm) to protect against the Delta variant or COVID-19-induced gastrointestinal symptoms in the real world are insufficient. Thus, the present retrospective observational study first attempted to use the total gastrointestinal symptom rating scale scores (GSRS) to quantify the possible changes in digestive system functions following the Delta variant infection in the early stage. In addition, the study discusses the potential of inactivated vaccines in preventing severe or critical symptoms or Delta variant-induced digestive system dysfunction. Methods. To evaluate the difference between mild illness group, moderate illness group, and severe or critical illness group, analysis of variance (ANOVA) was employed to compare the three groups' total gastrointestinal symptom rating scale scores (GSRS). A chi-squared test was used to compare the differences in the ratio of the abnormal biochemical measurements among the three groups first. Then, the percentage of the vaccinated population was compared among the three groups. Additionally, the ratio of the abnormal serum markers between the vaccinated and nonvaccinated cohorts was compared. A P value &lt; 0.05 was considered statistically significant. Results. Significant differences were observed in the abnormal ratio of alanine aminotransferase (ALT), total bilirubin (TBIL), direct bilirubin (DBIL), lactate dehydrogenase (LDH), and Interleukin 6 (IL-6) ratio among the three groups (P&lt;0.05). Additionally, no significant difference was observed in the abnormal serum markers ratio between day 14 and day 21 after treatment (P&gt;0.05). A significant difference was observed in the total GSRS scores among the three groups and the ratio of the vaccinated population among the three groups (P&lt;0.05). A significant difference was observed in the ratio of the abnormal serum ALT and AST levels between the vaccinated and nonvaccinated cohorts (P&lt;0.05). Conclusions. In summary, serum AST, DBIL, LDH, and IL-6 levels are potential markers for distinguishing severe or critical patients in the early stage of the Delta variant infection. Additionally, changes in the levels of these serum makers are transient, and the levels can return to normal after treatment. Furthermore, severe gastrointestinal discomfort was significantly more prevalent in patients with severe or critical diseases and should thus be considered in patients diagnosed with Delta variant infection. Finally, inactivated vaccines may prevent severe or critical symptoms and Delta variant-induced liver dysfunction. 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Li, Yong ; Xie, Ruijin ; Dong, Yuying ; Wei, Yan ; Cheng, Ce ; Lowe, Scott ; Sun, Chenyu ; Wang, Cunjin ; Gao, Ju</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-62bb292cd703a464ea63403e42324e9812f5223520648ab13eab177c1674e30d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Alanine transaminase</topic><topic>Bilirubin</topic><topic>Biomarkers</topic><topic>Cardiovascular disease</topic><topic>China - epidemiology</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - prevention &amp; control</topic><topic>COVID-19 vaccines</topic><topic>Cytokines</topic><topic>Diarrhea</topic><topic>Digestive System</topic><topic>Gastrointestinal Diseases - diagnosis</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Illnesses</topic><topic>Infections</topic><topic>Interleukin 6</topic><topic>Kinases</topic><topic>L-Lactate dehydrogenase</topic><topic>Liver diseases</topic><topic>Medical records</topic><topic>Observational studies</topic><topic>Patients</topic><topic>Public health</topic><topic>Respiratory tract</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Statistical analysis</topic><topic>Vaccines</topic><topic>Vaccines, Inactivated - therapeutic use</topic><topic>Variance analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhao, Wenjing</creatorcontrib><creatorcontrib>Li, Yong</creatorcontrib><creatorcontrib>Xie, Ruijin</creatorcontrib><creatorcontrib>Dong, Yuying</creatorcontrib><creatorcontrib>Wei, Yan</creatorcontrib><creatorcontrib>Cheng, Ce</creatorcontrib><creatorcontrib>Lowe, Scott</creatorcontrib><creatorcontrib>Sun, Chenyu</creatorcontrib><creatorcontrib>Wang, Cunjin</creatorcontrib><creatorcontrib>Gao, Ju</creatorcontrib><collection>Hindawi Publishing Complete</collection><collection>Hindawi Publishing Subscription Journals</collection><collection>Hindawi Publishing Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; 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Coronavirus