Clinical Case Series of Gastrointestinal Symptoms in Patients With Novel Coronavirus 2019 Infection

Various digestive symptoms have been frequently reported in a significant portion of patients infected with the virus since the outbreak of Coronavirus Disease 2019 (COVID-19). Most patients with COVID-19 have a fever accompanied by respiratory signs and symptoms, such as cough and dyspnea. We present 36 cases with a chief complaint of Gastrointestinal (GI) symptoms along with respiratory symptoms. In this study, we aimed at investigating the prevalence and outcomes of COVID-19 patients with digestive symptoms.

A variety of observed GI symptoms included nausea and vomiting (72.2%), diarrhea (25%), abdominal pain (19.4%), loss of appetite (14%), and anosmia (14%). The most non-GI symptoms were dyspnea (66.7%), fever (66.7%), dry cough (58.3%), myalgia (52.4%), and others. Six patients (16.6%) were critically ill, 7 (19.4%) were in stable condition, and 23 patients (64%) showed moderate symptoms. Among the patients, 7 (19.5%) needed critical care and were admitted to ICU. Leucopenia, lymphopenia, and elevated acute-phase proteins were other features observed in these patients. The most common antiviral regimen was hydroxychloroquine and oseltamivir. Finally, 32 patients (89%) were discharged, and 4 (11%) died. 

This case series study highlights that patients with COVID-19 are prone to GI symptoms along with fever and respiratory symptoms. Patients may even present with digestive symptoms and without any respiratory symptoms. Hence, clinicians should pay more attention to these patients and help diagnose COVID-19 earlier to start prompt treatment before the occurrence of severe disease.