key: cord-0777065-p8ztdwfe
authors: Cao, Chao; Chen, Meiping; He, Li; Xie, Jiao; Chen, Xiaomin
title: Clinical features and outcomes of COVID-19 patients with gastrointestinal symptoms
date: 2020-06-15
journal: Crit Care
DOI: 10.1186/s13054-020-03034-x
sha: f0b3587192ad1664cf2d6e0fd975222010f1b1c4
doc_id: 777065
cord_uid: p8ztdwfe

nan

Of the 63 patients, 21 (33.3%) had nausea, 47 (74.6%) had anorexia, and 25 (39.7%) had diarrhea. The mean age of those patients was 51.9 years (SD, 14.9). Twentyfour (38.1%) were male, and 24 (38.1%) had chronic diseases. The most common symptoms were cough, fatigue, fever, and muscle soreness. Neither the median white blood cell nor lymphocyte counts were different between patients with and without GI symptoms (Table 1) .

There was no significant difference in viral shedding, the time to clinical recovery, or hospitalization duration between patients with and without GI symptoms (Table 1) . Among patients with GI symptoms, 63.5% received corticosteroids treatment, which is much lower than patients without GI symptoms group (63.5% vs 76.6%; p = 0.0751). Moreover, less patients with GI symptoms developed into severe cases compared with those without GI symptoms (12.7% vs 35.1%; p = 0.0016).

In our experience, 4 out of 10 patients with COVID-19 have significant GI symptoms. There was no significant difference in gender, age, and comorbidities between patients with and without GI symptoms. Leukocyte and lymphocyte counts were similar between the two groups. Besides, there was no significant difference in viral shedding, the time to clinical recovery, or hospitalization duration between patients with and without GI symptoms. Nonetheless, less patients with GI symptoms received corticosteroids and developed into severe cases.

This study suggested that GI symptoms in COVID-19 are frequent but are not associated with the severity of diseases or worse outcomes. However, because SARS-CoV-2 can be found in patient feces and the digestive system, we should be cautious with these potential routes for transmission [2, 3] . This study is limited by the lacked of data of reverse transcriptase polymerase chain reaction on COVID-19 in GI specimens. Our observations indicate that a substantial number of patients present with predominantly GI symptoms, and caution about this atypical presentation is necessary. Authors' contributions CC, LH, JX, and XC design the study; CC, MC, LH, and JX acquired and interpreted the data; CC, MC, and JX analyzed the data and wrote the paper; XC supervised the study. All authors have seen and approved the final draft. GI gastrointestinal, IQR interquartile range, SD standard deviation, WBC white blood cell, ALT alanine aminotransferase, AST aspartate aminotransferase *P values indicate differences between patients with GI symptoms and those without. P < 0.05 was defined as statistically significant

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Participant data without names and identifiers will be made available after approval from the corresponding author.

Ethical approvals for this study were obtained from the Ethics Commission of Ningbo First Hospital (2020-R017) and the Ethics Commission of Jingzhou Central Hospital (2020-2-19) . Written informed consent was waived due to the rapid emergence of this disease.

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Authors have disclosed no conflicts of interest.Author details