tetano
Editor, Senior Moderator
Gut. 2020 Mar 24. pii: gutjnl-2020-320926. doi: 10.1136/gutjnl-2020-320926. [Epub ahead of print]
Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms.
Jin X[SUP]1[/SUP], Lian JS[SUP]2[/SUP], Hu JH[SUP]2[/SUP], Gao J[SUP]1[/SUP], Zheng L[SUP]2[/SUP], Zhang YM[SUP]2[/SUP], Hao SR[SUP]2[/SUP], Jia HY[SUP]2[/SUP], Cai H[SUP]2[/SUP], Zhang XL[SUP]2[/SUP], Yu GD[SUP]2[/SUP], Xu KJ[SUP]2[/SUP], Wang XY[SUP]2[/SUP], Gu JQ[SUP]2[/SUP], Zhang SY[SUP]2[/SUP], Ye CY[SUP]2[/SUP], Jin CL[SUP]2[/SUP], Lu YF[SUP]2[/SUP], Yu X[SUP]2[/SUP], Yu XP[SUP]2[/SUP], Huang JR[SUP]2[/SUP], Xu KL[SUP]3[/SUP], Ni Q[SUP]2[/SUP], Yu CB[SUP]2[/SUP], Zhu B[SUP]2[/SUP], Li YT[SUP]2[/SUP], Liu J[SUP]2[/SUP], Zhao H[SUP]2[/SUP], Zhang X[SUP]2[/SUP], Yu L[SUP]2[/SUP], Guo YZ[SUP]2[/SUP], Su JW[SUP]2[/SUP], Tao JJ[SUP]2[/SUP], Lang GJ[SUP]2[/SUP], Wu XX[SUP]2[/SUP], Wu WR[SUP]2[/SUP], Qv TT[SUP]2[/SUP], Xiang DR[SUP]2[/SUP], Yi P[SUP]2[/SUP], Shi D[SUP]2[/SUP], Chen Y[SUP]2[/SUP], Ren Y[SUP]1[/SUP], Qiu YQ[SUP]2[/SUP], Li LJ[SUP]2[/SUP], Sheng J[SUP]2[/SUP], Yang Y[SUP]4[/SUP].
Author information
Abstract
OBJECTIVE:
The SARS-CoV-2-infected disease (COVID-19) outbreak is a major threat to human beings. Previous studies mainly focused on Wuhan and typical symptoms. We analysed 74 confirmed COVID-19 cases with GI symptoms in the Zhejiang province to determine epidemiological, clinical and virological characteristics.
DESIGN:
COVID-19 hospital patients were admitted in the Zhejiang province from 17 January 2020 to 8 February 2020. Epidemiological, demographic, clinical, laboratory, management and outcome data of patients with GI symptoms were analysed using multivariate analysis for risk of severe/critical type. Bioinformatics were used to analyse features of SARS-CoV-2 from Zhejiang province.
RESULTS:
Among enrolled 651 patients, 74 (11.4%) presented with at least one GI symptom (nausea, vomiting or diarrhoea), average age of 46.14 years, 4-day incubation period and 10.8% had pre-existing liver disease. Of patients with COVID-19 with GI symptoms, 17 (22.97%) and 23 (31.08%) had severe/critical types and family clustering, respectively, significantly higher than those without GI symptoms, 47 (8.14%) and 118 (20.45%). Of patients with COVID-19 with GI symptoms, 29 (39.19%), 23 (31.08%), 8 (10.81%) and 16 (21.62%) had significantly higher rates of fever >38.5?C, fatigue, shortness of breath and headache, respectively. Low-dose glucocorticoids and antibiotics were administered to 14.86% and 41.89% of patients, respectively. Sputum production and increased lactate dehydrogenase/glucose levels were risk factors for severe/critical type. Bioinformatics showed sequence mutation of SARS-CoV-2 with m[SUP]6[/SUP]A methylation and changed binding capacity with ACE2.
CONCLUSION:
We report COVID-19 cases with GI symptoms with novel features outside Wuhan. Attention to patients with COVID-19 with non-classic symptoms should increase to protect health providers.
? Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
KEYWORDS:
diarrhoea; infectious disease
PMID:32213556DOI:10.1136/gutjnl-2020-320926
Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms.
Jin X[SUP]1[/SUP], Lian JS[SUP]2[/SUP], Hu JH[SUP]2[/SUP], Gao J[SUP]1[/SUP], Zheng L[SUP]2[/SUP], Zhang YM[SUP]2[/SUP], Hao SR[SUP]2[/SUP], Jia HY[SUP]2[/SUP], Cai H[SUP]2[/SUP], Zhang XL[SUP]2[/SUP], Yu GD[SUP]2[/SUP], Xu KJ[SUP]2[/SUP], Wang XY[SUP]2[/SUP], Gu JQ[SUP]2[/SUP], Zhang SY[SUP]2[/SUP], Ye CY[SUP]2[/SUP], Jin CL[SUP]2[/SUP], Lu YF[SUP]2[/SUP], Yu X[SUP]2[/SUP], Yu XP[SUP]2[/SUP], Huang JR[SUP]2[/SUP], Xu KL[SUP]3[/SUP], Ni Q[SUP]2[/SUP], Yu CB[SUP]2[/SUP], Zhu B[SUP]2[/SUP], Li YT[SUP]2[/SUP], Liu J[SUP]2[/SUP], Zhao H[SUP]2[/SUP], Zhang X[SUP]2[/SUP], Yu L[SUP]2[/SUP], Guo YZ[SUP]2[/SUP], Su JW[SUP]2[/SUP], Tao JJ[SUP]2[/SUP], Lang GJ[SUP]2[/SUP], Wu XX[SUP]2[/SUP], Wu WR[SUP]2[/SUP], Qv TT[SUP]2[/SUP], Xiang DR[SUP]2[/SUP], Yi P[SUP]2[/SUP], Shi D[SUP]2[/SUP], Chen Y[SUP]2[/SUP], Ren Y[SUP]1[/SUP], Qiu YQ[SUP]2[/SUP], Li LJ[SUP]2[/SUP], Sheng J[SUP]2[/SUP], Yang Y[SUP]4[/SUP].
Author information
Abstract
OBJECTIVE:
The SARS-CoV-2-infected disease (COVID-19) outbreak is a major threat to human beings. Previous studies mainly focused on Wuhan and typical symptoms. We analysed 74 confirmed COVID-19 cases with GI symptoms in the Zhejiang province to determine epidemiological, clinical and virological characteristics.
DESIGN:
COVID-19 hospital patients were admitted in the Zhejiang province from 17 January 2020 to 8 February 2020. Epidemiological, demographic, clinical, laboratory, management and outcome data of patients with GI symptoms were analysed using multivariate analysis for risk of severe/critical type. Bioinformatics were used to analyse features of SARS-CoV-2 from Zhejiang province.
RESULTS:
Among enrolled 651 patients, 74 (11.4%) presented with at least one GI symptom (nausea, vomiting or diarrhoea), average age of 46.14 years, 4-day incubation period and 10.8% had pre-existing liver disease. Of patients with COVID-19 with GI symptoms, 17 (22.97%) and 23 (31.08%) had severe/critical types and family clustering, respectively, significantly higher than those without GI symptoms, 47 (8.14%) and 118 (20.45%). Of patients with COVID-19 with GI symptoms, 29 (39.19%), 23 (31.08%), 8 (10.81%) and 16 (21.62%) had significantly higher rates of fever >38.5?C, fatigue, shortness of breath and headache, respectively. Low-dose glucocorticoids and antibiotics were administered to 14.86% and 41.89% of patients, respectively. Sputum production and increased lactate dehydrogenase/glucose levels were risk factors for severe/critical type. Bioinformatics showed sequence mutation of SARS-CoV-2 with m[SUP]6[/SUP]A methylation and changed binding capacity with ACE2.
CONCLUSION:
We report COVID-19 cases with GI symptoms with novel features outside Wuhan. Attention to patients with COVID-19 with non-classic symptoms should increase to protect health providers.
? Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
KEYWORDS:
diarrhoea; infectious disease
PMID:32213556DOI:10.1136/gutjnl-2020-320926