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
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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.