Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms
Xi Jin, Jiangshan Lian, Jianhua Hu, Jianguo Gao, Lin Zheng, Yimin Zhang, Shaorui Hao, Hongyu Jia, Huan Cai, Xiaoli Zhang, Guodong Yu, Kaijin Xu, Xiaoyan Wang, Jueqing Gu, Shanyan Zhang, Chanyuan Ye, Ciliang Jin, Yingfeng Lu, Yu Xia, Xiaopeng Yu, Jianrong Huang, Kang Xu, Qin Ni, Chengbo Yu, Biao Zhu, Yongtao Li, Jun Liu, Hong Zhao, Xuan Zhang, Liang Yu, Yongzheng Guo, Junwei Su, Jingjing Tao, Guanjing Lang, Xiaoxin Wu, Wenrui Wu, Ting-Ting Qv, Dairong Xiang, Ping Yi, Ding Shi, Yanfei Chen, Yue Ren, Yunqing Qiu, Lanjuan Li, Jifang Sheng, Yida Yang
Abstract
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 m 6 A 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.