SARS-CoV-2 induced diarrhoea as onset symptom in patient with COVID-19

Song, Yimeng; Liu, P; Shi, Xiaoli; Chu, Yufeng; Zhang, J; Xia, Jun; Gao, Xiaowen; Qu, Tingting; Wang, M Y

doi:10.1136/gutjnl-2020-320891

Cited by 322 publications

(297 citation statements)

References 5 publications

(4 reference statements)

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“…A recent study reported a patient initially presented with only GI symptoms. 12 In our study, 11 (11.6%) patients did not have any CT imaging features of COVID-19 pneumonia but only show GI symptoms with 3 (27.3%) occurred at diagnosis, indicating their higher susceptibility of GI system to SARS-CoV-2. While the presence of SARS-CoV-2 in faeces does not necessarily indicate more GI symptoms, the presence of SARS-CoV-2 in GI tissue generally indicates severe symptoms based on the fact that two severe patients have SARS-CoV-2 positive oesophagus, stomach, duodenum and rectum specimens but not the four nonsevere patients.…”

Section: Discussionmentioning

confidence: 45%

Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection

Lü

Jiang

Zhang

et al. 2020

Gut

835

836

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ObjectiveTo study the GI symptoms in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients.DesignWe analysed epidemiological, demographic, clinical and laboratory data of 95 cases with SARS-CoV-2 caused coronavirus disease 2019. Real-time reverse transcriptase PCR was used to detect the presence of SARS-CoV-2 in faeces and GI tissues.ResultsAmong the 95 patients, 58 cases exhibited GI symptoms of which 11 (11.6%) occurred on admission and 47 (49.5%) developed during hospitalisation. Diarrhoea (24.2%), anorexia (17.9%) and nausea (17.9%) were the main symptoms with five (5.3%), five (5.3%) and three (3.2%) cases occurred on the illness onset, respectively. A substantial proportion of patients developed diarrhoea during hospitalisation, potentially aggravated by various drugs including antibiotics. Faecal samples of 65 hospitalised patients were tested for the presence of SARS-CoV-2, including 42 with and 23 without GI symptoms, of which 22 (52.4%) and 9 (39.1%) were positive, respectively. Six patients with GI symptoms were subjected to endoscopy, revealing oesophageal bleeding with erosions and ulcers in one severe patient. SARS-CoV-2 RNA was detected in oesophagus, stomach, duodenum and rectum specimens for both two severe patients. In contrast, only duodenum was positive in one of the four non-severe patients.ConclusionsGI tract may be a potential transmission route and target organ of SARS-CoV-2.

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Section: Discussionmentioning

confidence: 45%

Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection

Lü

Jiang

Zhang

et al. 2020

Gut

835

836

View full text Add to dashboard Cite

show abstract

“…Although the risk of faecal transmission for SARS-Cov-2 is not clear, it remains plausible as SARS-CoV-2 has been detected in the stool of patients with and without symptoms, and viral shedding occurs. [9][10][11][12] It may also persist despite negative results in the respiratory tract. This can result in viral transmission via aerosolisation and faecal-oral route of contamination.…”

Section: Statement 8 Extra Precaution Is Recommended During Colonoscmentioning

confidence: 99%

“…8 Recently, it has been confirmed that COVID-19 can be found in the oral cavity and faecal samples of infected individuals. [9][10][11][12] To date, joint new guidance on the practice of endoscopy has been posted by the American College of Gastroenterology and the British Society of Gastroenterology. 13 14 Contrary to western countries, Asia has already accumulated substantial experience in combating the COVID-19 outbreak; some regions have shown their ability to prevent outbreaks and maintain a high-quality endoscopy service without subjecting patients and staff to undue health hazards.…”

Section: Introductionmentioning

confidence: 99%

Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements)

Chiu

Inoue

et al. 2020

Gut

311

386

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Coronavirus-19 (COVID-19) caused by SARS-CoV-2 has become a global pandemic. Risk of transmission may occur during endoscopy and the goal is to prevent infection among healthcare professionals while providing essential services to patients. Asia was the first continent to have a COVID-19 outbreak, and this position statement of the Asian Pacific Society for Digestive Endoscopy shares our successful experience in maintaining safe and high-quality endoscopy practice at a time when resources are limited. Sixteen experts from key societies of digestive endoscopy in Asia were invited to develop position statements, including patient triage and risk assessment before endoscopy, resource prioritisation and allocation, regular monitoring of personal protective equipment, infection control measures, protective device training and implementation of a strategy for stepwise resumption of endoscopy services after control of the COVID-19 outbreak.

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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: 80%

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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SARS-CoV-2 induced diarrhoea as onset symptom in patient with COVID-19

Cited by 322 publications

References 5 publications

Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection

Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection

Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements)

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)

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