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GI symptoms and fever increase the risk of severe illness and death in patients with COVID-19
  1. Jue Liu1,
  2. Liyuan Tao2,
  3. Xia Liu3,
  4. Hongyan Yao4,
  5. Shicheng Yu4,
  6. Qiqi Wang4,
  7. Jiaojiao Zhang4,
  8. Zhancheng Gao5,
  9. Rongmeng Jiang6,
  10. Wenzhan Jing1,
  11. Min Liu1
  1. 1 Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
  2. 2 Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
  3. 3 Chinese Preventive Medicine Association, Beijing, China
  4. 4 Chinese Center for Disease Control and Prevention, Beijing, China
  5. 5 Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China
  6. 6 Centre for Infectious Disease, Capital Medical University Affiliated Beijing Ditan Hospital, Beijing, China
  1. Correspondence to Professor Min Liu, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China; liumin{at}bjmu.edu.cn

https://doi.org/10.1136/gutjnl-2020-321751

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    COVID-19 pandemic has become a major public health problem globally. Fever is the most common symptom. Besides fever, GI symptoms has also been reported in patients with COVID-19, such as diarrhoea, nausea, vomiting and abdominal pain and affect up to 28% of patients.1–5 Several previous studies assessed the association between GI symptoms and disease severity and yielded inconsistent results.1 2 6 In this retrospective cohort study, we explored whether GI symptoms and fever increased the risk of severe illness or death in patients with COVID-19.

    We analysed 29 393 laboratory-confirmed COVID-19 patients diagnosed before 21 March 2020 in cities outside of Wuhan in mainland China. The study was supported by the National Health Commission of China. The final data of follow-up were 17 April 2020. We excluded clinically diagnosed cases who were not laboratory confirmed and patients who were not discharged from hospital by 17 April 2020. The diagnosis of laboratory-confirmed COVID-19 case, severe cases (including critical cases) and death was conducted by local healthcare workers according to the national diagnosis and treatment protocol for COVID-19 released by the National Health Commission.7 The definition of having …

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