INTRODUCTION: Gastrointestinal (GI) symptoms in coronavirus-19 disease (COVID-19) have been reported with great variability and without standardization. In hospitalized patients, we aimed to evaluate the prevalence of GI symptoms, factors associated with their occurrence, and variation at 1 month. METHODS: The GI-COVID-19 is a prospective, multicenter, controlled study. Patients with and without COVID-19 diagnosis were recruited at hospital admission and asked for GI symptoms at admission and after 1 month, using the validated Gastrointestinal Symptom Rating Scale questionnaire. RESULTS: The study included 2036 hospitalized patients. A total of 871 patients (575 COVID+ and 296 COVID−) were included for the primary analysis. GI symptoms occurred more frequently in patients with COVID-19 (59.7%; 343/575 patients) than in the control group (43.2%; 128/296 patients) (P < 0.001). Patients with COVID-19 complained of higher presence or intensity of nausea, diarrhea, loose stools, and urgency as compared with controls. At a 1-month follow-up, a reduction in the presence or intensity of GI symptoms was found in COVID-19 patients with GI symptoms at hospital admission. Nausea remained increased over controls. Factors significantly associated with nausea persistence in COVID-19 were female sex, high body mass index, the presence of dyspnea, and increased C-reactive protein levels. DISCUSSION: The prevalence of GI symptoms in hospitalized patients with COVID-19 is higher than previously reported. Systemic and respiratory symptoms are often associated with GI complaints. Nausea may persist after the resolution of COVID-19 infection.

Object We aimed to evaluate the elevation of amylase and lipase enzymes in coronavirus disease 2019 (COVID-19) patients and their relationship with the severity of COVID-19. Method In this study, 1378 patients with COVID-19 infection were included. Relation of elevated amylase and lipase levels and comorbidities with the severity of COVID-19 was analyzed. The effects of hemodynamic parameters and organ failure on pancreatic enzymes and their relations with prognosis were statistically analyzed. Results The 1378 patients comprised 700 (51.8%) men and 678 (%49.2) women. Of all patients, 687 (49.9%) had mild and 691 (50.1%) patients had severe COVID-19 infection. Amylase elevation at different levels occurred in 316 (%23) out of 1378 patients. In these patients, the amylase levels increased 1-3 times in 261 and 3 times in 55 patients. Pancreatitis was detected in only 6 (%1.89) of these patients according to the Atlanta criteria. According to univariate and multivariate analyses, elevated amylase levels were significantly associated with the severity of COVID-19 (Odds Ratio [OR]: 4.37; p<0.001). Moreover, diabetes mellitus (DM) (OR: 1.82; p=0.001), kidney failure (OR: 5.18; p<0.001), liver damage (OR: 6.63; p<0.001), hypotension (OR: 6.86; p<0.001), and sepsis (OR: 6.20; p=0.008) were found to be associated with mortality from COVID-19. Conclusion Elevated pancreatic enzyme levels in COVID-19 infections are related to the severity of COVID-19 infection and hemodynamic instability. In a similar way to other organs, the pancreas can be affected by severe COVID-19 infection.

Background/Aims: The aim of our study was to investigate the underlying causes behind the etiology of cirrhosis in Türkiye. Materials and Methods: The study was comprised of patients with cirrhosis located in the gastroenterology clinics of 28 centers in Türkiye between January 2000 and June 2021. Results: The study group consisted of 4953 cirrhotic patients (median age: 62.2 years, male / female: 58% / 42%). Among the patients, 39% of the patients were compensated, and 61% were decompensated. Furthermore, 47.5% had Child-Pugh class A, 38% had ChildPugh class B, and 14.5% had Child-Pugh class C. The most frequent complaints were abdominal bloating (28%). Ascites (54.2%) was the most common manifestation of decompensation. The median Child-Pugh and MELD-Na scores were 7.0 and 10.0, respectively. The most common cause of cirrhosis was chronic viral hepatitis (43%), followed by cryptogenic cirrhosis (CC) (19%), metabolic dysfunction-associated steatotic liver disease (MASLD)-related cirrhosis (13%), and alcohol-related cirrhosis (11%). Among the 950 patients with CC, 416 had metabolic abnormalities. If these 416 CC patients with metabolic abnormalities were categorized as having MASLDrelated cirrhosis, the proportion of MASLD-related cirrhosis increased to 21%. Thirteen percent of the patients were diagnosed with HCC, while 4% had extrahepatic malignancy. Female breast cancer (18%) and colorectal cancer (18%) were the most frequent extrahepatic malignancies. Conclusion: Viral hepatitis remains the main cause of cirrhosis in Türkiye. However, its prevalence seems to be declining, whereas the prevalence of steatotic liver disease-related cirrhosis is increasing. Cite this article as: Üçbilek E, Yıldırım AE, Ellik Z, et al. Changing trends in the etiology of cirrhosis in Türkiye: A multicenter nationwide study. Turk J Gastroenterol. 2024;35(10):772-777.