disease 2019 (COVID-19) is rapidly disseminated worldwide, and it continues to threaten global public health. Recently, the Delta variant has emerged as the most dreaded variant worldwide. COVID-19 predominantly affects the respiratory tract, and studies have reported the transient effects of COVID-19 on digestive system function. However, the relationship between the severity of the Delta variant and digestive system function remains to be investigated. Additionally, data on the ability of the inactive Chinese vaccines (Sinovac or Sinopharm) to protect against the Delta variant or COVID-19-induced gastrointestinal symptoms in the real world are insufficient. Thus, the present retrospective observational study first attempted to use the total gastrointestinal symptom rating scale scores (GSRS) to quantify the possible changes in digestive system functions following the Delta variant infection in the early stage. In addition, the study discusses the potential of inactivated vaccines in preventing severe or critical symptoms or Delta variant-induced digestive system dysfunction. Methods. To evaluate the difference between mild illness group, moderate illness group, and severe or critical illness group, analysis of variance (ANOVA) was employed to compare the three groups' total gastrointestinal symptom rating scale scores (GSRS). A chi-squared test was used to compare the differences in the ratio of the abnormal biochemical measurements among the three groups first. Then, the percentage of the vaccinated population was compared among the three groups. Additionally, the ratio of the abnormal serum markers between the vaccinated and nonvaccinated cohorts was compared. A P value &lt; 0.05 was considered statistically significant. Results. Significant differences were observed in the abnormal ratio of alanine aminotransferase (ALT), total bilirubin (TBIL), direct bilirubin (DBIL), lactate dehydrogenase (LDH), and Interleukin 6 (IL-6) ratio among the three groups (P&lt;0.05). Additionally, no significant difference was observed in the abnormal serum markers ratio between day 14 and day 21 after treatment (P&gt;0.05). A significant difference was observed in the total GSRS scores among the three groups and the ratio of the vaccinated population among the three groups (P&lt;0.05). A significant difference was observed in the ratio of the abnormal serum ALT and AST levels between the vaccinated and nonvaccinated cohorts (P&lt;0.05). Conclusions. In summary, serum AST, DBIL, LDH, and IL-6 levels are potential markers for distinguishing severe or critical patients in the early stage of the Delta variant infection. Additionally, changes in the levels of these serum makers are transient, and the levels can return to normal after treatment. Furthermore, severe gastrointestinal discomfort was significantly more prevalent in patients with severe or critical diseases and should thus be considered in patients diagnosed with Delta variant infection. Finally, inactivated vaccines may prevent severe or critical symptoms and Delta variant-induced liver dysfunction. Vaccination programs must be promoted to protect public health.</abstract><cop>India</cop><pub>Hindawi</pub><pmid>36052305</pmid><doi>10.1155/2022/7405448</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-8223-389X</orcidid><orcidid>https://orcid.org/0000-0003-3812-3164</orcidid><orcidid>https://orcid.org/0000-0002-3035-7786</orcidid><orcidid>https://orcid.org/0000-0001-7063-7574</orcidid><oa>free_for_read</oa></addata></record>
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source Wiley-Blackwell Open Access Titles; PubMed Central
subjects Alanine transaminase
Bilirubin
Biomarkers
Cardiovascular disease
China - epidemiology
Chronic obstructive pulmonary disease
Coronaviruses
COVID-19
COVID-19 - prevention & control
COVID-19 vaccines
Cytokines
Diarrhea
Digestive System
Gastrointestinal Diseases - diagnosis
Hospitals
Humans
Illnesses
Infections
Interleukin 6
Kinases
L-Lactate dehydrogenase
Liver diseases
Medical records
Observational studies
Patients
Public health
Respiratory tract
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Statistical analysis
Vaccines
Vaccines, Inactivated - therapeutic use
Variance analysis
title Real-World Evidence for COVID-19 Delta Variant’s Effects on the Digestive System and Protection of Inactivated Vaccines from a Medical Center in Yangzhou, China: A Retrospective Observational Study
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