PT - JOURNAL ARTICLE AU - Jin, Xi AU - Lian, Jiang-Shan AU - Hu, Jian-Hua AU - Gao, Jianguo AU - Zheng, Lin AU - Zhang, Yi-Min AU - Hao, Shao-Rui AU - Jia, Hong-Yu AU - Cai, Huan AU - Zhang, Xiao-Li AU - Yu, Guo-Dong AU - Xu, Kai-Jin AU - Wang, Xiao-Yan AU - Gu, Jue-Qing AU - Zhang, Shan-Yan AU - Ye, Chan-Yuan AU - Jin, Ci-Liang AU - Lu, Ying-Feng AU - Yu, Xia AU - Yu, Xiao-Peng AU - Huang, Jian-Rong AU - Xu, Kang-Li AU - Ni, Qin AU - Yu, Cheng-Bo AU - Zhu, Biao AU - Li, Yong-Tao AU - Liu, Jun AU - Zhao, Hong AU - Zhang, Xuan AU - Yu, Liang AU - Guo, Yong-Zheng AU - Su, Jun-Wei AU - Tao, Jing-Jing AU - Lang, Guan-Jing AU - Wu, Xiao-Xin AU - Wu, Wen-Rui AU - Qv, Ting-Ting AU - Xiang, Dai-Rong AU - Yi, Ping AU - Shi, Ding AU - Chen, Yanfei AU - Ren, Yue AU - Qiu, Yun-Qing AU - Li, Lan-Juan AU - Sheng, Jifang AU - Yang, Yida TI - Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms AID - 10.1136/gutjnl-2020-320926 DP - 2020 Jun 01 TA - Gut PG - 1002--1009 VI - 69 IP - 6 4099 - http://gut.bmj.com/content/69/6/1002.short 4100 - http://gut.bmj.com/content/69/6/1002.full SO - Gut2020 Jun 01; 69 AB - 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.