Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus

Liang, Weicheng; Zhang, Feng; Rao, Shitao; Xiao, Cuicui; Xue, Xingyang; Lin, Zhiyuan; Zhang, Qi; Wei, Qi

doi:10.1136/gutjnl-2020-320832

Cited by 357 publications

(371 citation statements)

References 10 publications

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“…Compared to patients infected with influenza A/B, MPV, PDW, TP, ALB, ALT, CO 2 CP were increased, whereas EO%, EO#, IP, and CK-MB were reduced. Changes in MONO%, WBC, PLT, PLT-I, LYMPH#, EO%, EO#, NEOT#, serum urea, ALT, TP, and ALB were consistent with the results of previous studies [11][12][13][14]. Hematology indices, such as HFLC%, MPV, PCT, PDW, IG%, CO 2 CP, IP, and CK-MB were not mentioned.…”

Section: Discussionsupporting

confidence: 90%

Laboratory data analysis of novel coronavirus (COVID-19) screening in 2510 patients

Sun

et al. 2020

Clinica Chimica Acta

101

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Section: Discussionsupporting

confidence: 90%

Laboratory data analysis of novel coronavirus (COVID-19) screening in 2510 patients

Sun

et al. 2020

Clinica Chimica Acta

101

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“…A significant number of patients with COVID-19 have reported diarrhoea, vomiting and abdominal pain [32]. This is not unexpected as ACE-2 is highly expressed in the small intestinal epithelium [33].These observations underscore the importance of considering COVID-19 while evaluating a patient with fever, cough and diarrhoea.…”

Section: Gastrointestinal Tract and Livermentioning

confidence: 84%

Contentious issues and evolving concepts in the clinical presentation and management of patients with COVID-19 infectionwith reference to use of therapeutic and other drugs used in Co-morbid diseases (Hypertension, diabetes etc)

Gupta

Misra

2020

Diabetes & Metabolic Syndrome: Clinical Research & Revi

111

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a b s t r a c tBackground and aims: Multiple issues in management of COVID have emerged, but confusion persists regarding rational interpretation. Aim of this brief review is to review these issues based on current literature. Methods: This is a narrative review with Pubmed and Google Scholar search till 23 March 2020. Search terms were, COVID-19, treatment of coronavirus, COVID 19 and following terms; chloroquine, hydroxychloroquine, ibuprofen, ACE-inhibitors or angiotensin receptor blockers, cardiovascular disease, diarrhoea, liver, testis and gastrointestinal disease. Results: We discuss evidence regarding role of chloroquine and hydroxychloroquine in treatment and prophylaxis, use of inhibitors of the renin angiotensin system, safety of ibuprofen, unusual clinical features like gastrointestinal symptoms and interpretation of tests for cardiac enzymes and biomarkers. Conclusions: While our conclusions on management of COVID-19 patients with co-morbidities are based on current evidence, however, data is limited and there is immediate need for fast track research.

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“…7 In the prior SARS coronavirus outbreak, diarrhea was reported in up to 25% of patients. 11 Interestingly, the cell entry receptor ACE2 appears to mediate entry of SARS-CoV-2 (similar to SARS) and has been demonstrated to be highly expressed in small intestinal enterocytes. 11 ACE2 is important in controlling intestinal inflammation and its disruption may lead to diarrhea.…”

mentioning

confidence: 99%

“…11 ACE2 is important in controlling intestinal inflammation and its disruption may lead to diarrhea. 11 The reported frequency of diarrhea among COVID-19 patients has varied from 2 to 33% and was one of the prominent symptoms reported by the first case in the United States. 11,12 SARS-CoV-2 has been detected in the stool of COVID-19 patients.…”

mentioning

confidence: 99%

“…11 The reported frequency of diarrhea among COVID-19 patients has varied from 2 to 33% and was one of the prominent symptoms reported by the first case in the United States. 11,12 SARS-CoV-2 has been detected in the stool of COVID-19 patients. 12,13 So while COVID-19 appears to primarily spread through respiratory droplets and secretions, the gastrointestinal tract may be another potential route of infection, highlighting importance of personal protective equipment during endoscopy.…”

mentioning

confidence: 99%

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