Study from The American Journal of Gastroenterology Reveals Diarrhea is a Prominent Symptom of COVID-19
BETHESDA, Md., March 18, 2020 /PRNewswire/ -- Digestive symptoms are common in COVID-19, occurring as the chief complaint in nearly half of patients presenting to hospital according to a new descriptive, cross-sectional multicenter study from China by investigators from the Wuhan Medical Treatment Expert Group for COVID-19 published today in The American Journal of Gastroenterology, the official publication of the American College of Gastroenterology.
Most patients with COVID-19 present with typical respiratory symptoms and signs. However, early experience with the outbreak in Wuhan, China revealed that many patients experienced digestive symptoms as their chief complaint. "Clinicians must bear in mind that digestive symptoms, such as diarrhea, may be a presenting feature of COVID-19, and that the index of suspicion may need to be raised earlier in these cases rather than waiting for respiratory symptoms to emerge," write the authors.
"In this study, COVID-19 patients with digestive symptoms have a worse clinical outcome and higher risk of mortality compared to those without digestive symptoms, emphasizing the importance of including symptoms like diarrhea to suspect COVID-19 early in the disease course before respiratory symptoms develop," said Brennan M.R. Spiegel, MD, MSHS, FACG, Co-Editor-in-Chief of The American Journal of Gastroenterology. "This may lead to earlier diagnosis of COVID-19, which can lead to earlier treatment and more expeditious quarantine to minimize transmission from people who otherwise remain undiagnosed."
The authors underscore the importance of their finding that COVID-19 patients present with GI symptoms as their chief complaint and warn, "If clinicians solely monitor for respiratory symptoms to establish case definitions for COVID-19, they may miss cases initially presenting with extra-pulmonary symptoms, or the disease may not be diagnosed later until respiratory symptoms emerge."
Compared to COVID-19 patients without digestive symptoms, those with digestive symptoms have a longer time from onset to admission and a worse clinical outcome according to this analysis by investigators from several hospitals and research centers in China who gathered data on 204 patients with COVID-19 presenting to three hospitals in Hubei province from January 18, 2020 to February 28, 2020. Diagnosis was confirmed by real-time RT-PCR. Clinical characteristics, laboratory data and treatment information for the patients were included in the final analysis.
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SOURCE American College of Gastroenterology