Acute gastrointestinal injury in critically ill patients with coronavirus disease 2019 in Wuhan, China

Jia-Kui Sun

A identified case of COVID-19 was defined as a positive finding on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens (4, 5, 7) . Only laboratory-confirmed cases were enrolled in the analysis. The clinical classification of critical COVID-19 was in accordance with the Chinese recommendations(5): Meeting any of the following, I, respiratory failure with mechanical ventilation (MV); II, shock; III, multiple organs failure requiring ICU treatment. AGI was defined as a malfunction of the gastrointestinal tract due to acute illness and was categorized into four grades according to its severity (10) . This AGI grading system was based mainly on gastrointestinal symptoms, intra-abdominal pressure, feeding tolerance or not. AGI grade I was defined as an increased risk of developing gastrointestinal dysfunction or failure (a self-limiting condition); AGI grade II was defined as gastrointestinal dysfunction (a condition that requires interventions); AGI grade III was defined as gastrointestinal failure (GI function cannot be restored with interventions); AGI grade IV was defined as dramatically manifesting gastrointestinal failure (a condition that is immediately life-threatening) (10) . Sepsis was defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, septic shock was defined as a subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality (11) . The diagnostic criteria of ARDS were in accordance with the Berlin definitions (12) . The definitions of AKI were based on the 2012 Kidney All rights reserved. No reuse allowed without permission. author/funder, who has granted medRxiv a license to display the preprint in perpetuity.