Digestive Symptoms in COVID-19 Patients with mild disease se
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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. This study, we sought to describe the clinical characteristics of COVID-19 patients with digestive symptoms and mild disease severity.

We identified COVID-19 patients with mild disease and one or more digestive symptoms (diarrhea, nausea, vomiting), with or without respiratory symptoms, and compared them to a group presenting solely with respiratory symptoms. We followed patients clinically until they tested negative for COVID-19 on at least two sequential respiratory tract specimens collected ≥24 hours apart. We then compared clinical features between those with digestive vs. 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 two 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. 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 vs. those with respiratory symptoms.

Conclusively, this study describes a unique sub-group of COVID-19 patients with mild disease severity marked by 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 to patients with only respiratory symptoms.

Source: https://journals.lww.com/ajg/Documents/COVID19_Han_et_al_AJG_Preproof.pdf
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