GI Manifestations Seen for Nearly One in Three With SARS-CoV-2
Significant portion have diarrhea, nausea, vomiting, and/or abdominal discomfort before respiratory symptoms
WEDNESDAY, April 29, 2020 (HealthDay News) -- A considerable proportion of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have gastrointestinal manifestations, according to a study involving patients at a U.S. hospital published online April 10 in Gastroenterology.
George Cholankeril, M.D., from Stanford University School of Medicine in Redwood City, California, and colleagues conducted a retrospective analysis on data collected from consecutive patients with confirmed SARS-CoV-2 who presented to a single institution between March 4 and 24, 2020.
The researchers identified 116 patients with confirmed SARS-CoV-2. The most common symptoms at presentation included cough, fever, dyspnea, and myalgias (94.8, 76.7, 58, and 52.2 percent, respectively). These respiratory symptoms had a median duration of 5.0 days. Overall, 31.9 percent of patients reported gastrointestinal symptoms, with 89.2 percent describing their complaints as mild. The most common gastrointestinal symptoms were loss of appetite, nausea/vomiting, and diarrhea (22.3, 12.0, and 12.0 percent, respectively). Isolated gastrointestinal symptoms were not developed by any of the patients, and none had gastrointestinal symptoms as an initial manifestation of SARS-CoV-2 infection. The median duration of gastrointestinal-specific symptoms was one day. Twenty-six of the 65 patients who underwent laboratory testing including liver enzymes had hepatic dysfunction. There was a correlation for severity of overall illness and level of care with aspartate aminotransferase levels at the time of presentation.
"It's possible we may be missing a significant portion of patients sick with the coronavirus due to our current testing strategies focusing on respiratory symptoms alone," one coauthor said in a statement.