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Covid-19
Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection
  1. Lu Lin1,
  2. Xiayang Jiang1,
  3. Zhenling Zhang1,
  4. Siwen Huang1,
  5. Zhenyi Zhang1,
  6. Zhaoxiong Fang1,
  7. Zhiqiang Gu1,
  8. Liangqing Gao1,
  9. Honggang Shi1,
  10. Lei Mai1,
  11. Yuan Liu1,
  12. Xianqi Lin1,
  13. Renxu Lai1,
  14. Zhixiang Yan2,
  15. Xiaofeng Li1,
  16. Hong Shan2,3
  1. 1 Department of Gastroenterology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
  2. 2 Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
  3. 3 Center for Interventional Medicine, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
  1. Correspondence to Professor Hong Shan, Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China; shanhong{at}mail.sysu.edu.cn; Dr Zhixiang Yan, Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China; yanzhx3{at}mail.sysu.edu.cn; Dr Xiaofeng Li, Department of Gastroenterology, Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China; zdwylxf{at}163.com

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.

  • gastrointestinal pathology
  • gastrointestinal tract
  • gastric diseases

This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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http://dx.doi.org/10.1136/gutjnl-2020-321013

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    Footnotes

    • LL and XJ contributed equally.

    • Contributors HS, XL and ZY designed the study. LL, ZY and XJ wrote the manuscript. LL, HS, XL and ZY analysed the data. All authors contributed to the data collection and interpretation of results. All authors read and approved the final manuscript.

    • Funding This work was supported by the National Key Research and Development Program of China (2020YFC082400), the National Natural Science Foundation of China (31900070), the Task-Force Project on the Prevention and Control of Novel Coronavirus of Guangdong Province (20201113), the Three Major Constructions of Sun Yat-sen University (the Task-Force Project on the Prevention and Control of Novel Coronavirus of Sun Yat-sen University), the Emergency Task-Force of SARS-CoV-2 research of Guangzhou Regenerative Medicine and Health Guangdong Laboratory, the Emergency Task-Force Project on the Prevention and Control of Novel Coronavirus of Zhuhai 2020, and Young and middle-aged talents in the Hundred Talents Program of Sun Yat-sen University.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available on reasonable request.

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    © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. https://bmj.com/coronavirus/usage

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