The DOI matches its Crossref record; 15 of the 15 references it cites were found in a registry or an index.
Digestive Symptoms in COVID-19 Patients With Mild Disease Severity: Clinical Presentation, Stool Viral RNA Testing, and Outcomes
Open accessAbstract
OBJECTIVES: Coronavirus disease 2019 (COVID-19) most commonly presents with respiratory symptoms, including cough, shortness of breath, and sore throat. However, digestive symptoms also occur in patients with COVID-19 and are often described in outpatients with less severe disease. In this study, we sought to describe the clinical characteristics of COVID-19 patients with digestive symptoms and mild disease severity. METHODS: We identified COVID-19 patients with mild disease and one or more digestive symptoms (diarrhea, nausea, and vomiting), with or without respiratory symptoms, and compared them with a group presenting solely with respiratory symptoms. We followed up patients clinically until they tested negative for COVID-19 on at least 2 sequential respiratory tract specimens collected ≥24 hours apart. We then compared the clinical features between those with digestive symptoms and those with respiratory symptoms. RESULTS: There were 206 patients with low severity COVID-19, including 48 presenting with a digestive symptom alone, 69 with both digestive and respiratory symptoms, and 89 with respiratory symptoms alone. Between the 2 groups with digestive symptoms, 67 presented with diarrhea, of whom 19.4% experienced diarrhea as the first symptom in their illness course. The diarrhea lasted from 1 to 14 days, with an average duration of 5.4 ± 3.1 days and a frequency of 4.3 ± 2.2 bowel movements per day. Concurrent fever was found in 62.4% of patients with a digestive symptom. Patients with digestive symptoms presented for care later than those with respiratory symptoms (16.0 ± 7.7 vs 11.6 ± 5.1 days, P < 0.001). Nevertheless, patients with digestive symptoms had a longer duration between symptom onset and viral clearance ( P < 0.001) and were more likely to be fecal virus positive (73.3% vs 14.3%, P = 0.033) than those with respiratory symptoms. DISCUSSION: We describe a unique subgroup of COVID-19 patients with mild disease severity marked by the presence of digestive symptoms. These patients are more likely to test positive for viral RNA in stool, to have a longer delay before viral clearance, and to experience delayed diagnosis compared with patients with only respiratory symptoms.
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Mao, R., Qiu, Y., He, J.-S., Tan, J.-Y., Li, X.-H., Liang, J., Shen, J., Zhu, L.-R., Chen, Y., Iacucci, M., et al. (2020) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(20)30126-6 · Cited by 1,056
Digestive Manifestations in Patients Hospitalized With Coronavirus Disease 2019
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Bowel ischemia in COVID‐19: A systematic review
Patel, S., Parikh, C., Verma, D., Sundararajan, R., Agrawal, U., Bheemisetty, N., Akku, R., Sánchez‐Velazco, D., & Waleed, M. S. (2021) · International Journal of Clinical Practice · doi:10.1111/ijcp.14930 · Cited by 31
Metadata
- Authors
- Han, C., Duan, C., Zhang, S., Spiegel, B., Shi, H., Wang, W., Zhang, L., Lin, R., Liu, J., Ding, Z., & Hou, X.
- Affiliations
- Wuhan Union Hospital (CN)
- Cedars-Sinai Medical Center (US)
- Corresponding author
- Hou, Xiaohua
- ORCID
- Venue
- American Journal of Gastroenterology
- Published
- 2020-04-15
- Volume
- 115
- Issue
- 6
- Pages
- 916-923
- ISSN
- 0002-9270 (ISSN-L)
- 1572-0241
- PMC
- PMC7172493
- OpenAlex
- W3016330801
- Cited by
- 587
- References
- 15
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 36 · 2023: 51 · 2022: 119 · 2021: 181 · 2020: 186
- FWCI
- 17.59
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Dermatology › Dermatological and COVID-19 studies
- Keywords
- COVID-19 pandemic, gastrointestinal symptoms, diarrhea, viral clearance, delayed diagnosis, nausea and vomiting, clinical features
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, COVID-19 Testing, China, Diarrhea, Digestive System Diseases, Feces, Female, Humans, Male, Middle Aged, Pneumonia, Viral, RNA, Viral, Severity of Illness Index, Outcome Assessment, Health Care, Coronavirus Infections, Clinical Laboratory Techniques, Pandemics, Symptom Assessment
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