TY - JOUR T1 - Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms JF - Gut JO - Gut DO - 10.1136/gutjnl-2020-320926 SP - gutjnl-2020-320926 AU - Xi Jin AU - Jiang-Shan Lian AU - Jian-Hua Hu AU - Jianguo Gao AU - Lin Zheng AU - Yi-Min Zhang AU - Shao-Rui Hao AU - Hong-Yu Jia AU - Huan Cai AU - Xiao-Li Zhang AU - Guo-Dong Yu AU - Kai-Jin Xu AU - Xiao-Yan Wang AU - Jue-Qing Gu AU - Shan-Yan Zhang AU - Chan-Yuan Ye AU - Ci-Liang Jin AU - Ying-Feng Lu AU - Xia Yu AU - Xiao-Peng Yu AU - Jian-Rong Huang AU - Kang-Li Xu AU - Qin Ni AU - Cheng-Bo Yu AU - Biao Zhu AU - Yong-Tao Li AU - Jun Liu AU - Hong Zhao AU - Xuan Zhang AU - Liang Yu AU - Yong-Zheng Guo AU - Jun-Wei Su AU - Jing-Jing Tao AU - Guan-Jing Lang AU - Xiao-Xin Wu AU - Wen-Rui Wu AU - Ting-Ting Qv AU - Dai-Rong Xiang AU - Ping Yi AU - Ding Shi AU - Yanfei Chen AU - Yue Ren AU - Yun-Qing Qiu AU - Lan-Juan Li AU - Jifang Sheng AU - Yida Yang Y1 - 2020/03/25 UR - http://gut.bmj.com/content/early/2020/03/24/gutjnl-2020-320926.abstract N2 - Objective The SARS-CoV-2-infected disease (COVID-19) outbreak is a major threat to human beings. Previous studies mainly focused on Wuhan and typical symptoms. We analysed 74 confirmed COVID-19 cases with GI symptoms in the Zhejiang province to determine epidemiological, clinical and virological characteristics.Design COVID-19 hospital patients were admitted in the Zhejiang province from 17 January 2020 to 8 February 2020. Epidemiological, demographic, clinical, laboratory, management and outcome data of patients with GI symptoms were analysed using multivariate analysis for risk of severe/critical type. Bioinformatics were used to analyse features of SARS-CoV-2 from Zhejiang province.Results Among enrolled 651 patients, 74 (11.4%) presented with at least one GI symptom (nausea, vomiting or diarrhoea), average age of 46.14 years, 4-day incubation period and 10.8% had pre-existing liver disease. Of patients with COVID-19 with GI symptoms, 17 (22.97%) and 23 (31.08%) had severe/critical types and family clustering, respectively, significantly higher than those without GI symptoms, 47 (8.14%) and 118 (20.45%). Of patients with COVID-19 with GI symptoms, 29 (39.19%), 23 (31.08%), 8 (10.81%) and 16 (21.62%) had significantly higher rates of fever >38.5°C, fatigue, shortness of breath and headache, respectively. Low-dose glucocorticoids and antibiotics were administered to 14.86% and 41.89% of patients, respectively. Sputum production and increased lactate dehydrogenase/glucose levels were risk factors for severe/critical type. Bioinformatics showed sequence mutation of SARS-CoV-2 with m6A methylation and changed binding capacity with ACE2.Conclusion We report COVID-19 cases with GI symptoms with novel features outside Wuhan. Attention to patients with COVID-19 with non-classic symptoms should increase to protect health providers. ER -