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.