Background: To investigage the thiol and disulphide levels in Helicobacter pylori-positive patients with non-ulcer dyspepsia and investigate the change in these levels with eradication therapy. Methods: This is a prospective observational study. A total of 320 patients diagnosed with dyspepsia according to Rome IV criteria were included in the study. First, blood samples were drawn from patients to determine their serum thiol and disulphide levels. Endoscopic biopsy was performed on all patients and the biopsy specimens obtained were examined pathologically. Patients positive for H. pylori were administered eradication therapy. Blood samples were drawn from these patients for the second time, and their serum thiol and disulphide levels were measured. The thiol–disulfide levels of the patients who were successful in H. pylori eradication treatment, with those who were not, were compared before and after the treatment. Results: The mean plasma disulphide level decreased significantly from 14.0 ± 6.6 to 10.9 ± 5.9 μmol/L in H. pylori-positive patients that responded to the H. pylori eradication treatment (P = 0.033). On the other hand, there was an insignificant increase in the mean serum thiol level (341.4 ± 30.5 vs. 342.6 ± 29.8 μmol/L; P = 0.273) and an insignificant decrease in the mean serum disulphide level (15.2 ± 2.5 vs. 14.8 ± 2.3 μmol/L; P = 0.163) in H. pylori-positive patients that did not respond to the H. pylori eradication treatment. Conclusion: The inflammation caused by H. pylori shifted the thiol–disulphide equilibrium in the cell redox system towards the direction of disulphide. The study findings suggest that the restoration of the said hemostatic balance with eradication therapy relieved the organism from oxidative stress.

Background Viral infections can cause acute pancreatitis. Idiopathic pancreatitis has an important proportion in the etiology of acute pancreatitis. Objective To investigate the rate of development of acute pancreatitis (AP) in COVID-19 patients and to determine the rate of idiopathic pancreatitis in the etiology of this pancreatitis. Methods A total of 6.467 patients hospitalized with the COVID-19 diagnosis were included in the study. Patients diagnosed with AP based on the Atlanta criteria were identified. Etiological factors were determined in patients who developed acute pancreatitis and compared with the etiological factors in 315 patients with non-COVID-19, hospitalized with the diagnosis of AP before the COVID-19 pandemic. AP was detected in 0.1% of patients with COVID-19. While gallstone was the etiologic factor in 2 (28.6%) of seven patients who developed acute pancreatitis during COVID-19, hyperlipidemia was the factor for 1 (14.3%) patient. Moreover, the etiologic factor could not be determined in 4 (57.1%) patients, and they were regarded as idiopathic pancreatitis patients. Biliary pancreatitis was the most common etiologic factor in 315 (78.4%) patients admitted to the hospital for AP before the COVID-19 pandemic. Idiopathic pancreatitis was ranked second with 16.8%. Conclusion It was observed that there was a significant difference in the incidence of idiopathic pancreatitis between patients with COVID-19 and non-COVID-19 (P=0.015). Results suggest that the SARS-Cov-2 virus may be among the factors leading to AP.

In this study, we evaluated the relation between the presence of lymphopenia and the need of intensive care unit (ICU) or mortality. A total of 1670 COVID-19 patients were divided according to the severity of lymphopenia developing at the time of C...