tetano
Editor, Senior Moderator
Gut. 2020 Apr 2. pii: gutjnl-2020-321013. doi: 10.1136/gutjnl-2020-321013. [Epub ahead of print]
Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection.
Lin L[SUP]#[/SUP][SUP]1[/SUP], Jiang X[SUP]#[/SUP][SUP]1[/SUP], Zhang Z[SUP]1[/SUP], Huang S[SUP]1[/SUP], Zhang Z[SUP]1[/SUP], Fang Z[SUP]1[/SUP], Gu Z[SUP]1[/SUP], Gao L[SUP]1[/SUP], Shi H[SUP]1[/SUP], Mai L[SUP]1[/SUP], Liu Y[SUP]1[/SUP], Lin X[SUP]1[/SUP], Lai R[SUP]1[/SUP], Yan Z[SUP]2[/SUP], Li X[SUP]3[/SUP], Shan H[SUP]2,[/SUP][SUP]4[/SUP].
Author information
Abstract
OBJECTIVE:
To study the GI symptoms in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients.
DESIGN:
We analysed epidemiological, demographic, clinical and laboratory data of 95 cases with SARS-CoV-2 caused coronavirus disease 2019. Real-time reverse transcriptase PCR was used to detect the presence of SARS-CoV-2 in faeces and GI tissues.
RESULTS:
Among the 95 patients, 58 cases exhibited GI symptoms of which 11 (11.6%) occurred on admission and 47 (49.5%) developed during hospitalisation. Diarrhoea (24.2%), anorexia (17.9%) and nausea (17.9%) were the main symptoms with five (5.3%), five (5.3%) and three (3.2%) cases occurred on the illness onset, respectively. A substantial proportion of patients developed diarrhoea during hospitalisation, potentially aggravated by various drugs including antibiotics. Faecal samples of 65 hospitalised patients were tested for the presence of SARS-CoV-2, including 42 with and 23 without GI symptoms, of which 22 (52.4%) and 9 (39.1%) were positive, respectively. Six patients with GI symptoms were subjected to endoscopy, revealing oesophageal bleeding with erosions and ulcers in one severe patient. SARS-CoV-2 RNA was detected in oesophagus, stomach, duodenum and rectum specimens for both two severe patients. In contrast, only duodenum was positive in one of the four non-severe patients.
CONCLUSIONS:
GI tract may be a potential transmission route and target organ of SARS-CoV-2.
? Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
KEYWORDS:
gastric diseases; gastrointestinal pathology; gastrointestinal tract
PMID:32241899DOI:10.1136/gutjnl-2020-321013
Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection.
Lin L[SUP]#[/SUP][SUP]1[/SUP], Jiang X[SUP]#[/SUP][SUP]1[/SUP], Zhang Z[SUP]1[/SUP], Huang S[SUP]1[/SUP], Zhang Z[SUP]1[/SUP], Fang Z[SUP]1[/SUP], Gu Z[SUP]1[/SUP], Gao L[SUP]1[/SUP], Shi H[SUP]1[/SUP], Mai L[SUP]1[/SUP], Liu Y[SUP]1[/SUP], Lin X[SUP]1[/SUP], Lai R[SUP]1[/SUP], Yan Z[SUP]2[/SUP], Li X[SUP]3[/SUP], Shan H[SUP]2,[/SUP][SUP]4[/SUP].
Author information
Abstract
OBJECTIVE:
To study the GI symptoms in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients.
DESIGN:
We analysed epidemiological, demographic, clinical and laboratory data of 95 cases with SARS-CoV-2 caused coronavirus disease 2019. Real-time reverse transcriptase PCR was used to detect the presence of SARS-CoV-2 in faeces and GI tissues.
RESULTS:
Among the 95 patients, 58 cases exhibited GI symptoms of which 11 (11.6%) occurred on admission and 47 (49.5%) developed during hospitalisation. Diarrhoea (24.2%), anorexia (17.9%) and nausea (17.9%) were the main symptoms with five (5.3%), five (5.3%) and three (3.2%) cases occurred on the illness onset, respectively. A substantial proportion of patients developed diarrhoea during hospitalisation, potentially aggravated by various drugs including antibiotics. Faecal samples of 65 hospitalised patients were tested for the presence of SARS-CoV-2, including 42 with and 23 without GI symptoms, of which 22 (52.4%) and 9 (39.1%) were positive, respectively. Six patients with GI symptoms were subjected to endoscopy, revealing oesophageal bleeding with erosions and ulcers in one severe patient. SARS-CoV-2 RNA was detected in oesophagus, stomach, duodenum and rectum specimens for both two severe patients. In contrast, only duodenum was positive in one of the four non-severe patients.
CONCLUSIONS:
GI tract may be a potential transmission route and target organ of SARS-CoV-2.
? Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
KEYWORDS:
gastric diseases; gastrointestinal pathology; gastrointestinal tract
PMID:32241899DOI:10.1136/gutjnl-2020-321013