• Xi Jin, Jiang-Shan Lian, Jian-Hua Hu, Jianguo Gao, Lin Zheng, Yi-Min Zhang, Shao-Rui Hao, Hong-Yu Jia, Huan Cai, Xiao-Li Zhang, Guo-Dong Yu, Kai-Jin Xu, Xiao-Yan Wang, Jue-Qing Gu, Shan-Yan Zhang, Chan-Yuan Ye, Ci-Liang Jin, Ying-Feng Lu, Xia Yu, Xiao-Peng Yu, Jian-Rong Huang, Kang-Li Xu, Qin Ni, Cheng-Bo Yu, Biao Zhu, Yong-Tao Li, Jun Liu, Hong Zhao, Xuan Zhang, Liang Yu, Yong-Zheng Guo, Jun-Wei Su, Jing-Jing Tao, Guan-Jing Lang, Xiao-Xin Wu, Wen-Rui Wu, Ting-Ting Qv, Dai-Rong Xiang, Ping Yi, Ding Shi, Yanfei Chen, Yue Ren, Yun-Qing Qiu, Lan-Juan Li, Jifang Sheng, and Yida Yang.
• Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
• Gut. 2020 Jun 1; 69 (6): 1002-1009.

ObjectiveThe 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.DesignCOVID-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.ResultsAmong 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.ConclusionWe 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.© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

26 keywords...

hide…