Table 1.
Gastrointestinal manifestations in patients with SARS‐CoV‐2 infection
Date | Region | Total patients | Age of affected patients average ± SD/median (range) | Duration of diarrhoea | Disease severity of patients with GI symptoms | Gastrointestinal symptoms | Patients with GI symptoms without respiratory symptoms | Notes | |||
---|---|---|---|---|---|---|---|---|---|---|---|
Huang et al 5 | 16 December‐2 January | Wuhan | 41 | 49 (IQR 41‐58) y | NA | Non‐ICU | Diarrhoea | 1 (3%) | NA | Suggest to test faecal and urine samples to exclude a potential alternative route of transmission | |
Yang et al 6 | Late December‐26 January | Wuhan | 52 | 59.7 ± 13.3 y | NA | All critically ill patients | Gastrointestinal haemorrhage | 2 (4%) | NA | — | |
Vomiting | 2 (4%) | ||||||||||
Liu et al 7 | 1 January‐15 January | Wuhan | 6 children | 3 (1‐7) y | NA |
1 critical case 5 mild‐moderate cases |
Vomiting | 4 (66.7%) | NA | — | |
Chen et al 8 | 1 January‐20 January | Wuhan | 99 | 55.5 ± 13.1 y(21‐82) | NA | NA | Diarrhoea | 2(2%) | NA | — | |
Nausea and vomiting | 1(1%) | ||||||||||
Wang et al 9 | 1 January‐28 January | Wuhan | 138 | 56 (22‐92) y | NA | 36 ICU | 102 non‐ICU | Anorexia | 55 (39.9%) |
14 (10.1%) patients initially presented with diarrhoea and nausea before typical symptoms of fever and dyspnoea One patient presented with abdominal symptoms and was admitted to the surgical department, and infected more than 10 health care workers in this department and 4 hospitalised patients in the same ward |
ICU patients were more likely to present anorexia and abdominal pain |
Anorexia 24(66.7%) | Anorexia 31(30.4%) | ||||||||||
Diarrhoea 6 (16.7%) | Diarrhoea 8 (7.8%) | Diarrhoea | 14 (10.1%) | ||||||||
Nausea 4 (11.1%) | Nausea 10 (9.8%) | Nausea | 14 (10.1%) | ||||||||
Vomiting 3 (8.3%) | Vomiting 2 (2.0%) | Vomiting | 5 (3.6%) | ||||||||
Abdominal pain 3 (8.3%) | Abdominal pain 0 (0%) | Abdominal pain | 3 (2.2%) | ||||||||
Ping et al 10 | 17 January‐24 January | Wuhan | 9 | 35.8 (28‐45) y | NA | No critical cases | Anorexia | 6 |
All nine patients showed only digestive symptoms with no fever onset, and four patients never had respiratory symptoms or fever |
The time between initial nonspecific and specific symptoms was 2‐5 d Digestive symptoms occurred 1‐3 days (median 2.1 d) before the patients’ visit |
|
Nausea | 1 | ||||||||||
Vomiting | 1 | ||||||||||
Diarrhoea | 1 | ||||||||||
Wei et al 11 | 23 January‐8 February | Wuhan | 20 children | 2 years and 1.5 mo (1 d‐14 y 7 mo) | NA | All the patients had good prognosis | Diarrhoea | 3 (15%) | NA | — | |
Vomiting | 2 (10%) | ||||||||||
Fang et al 4 | 27 January‐14 February | Wuhan | 305 | 57 (18‐95) y | 4.1 ± 2.5 d (1‐14) | 46 critical cases | 259 noncritical cases | Diarrhoea | 146/295 (49.5%) | NA |
Diarrhoea appeared 1‐8 d after onset, with a median time of 3.3 d The frequency of diarrhoea was up to nine times per day, median of (3.3 ± 1.6) times per day, 34.3% were watery stools 55.2% (58/105) of patients had diarrhoea after drugs estimating 22.2% of the patients had nondrug‐related diarrhoea |
Digestive symptom 17/20 (85.0%) | Digestive symptom 142/181 (78.5%) | Loss of appetite | 101/201 (50.2%) | ||||||||
Nausea | 59/201 (29.4%) | ||||||||||
Diarrhoea 17/38 (44.7%) | Diarrhoea 129/257 (50.2%) | Vomiting | 32/201 (15.9%) | ||||||||
Abdominal pain | 12/201 (6.0%) | ||||||||||
Chang et al 12 | 16 January‐29 January | Beijing | 13 | 34 (IQR 34 ‐48) y | NA | NA | Diarrhoea | 1 (7.7%) | NA | — | |
Guan et al 13 | 11 December‐29 January | 30 provinces | 1099 | 47 (IQR 35 ‐58) y | NA | 173 Severe | 926 Nonsevere | Nausea or vomiting | 55 (5.0%) | NA | — |
Nausea and vomiting 12 (6.9%) | Nausea and vomiting 43 (4.6%) | ||||||||||
Diarrhoea 10 (5.8%) | Diarrhoea 32 (3.5%) | Diarrhoea | 42(3.8%) | ||||||||
Xu et al 14 | 10 January‐26 January | Zhejiang province | 62 | 41(IQR 32‐52) y | >10 d | 1 critical case | Diarrhoea | 3 (5%) | NA | Three patients showed diarrhoea at onset | |
Song et al 15 | 20 January‐27 January | Shanghai | 51 | 49 ± 16 y (16‐76) | NA | NA | Diarrhoea | 5 (10%) | NA | — | |
Nausea and vomiting | 3 (6%) | ||||||||||
Hu et al 16 | 28 January‐9 February | Nanjing | 24 asymptomatic onset cases |
32.5 (5‐59) y 5 cases <15 y |
NA | All cases were mild‐moderate | Diarrhoea | 2 (8.3%) | NA | Diarrhoea was considered as a reaction of drugs | |
Wang et al 17 | 25 January‐21 February | Six provinces in North | 31 children | 7 y 1 mo, (6 mo‐17 y) | NA | All cases were asymptomatic or mild‐moderate | Diarrhoea | 3 (9.6%) | Three cases had diarrhoea and one case had vomiting as the first symptom without fever or cough | Three cases with diarrhoea were yellow thin faeces, two to six times per day, and no symptoms of dehydration and electrolyte disturbance | |
Vomiting | 2 (6.5%) | ||||||||||
Xiao et al 18 | 1 February‐14 February | Guangzhou | 73 | 10 mo‐78 y | NA | NA | Diarrhoea | 26 (35.6%) | NA |
17/26 (65.4%) patients with diarrhoea were stool PCR positive 4/10 (40%) patients with gastrointestinal bleeding were stool PCR positive |
|
Gastrointestinal bleeding | 10 (13.7%) |
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