Gastrointestinal symptoms seen frequently in COVID-19

  • Gastroenterology

  • curated by Jenny Blair, MD
  • Clinical Essentials
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Takeaway

  • In this single-center study of patients ill with COVID-19 in Wuhan, China, 1 in 4 patients (most of whom were women) had gastrointestinal (GI) symptoms. 

Why this matters

  • The ACE2 receptor, to which the SARS-CoV-2 virus binds, is expressed not only in lung but also in enterocytes.
  • Infection could follow a digestive route.

Key results

  • Mean age, 50.6 years.
  • 26% had GI symptoms, of whom 62.8% were women (P=.033).
  • Patients with GI symptoms were significantly likelier than those without to experience:
    • Sore throat, dizziness, and fatigue (data not shown).
    • Lower hemoglobin: 116.7 (106-127) vs 133 (114-141) g/L; P=.028.
    • Higher C-reactive protein: 7.3 (2.9-6.6) vs 3.8 (1.8-5.8) mg/L; P=.021.
    • Higher alanine transaminase: 64.1 (51.2-64.4) vs 46.6 (31.9-61.2) IU/L; P=.049.
  • Both groups underwent similar treatments and had similar outcomes (data not shown).

Study design

  • Single-center study of patients with COVID-19 pneumonia in Wuhan (n=254).
  • Authors compared characteristics, clinical outcomes of patients with GI symptoms vs without.
  • Funding: National Natural Science Foundation of China. 

Limitations

  • Specific GI symptoms not listed.
  • Enrollment period was specified (December 20, 2019 through February 9, 2020), but not duration of follow-up.
  • Many patients still hospitalized at close of study; clinical outcomes difficult to assess.
  • Many data summarized but not reported.