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Patients With Mild COVID-19 May Present With Digestive Symptoms

Many with digestive symptoms present with diarrhea; 62.4 percent with digestive symptoms have fever

WEDNESDAY, April 1, 2020 (HealthDay News) — Patients with mild coronavirus disease 2019 (COVID-19) can present with digestive symptoms, sometimes without concurrent fever, according to a study published online March 30 in the American Journal of Gastroenterology.

Chaoqun Han, Ph.D., from Tongji Medical College in Wuhan, China, and colleagues describe the characteristics of COVID-19 patients with digestive symptoms and mild disease severity. Those with one or more digestive symptoms with or without respiratory symptoms were compared to a group presenting with respiratory symptoms only. Data were included for 206 patients: 48 presenting with a digestive symptom alone, 69 with digestive and respiratory symptoms, and 89 with respiratory symptoms alone.

The researchers found that 67 patients in the two groups with digestive symptoms presented with diarrhea; of these patients, 19.4 percent experienced diarrhea as the first symptom. Diarrhea lasted from one to 14 days (average duration, 5.4 ± 3.1 days). Overall, 62.4 percent of patients with a digestive symptom had concurrent fever. Compared with patients with respiratory symptoms, those with digestive symptoms presented for care later (16.0 ± 7.7 days versus 11.6 ± 5.1 days). Compared with those with respiratory symptoms, patients with digestive symptoms had a longer duration between symptom onset and viral clearance and were more likely to be fecal virus positive (73.3 versus 14.3 percent).

“Failure to recognize these patients early and often may lead to unwitting spread of the disease among outpatients with mild illness who remain undiagnosed and unaware of their potential to infect others,” the authors write.

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