A considerable proportion of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have gastrointestinal manifestations, according to a study involving hospital patients published online 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, dyspnoea, 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 diarrhoea (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 co-author said in a statement.
REFERENCE: Cholankeril et al: High Prevalence of Concurrent Gastrointestinal Manifestations in Patients with SARS-CoV-2: Early Experience from California; https://www.gastrojournal.org/article/S0016-5085(20)30471-6/fulltext