The relationship between gastrointestinal symptoms, appetite, anxiety and nutritional status in patients with COVID-19

This study was conducted to determine the relationship between gastrointestinal symptoms, appetite and anxiety and nutritional status in individuals followed up with COVID-19. In this study, which is planned as a descriptive and cross-sectional research type, 103 individuals over the age of 20 who were hospitalized due to COVID-19 in Konya Selcuk University Faculty of Medicine chest diseases clinic between February 2021 and April 2021 participated. The demographic characteristics, general health status, anthropometric measurements of the individuals, nutritional and lifestyle habits before and during COVID-19, appetite status, taste and smell status were questioned by the researcher through a questionnaire. Visual analog scale (VAS) was used to subjectively determine the taste, smell, appetite and stress status of individuals. The Gastrointestinal Symptom Rating Scale (GSRS) was used to evaluate gastrointestinal symptoms of individuals, Beck Depression Inventory (BDI) was used to determine anxiety levels, and Subjective Global Assessment (SGD) was used to evaluate nutritional status. It has been observed that individuals experience a loss in their sense of smell (olfaction), taste (gustation), chemesthesis and appetite during the disease process compared to pre-COVID-19. During this period, compared to pre-COVID-19, the appetite of both men and women decreased by about half. The decrease in appetite was higher in women compared to men (p>0.05). It was observed that the loss of taste was significantly higher in women than in men (p<0.05). According to their nutritional status, 59.6% of men followed up with COVID-19 were well-nourished, 40.4% had moderate malnutrition, while 57.1% of women were well-nourished and 42.9% had moderate malnutrition. Women's abdominal pain, reflux, diarrhea, indigestion and constipation mean scores were higher than men. A statistically significant difference was found between the mean constipation scores according to gender (p<0.05). It was observed that the mean scores of abdominal pain, reflux, diarrhea, indigestion and constipation in individuals with moderate malnutrition during the COVID-19 period were higher than those of well-nourished individuals. It was determined that there was a statistically significant difference between individuals with good nutritional status and moderate malnutrition in other gastrointestinal symptoms except diarrhea mean scores (p<0.05). The mean BDI total score was found to be higher in women followed up with COVID-19 than men, and the difference between them was not statistically significant (p>0.05). Among individuals with minimal and mild depression, the rate of those with good nutritional status was found to be higher than those with moderate and severe depression. While loss of taste and smell was more common in individuals with moderate depression, loss of appetite was observed the most in individuals with severe depression. A significant positive correlation was found between the mean BDI total score of individuals with COVID-19 and the differences in VAS appetite (r=0.354), smell (r=0.344), taste (r=0.379) and ghrelin level (r=0.311) (p<0.01). Similarly, a positive and significant correlation was found between the mean GSRS total score and the differences of appetite (r=0.315), smell (r=0.225), taste (r=0.314) visual analog scale and ghrelin mean levels (r=0.228) (p< 0.05). As a result, it has been observed that the appetite is adversely affected in individuals with COVID-19, and there are disturbances or losses in the perception of taste and smell. In addition, individuals developed different gastrointestinal symptoms due to COVID-19 and their anxiety levels were adversely affected. With all these results, it has been determined that individuals followed up with COVID-19 are at risk in terms of nutritional status. For this reason, it is of great importance to evaluate the nutritional status of these patients with appropriate screening tools and to develop strategies to reduce the factors that adversely affect food intake and absorption.