In a new study, researchers found that fever, cough, and shortness of breath are the classic symptoms of COVID-19, but there may be gastrointestinal symptoms that are getting missed.
They found that in addition to upper respiratory symptoms, a big number of those sick with the new virus also suffered from loss of appetite, nausea, vomiting, and diarrhea.
The study is one of the earliest on U.S. patients with the coronavirus.
The research was conducted by a team at Stanford University.
As the coronavirus pandemic hit the San Francisco Bay Area in early March, hospitals began canceling elective surgeries and postponing nonemergency patient visits to make room for a surge of coronavirus patients.
With their clinics closed and other projects on hold, a group of gastroenterology fellows had time to work together on a project.
The researchers were aware of a growing body of research out of China and Singapore that showed a prevalence of GI symptoms in COVID-19 patients but could find no data on the topic from patients in the United States.
They decided to conduct their own study by examining the charts of the earliest group of patients treated for the virus at Stanford Health Care.
The researchers analyzed data collected from 116 patients who tested positive for the coronavirus at Stanford Health Care from March 4-24.
The majority were treated and released from a hospital emergency room or a clinic. A total of 33 were hospitalized, eight of those in an intensive care unit.
The median age of the patients was 50, and 53% of them were men. Only one death was reported within the group.
They found gastrointestinal symptoms were reported by 31.9% of the patients.
The majority of that group described the symptoms as mild. Twenty-two percent said they experienced the loss of appetite, 22% had nausea and vomiting, and 12% had diarrhea, the study said.
They also noticed that 40% of patients had elevated levels of an abnormal liver enzyme and that those with high levels required more hospitalization.
The researchers suggest that while this data is early and from only a single institution, the results do raise the possibility that people exposed to the coronavirus who are experiencing gastrointestinal symptoms—not just those with respiratory symptoms—should also be tested.
The researchers plan to study the role of GI symptoms in COVID-19 and their implications on disease severity and hospitalization outcomes.
The lead authors of the study are Gastroenterology fellows George Cholankeril, MD, and Alexander Podboy, MD.
The study is published in Gastroenterology.
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