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Jin, X.; Lian, J. S.; Hu, J. H.; Gao, J.; Zheng, L.; Zhang, Y. M.; Hao, S. R.; Jia, H. Y.; Cai, H.; Zhang, X. L.; Yu, G. D.; Xu, K. J.; Wang, X. Y.; Gu, J. Q.; Zhang, S. Y.; Ye, C. Y.; Jin, C. L.; Lu, Y. F.; Yu, X.; Yu, X. P.; Huang, J. R.; Xu, K. L.; Ni, Q.; Yu, C. B.; Zhu, B.; Li, Y. T.; Liu, J.; Zhao, H.; Zhang, X.; Yu, L.; Guo, Y. Z.; Su, J. W.; Tao, J. J.; Lang, G. J.; Wu, X. X.; Wu, W. R.; Qv, T. T.; Xiang, D. R.; Yi, P.; Shi, D.; Chen, Y.; Ren, Y.; Qiu, Y. Q.; Li, L. J.; Sheng, J.; Yang, Y.
Abstract
OBJECTIVE: The SARS-CoV-2-infected disease (COVID-19) outbreak is a major threat to human beings. Previous studies mainly focused on Wuhan and typical symptoms. We analysed 74 confirmed COVID-19 cases with GI symptoms in the Zhejiang province to determine epidemiological, clinical and virological characteristics.
DESIGN: COVID-19 hospital patients were admitted in the Zhejiang province from 17 January 2020 to 8 February 2020. Epidemiological, demographic, clinical, laboratory, management and outcome data of patients with GI symptoms were analysed using multivariate analysis for risk of severe/critical type. Bioinformatics were used to analyse features of SARS-CoV-2 from Zhejiang province. RESULTS: Among enrolled 651 patients, 74 (11.4%) presented with at least one GI symptom (nausea, vomiting or diarrhoea), average age of 46.14 years, 4-day incubation period and 10.8% had pre-existing liver disease. Of patients with COVID-19 with GI symptoms, 17 (22.97%) and 23 (31.08%) had severe/critical types and family clustering, respectively, significantly higher than those without GI symptoms, 47 (8.14%) and 118 (20.45%). Of patients with COVID-19 with GI symptoms, 29 (39.19%), 23 (31.08%), 8 (10.81%) and 16 (21.62%) had significantly higher rates of fever >38.5 degrees C, fatigue, shortness of breath and headache, respectively. Low-dose glucocorticoids and antibiotics were administered to 14.86% and 41.89% of patients, respectively. Sputum production and increased lactate dehydrogenase/glucose levels were risk factors for severe/critical type. Bioinformatics showed sequence mutation of SARS-CoV-2 with m(6)A methylation and changed binding capacity with ACE2.
CONCLUSION: We report COVID-19 cases with GI symptoms with novel features outside Wuhan. Attention to patients with COVID-19 with non-classic symptoms should increase to protect health providers.
Keywords
Clinical aspects, diagnosis, treatment