95 例 SARS-CoV-2 感染患者的胃肠道症状。

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

机构信息

Department of Gastroenterology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.

Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China

出版信息

Gut. 2020 Jun;69(6):997-1001. doi: 10.1136/gutjnl-2020-321013. Epub 2020 Apr 2.

DOI:10.1136/gutjnl-2020-321013

PMID:32241899

Abstract

OBJECTIVE

To study the GI symptoms in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients.

DESIGN

We 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.

RESULTS

Among 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.

CONCLUSIONS

GI tract may be a potential transmission route and target organ of SARS-CoV-2.

摘要

目的

研究严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染患者的胃肠道症状。

设计

我们分析了 95 例由 SARS-CoV-2 引起的 2019 年冠状病毒病患者的流行病学、人口统计学、临床和实验室数据。采用实时逆转录聚合酶链反应检测粪便和胃肠道组织中 SARS-CoV-2 的存在。

结果

在 95 例患者中，有 58 例出现胃肠道症状，其中 11 例（11.6%）在入院时发生，47 例（49.5%）在住院期间发生。腹泻（24.2%）、食欲不振（17.9%）和恶心（17.9%）是主要症状，分别有 5 例（5.3%）、5 例（5.3%）和 3 例（3.2%）在发病时发生。相当一部分住院患者出现腹泻，可能与包括抗生素在内的各种药物有关。对 65 例住院患者的粪便样本进行了 SARS-CoV-2 检测，其中 42 例有胃肠道症状，23 例无胃肠道症状，分别有 22 例（52.4%）和 9 例（39.1%）为阳性。6 例有胃肠道症状的患者进行了内镜检查，发现 1 例重症患者有食管出血、糜烂和溃疡。对 2 例重症患者的食管、胃、十二指肠和直肠标本进行了 SARS-CoV-2 RNA 检测，而在 4 例非重症患者中，仅 1 例十二指肠为阳性。