Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms

Jin, Xi; Lian, Jiang-Shan; Hu, Jian-Hua; Gao, Jianguo; Zheng, Lin; Zhang, Yi-Min; Hao, Shao-Rui; Jia, Hong-Yu; Cai, Huan; Zhang, Xiao-Li; Yu, Guo-Dong; Xu, Kai-Jin; Wang, Xiao-Yan; Gu, Jue-Qing; Zhang, Shan-Yan; Ye, Chan-Yuan; Jin, Ci-Liang; Lu, Ying-Feng; Yu, Xia; Yu, Xiao-Peng; Huang, Jian-Rong; Xu, Kang-Li; Ni, Qin; Yu, Cheng-Bo; Zhu, Biao; Li, Yong-Tao; Liu, Jun; Zhao, Hong; Zhang, Xuan; Yu, Liang; Guo, Yong-Zheng; Su, Jun-Wei; Tao, Jing-Jing; Lang, Guan-Jing; Wu, Xiao-Xin; Wu, Wen-Rui; Qv, Ting-Ting; Xiang, Dai-Rong; Yi, Ping; Shi, Ding; Chen, Yanfei; Ren, Yue; Qiu, Yun-Qing; Li, Lan-Juan; Sheng, Jifang; Yang, Yida

The definition of positive GI symptoms required that the patients have at least one of the following symptoms: nausea, vomiting and diarrhoea. GI symptoms were recorded on admission, precluding the influence of other medical therapy and external factors. The definition of diarrhoea was the passing of loose stools >3 times per day. A stool culture was performed with negative results for all patients with COVID-19 with GI symptoms. Since the diarrhoea was diagnosed on admission, those patients had no history of recent antibiotic use. Therefore, Clostridium difficile was not detected in the stools. Patients with COVID-19 were divided into four subtypes according to the degree of disease severity, based on the diagnosis and treatment scheme for SARS-CoV-2 of Chinese (sixth edition). The mild type is defined as having slight clinical symptoms without pneumonia on radiography. The common type is defined as presenting with fever and/or respiratory symptoms plus pneumonia on radiography. The severe type was diagnosed according to dyspnoea (respiratory rate (RR) ≥30 times/min), resting finger oxygen saturation ≤93%, artery PaO 2 /FiO 2 ≤300 mm Hg (1 mm Hg=0.133 kPa). The critical type is defined as respiratory failure with shock and multiorgan failure requiring mechanical ventilation and intensive care unit (ICU) admission. The definition of liver damage was alanine aminotransferase (ALT) >50 U/L or aspartate aminotransferase (AST) >40 U/L. The incubation period was calculated from the specific date of contact of the confirmed patient with COVID-19 to the time of onset of illness.