Wu Chun-Yang, Yu Xiao-Pin, Ma Ada Hoi Yan, Wang Li-Ping, Yang Nai-Bin, Li Guo-Xiang, Shi Jie-Jun, Qian Guo-Qing
Department of General Internal Medicine, Ningbo City First Hospital, Ningbo, Zhejiang Province, China.
Ningbo City First Hospital, Ningbo, Zhejiang Province, China.
J Int Med Res. 2020 Sep;48(9):300060520952256. doi: 10.1177/0300060520952256.
Since the outbreak of coronavirus disease 2019 (COVID-19) in December 2019, an epidemic has spread rapidly worldwide. COVID-19 is caused by the highly infectious severe acute respiratory syndrome coronavirus-2. A 42-year-old woman presented to hospital who was suffering from epigastric discomfort and dyspepsia for the past 5 days. Before the onset of symptoms, she was healthy, and had no travel history to Wuhan or contact with laboratory-confirmed COVID-19 cases. An examination showed chronic superficial gastritis with erosion and esophagitis. Enhanced magnetic resonance imaging of the abdomen showed a lesion in the right lower lobe of the lungs. Chest computed tomography showed multiple ground-glass opacity in the lungs. Reverse transcription-polymerase chain reaction was negative for severe acute respiratory syndrome coronavirus-2. There was no improvement after antibiotic treatment. Polymerase chain reaction performed 2 days later was positive and she was diagnosed with COVID-19. After several days of antiviral and symptomatic treatments, her symptoms improved and she was discharged. None of the medical staff were infected. Clinical manifestations of COVID-19 are nonspecific, making differentiating it from other diseases difficult. This case shows the sequence in which symptoms developed in a patient with COVID-19 with gastrointestinal symptoms as initial manifestations.
自2019年12月冠状病毒病2019（COVID-19）疫情爆发以来，一种流行病已在全球迅速蔓延。COVID-19由具有高度传染性的严重急性呼吸综合征冠状病毒2引起。一名42岁女性因过去5天出现上腹部不适和消化不良症状前来就医。在症状出现之前，她身体健康，没有前往武汉的旅行史，也没有接触过实验室确诊的COVID-19病例。检查显示为慢性浅表性胃炎伴糜烂和食管炎。腹部增强磁共振成像显示右肺下叶有一个病灶。胸部计算机断层扫描显示肺部有多个磨玻璃影。严重急性呼吸综合征冠状病毒2的逆转录-聚合酶链反应结果为阴性。抗生素治疗后病情无改善。2天后进行的聚合酶链反应结果为阳性，她被诊断为COVID-19。经过几天的抗病毒和对症治疗，她的症状有所改善并出院。医护人员均未被感染。COVID-19的临床表现不具有特异性，难以与其他疾病区分开来。本病例展示了一名以胃肠道症状为首发表现的COVID-19患者症状发展的过程。
