Summary: Digestive symptoms such as diarrhea and loss of appetite are common among COVID-19 patients. In a multicenter study from Hubei province, nearly half of the patients reported digestive complaints, and for some those symptoms were the primary or sole presentation.
Digestive Symptoms Frequently Present in COVID-19 Patients, Hubei Study Shows
Source: Wolters Kluwer Health
The American Journal of Gastroenterology has published a descriptive, cross-sectional, multicenter study reporting that digestive symptoms — including diarrhea and anorexia — occur commonly in patients with COVID-19. The research was conducted by the Wuhan Medical Treatment Expert Group for COVID-19 and analyzes clinical characteristics, laboratory findings, and outcomes for confirmed cases treated in Hubei province.
Key findings
In the study of 204 confirmed COVID-19 patients with complete clinical and laboratory records, 99 patients (48.5%) presented to the hospital with digestive symptoms as their main complaint. The most commonly reported digestive manifestations were anorexia (reported by 83 patients, 83.8% of those with digestive complaints) and diarrhea (29 patients, 29.3%). Less frequent symptoms included vomiting and abdominal pain. Importantly, seven patients exhibited digestive symptoms without any respiratory complaints at presentation.
Methods and patient population
The study enrolled confirmed COVID-19 patients who presented to three hospitals in Hubei province between January 18 and February 28, 2020. All cases were verified by real-time RT-PCR testing. Researchers compiled demographic data, clinical features, laboratory tests, imaging results, treatments administered, and clinical outcomes. Follow-up continued through March 5, 2020, allowing comparison of admission timing and discharge rates between patients with and without digestive symptoms.
Clinical course and outcomes
Patients with digestive symptoms experienced a longer interval from symptom onset to hospital admission compared with those who had only respiratory symptoms (median 9.0 days versus 7.3 days). The study also found a difference in short-term outcomes: patients who did not have digestive symptoms were more likely to be cured and discharged during the follow-up period than those with digestive complaints (60% vs. 34.3%). Laboratory testing in this series did not indicate significant liver injury associated with the disease course.
Interpretation and clinical implications
These findings indicate that digestive complaints are not rare in COVID-19 and may signal earlier disease in some patients. Since almost half of the study cohort reported gastrointestinal symptoms and a subset had no respiratory signs, clinicians should consider COVID-19 in patients who present with new-onset digestive symptoms in the appropriate epidemiological context. The authors recommend maintaining a higher index of suspicion for at-risk patients presenting with gastrointestinal manifestations, and not delaying evaluation until respiratory symptoms appear.
Limitations and further research
This study is descriptive and based on patients from a specific geographic region during the early phase of the outbreak. While the data highlight important associations between digestive symptoms and clinical course, larger studies that include broader populations and longer follow-up are needed to confirm these findings, clarify mechanisms, and determine whether digestive symptoms influence transmission, testing strategies, or treatment decisions.
Study citation and access
Original research: Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Authors include Martin Trapecar, Catherine Communal, Lei Pan, MD, PhD, and others. Published in The American Journal of Gastroenterology. DOI and full text are available through the journal.
Source:
Wolters Kluwer Health
Media Contacts:
Brennan M. R. Spiegel – Wolters Kluwer Health
Image Source:
The image is in the public domain.