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This study aimed to describe the incidence of these manifestations and their correlation with disease severity in a Brazilian population during the early phase of the pandemic, a context with limited published data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective cohort study of 253 consecutive patients with SARS-CoV-2 conducted in a tertiary hospital in Jo\u00e3o Pessoa, Brazil. Patients were evaluated for the presence of gastrointestinal symptoms, elevated liver enzymes, and clinical outcomes (ICU admission, mortality). Statistical analysis included Mann-Whitney, chi-square, or Fisher tests, and logistic regression. Inclusion criteria were a positive rRT-qPCR for SARS-CoV-2 or clinical-radiological findings (CO-RADS 5) with positive serology. Patients were classified as severe or critical based on respiratory rate, oxygen saturation, and organ failure requiring mechanical ventilation or ICU care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-nine (19.37%) patients presented with gastrointestinal symptoms. No significant differences were found in ICU admission (20.4% vs. 24.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.707) or mortality (16.2% vs. 18.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.674) between groups with and without these symptoms. Elevation of liver enzymes during hospitalization was associated with a longer hospital stay (median 7\u2009days vs. 5\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0016) but not with ICU admission or mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cohort, gastrointestinal symptoms and elevated liver enzymes at admission were not predictors of mortality. However, in-hospital liver enzyme elevation was associated with a longer hospital stay, highlighting its importance as a marker for resource management rather than mortality risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-026-12814-9","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T08:15:12Z","timestamp":1770970512000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of clinical and laboratory manifestations related to the gastrointestinal system and prognosis in hospitalized patients with COVID-19: a prospective cohort study"],"prefix":"10.1186","volume":"26","author":[{"given":"Thiago Henrique","family":"Fernandes de Carvalho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabyan Beltr\u00e3o","family":"Esberard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryana Cavalcanti","family":"Holanda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus Ven\u00e2ncio","family":"de Paiva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele Carvalhal","family":"de Almeida Beltr\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Carvalhal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Felipe","family":"Lacerda Fernandes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Alexandre","family":"Antunes de Brito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"12814_CR1","unstructured":"World Health Organization. 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