Infectious Diseases Unit.
Gastroenterology Department.
Eur J Gastroenterol Hepatol. 2021 May 1;33(5):691-694. doi: 10.1097/MEG.0000000000002152.
Infection due to severe acute respiratory syndrome coronavirus 2 is typically associated with a respiratory syndrome, but gastrointestinal symptoms have been described in early reports from China. However, data from European centres are scarce.
We aimed to characterise the gastrointestinal manifestations of patients with coronavirus disease 2019 (COVID-19) and their disease course.
Patients admitted at our centre between March and April 2020 with diagnosis of COVID-19 were included. Asymptomatic patients or those without symptom information were excluded. Clinical features, laboratory data and disease severity (mechanical ventilation, intensive care admission or death) were analysed.
Two-hundred one patients were included (median age 71 years; 56.2% male). Digestive symptoms were reported by 60 (29.9%) patients during the disease course, being part of the disease presentation in 34 (16.9%). The most frequent were diarrhoea in 36 patients (17.9%). Patients with gastrointestinal symptoms were younger (P = 0.032), had higher haemoglobin levels (P = 0.002) and lower C-reactive protein (P = 0.045) and potassium levels (P = 0.004). Patients with digestive symptoms had less severe disease (28.3 vs. 44.0%; P = 0.038). Regarding liver damage, aspartate aminotransferase (AST) was elevated in 65.2% of patients and alanine aminotransferase (ALT) in 62.7%, but these patients did not present a more severe disease (elevated AST P = 0.062; elevated ALT P = 0.276).
A significant portion of COVID-19 patients have digestive symptoms, mostly at presentation. This should be taken into account in order to keep a high level of suspicion to reach an early diagnosis and setup infection control measures to control the transmission rate. This subgroup of patients appears to have a less severe disease course.
严重急性呼吸综合征冠状病毒 2 引起的感染通常与呼吸道综合征有关，但中国早期的报告已经描述了胃肠道症状。然而，欧洲中心的数据却很少。
我们旨在描述 2019 年冠状病毒病（COVID-19）患者的胃肠道表现及其疾病过程。
我们纳入了 2020 年 3 月至 4 月期间在我们中心因 COVID-19 住院的患者。排除无症状患者或无症状信息的患者。分析了临床特征、实验室数据和疾病严重程度（机械通气、入住重症监护病房或死亡）。
共纳入 201 例患者（中位年龄 71 岁；56.2%为男性）。在疾病过程中，60 例（29.9%）患者报告有消化系统症状，其中 34 例（16.9%）为疾病首发症状。最常见的是 36 例腹泻（17.9%）。有胃肠道症状的患者年龄较小（P=0.032），血红蛋白水平较高（P=0.002），C 反应蛋白（P=0.045）和钾水平较低（P=0.004）。有消化症状的患者疾病较轻（28.3% vs. 44.0%；P=0.038）。至于肝损伤，65.2%的患者天门冬氨酸氨基转移酶（AST）升高，62.7%的患者丙氨酸氨基转移酶（ALT）升高，但这些患者的疾病并不严重（AST 升高 P=0.062；ALT 升高 P=0.276）。
相当一部分 COVID-19 患者有消化系统症状，主要在发病时。为了及早诊断并采取感染控制措施来控制传播率，应该对此予以重视。这一亚组患者的疾病病程似乎较轻。
