Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Research Article

Comparative Study on Clinical Characteristics of COVID-19 Patients with or without Digestive Symptoms in Razi Hospital, Ahvaz, Khuzestan

Author(s): Reza Khedri, Hossein Bahrami Moghadam, Wesam Kooti, Ali Delirrooyfard*, Payam Amini, Mahmood Maniati, Vahid Garmsiri, Mahsa Tabibi, Leila Jalalian, Mahsan Nouri, Seyed Saeed Seyedian, Kambiz Masoumi and Keramat Javdanzadeh

Volume 23, Issue 5, 2023

Published on: 19 December, 2022

Page: [647 - 671] Pages: 25

DOI: 10.2174/1871530322666220823155956

Price: $65

Abstract

Background: Most commonly reported clinical manifestations are fever, fatigue and dry cough. Interestingly, a small percentage of patients experience GI symptoms, with the most common being anorexia, diarrhea, nausea and vomiting. We aimed to conduct a comparative study on COVID-19 patients with or without gastrointestinal patients (GI).

Aims: The pandemic of coronavirus disease 2019 (COVID-19) has emerged as a dire health problem, causing a massive crisis for global health.

Methods: Collective data of clinical manifestations and laboratory reports of patients admitted to Razi Hospital, Ahvaz, Khuzestan, Iran, for two weeks were analyzed.

Results: Our results showed that GI symptoms are not statistically significant criteria to be predictive or prognostic factors in COVID-19 patients, although they are probably related to the acute or non-acute phase of the disease. Moreover, non-specific GI symptoms seem to result from cytokine storm that occurred during the disease.

Conclusion: Therefore, our results did not support GI tract involvement as a common route of COVID- 19 infection. Maybe future research will shed light on why and how the gastrointestinal system becomes infected by COVID-19.

Keywords: COVID-19, Gastrointestinal, Diabetes, Cytokine, Fever

Graphical Abstract

[1]
Wang, C.; Horby, P.W.; Hayden, F.G.; Gao, G.F. A novel coronavirus outbreak of global health concern. Lancet, 2020, 395(10223), 470-473.
[http://dx.doi.org/10.1016/S0140-6736(20)30185-9] [PMID: 31986257]
[2]
Gorbalenya, A.E. Severe acute respiratory syndrome-related coronavirus: The species and its viruses–a statement of the Coronavirus Study Group. bioRxiv, 2020.
[http://dx.doi.org/10.1101/2020.02.07.937862]
[3]
Linton, N.M.; Kobayashi, T.; Yang, Y.; Hayashi, K.; Akhmetzhanov, A.R.; Jung, S.M.; Yuan, B.; Kinoshita, R.; Nishiura, H. Incubation period and other epidemiological characteristics of 2019 novel coronavirus infections with right truncation: A statistical analysis of publicly available case data. J. Clin. Med., 2020, 9(2), 538.
[http://dx.doi.org/10.3390/jcm9020538] [PMID: 32079150]
[4]
Wu, J.; Liu, J.; Zhao, X.; Liu, C.; Wang, W.; Wang, D.; Xu, W.; Zhang, C.; Yu, J.; Jiang, B.; Cao, H.; Li, L. Clinical characteristics of imported cases of coronavirus disease 2019 (COVID-19) in Jiangsu Province: A multicenter descriptive study. Clin. Infect. Dis., 2020, 71(15), 706-712.
[http://dx.doi.org/10.1093/cid/ciaa199] [PMID: 32109279]
[5]
Yang, W.; Cao, Q.; Qin, L.; Wang, X.; Cheng, Z.; Pan, A.; Dai, J.; Sun, Q.; Zhao, F.; Qu, J.; Yan, F. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China. J. Infect., 2020, 80(4), 388-393.
[http://dx.doi.org/10.1016/j.jinf.2020.02.016] [PMID: 32112884]
[6]
Mao, L. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: A retrospective case series study. MedRxiv, 2020.
[7]
Li, X.; Wang, L.; Yan, S.; Yang, F.; Xiang, L.; Zhu, J.; Shen, B.; Gong, Z. Clinical characteristics of 25 death cases with COVID-19: A retrospective review of medical records in a single medical center, Wuhan, China. Int. J. Infect. Dis., 2020, 94, 128-132.
[http://dx.doi.org/10.1016/j.ijid.2020.03.053] [PMID: 32251805]
[8]
Gu, J.; Han, B.; Wang, J. COVID-19: Gastrointestinal manifestations and potential fecal–oral transmission. Gastroenterology, 2020, 158(6), 1518-1519.
[http://dx.doi.org/10.1053/j.gastro.2020.02.054] [PMID: 32142785]
[9]
Liang, W.; Feng, Z.; Rao, S.; Xiao, C.; Xue, X.; Lin, Z.; Zhang, Q.; Qi, W. Diarrhoea may be underestimated: A missing link in 2019 novel coronavirus. Gut, 2020, 69(6), 1141-1143.
[http://dx.doi.org/10.1136/gutjnl-2020-320832] [PMID: 32102928]
[10]
An, P.; Chen, H.; Jiang, X.; Su, J.; Xiao, Y.; Ding, Y.; Ren, H.; Ji, M.; Chen, Y.; Chen, W.; Lv, X.; Shen, L.; Chen, M.; Li, J.; Yin, A.; Kang, J.; Liu, S.; Tan, W.; Wu, L.; Dong, W.; Cao, J.; Zhou, Z.; Tan, S.; Chen, G.; Zhou, J.; Yang, Y.; Yu, H. Clinical features of 2019 novel coronavirus pneumonia presented gastrointestinal symptoms but without fever onset, 2020.
[http://dx.doi.org/10.2139/ssrn.3532530]
[11]
Zhu, N.; Zhang, D.; Wang, W.; Li, X.; Yang, B.; Song, J.; Zhao, X.; Huang, B.; Shi, W.; Lu, R.; Niu, P.; Zhan, F.; Ma, X.; Wang, D.; Xu, W.; Wu, G.; Gao, G.F.; Tan, W. A novel coronavirus from patients with pneumonia in China, 2019. N. Engl. J. Med., 2020, 382(8), 727-733.
[http://dx.doi.org/10.1056/NEJMoa2001017] [PMID: 31978945]
[12]
Wang, D.; Hu, B.; Hu, C.; Zhu, F.; Liu, X.; Zhang, J.; Wang, B.; Xiang, H.; Cheng, Z.; Xiong, Y.; Zhao, Y.; Li, Y.; Wang, X.; Peng, Z. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA, 2020, 323(11), 1061-1069.
[http://dx.doi.org/10.1001/jama.2020.1585] [PMID: 32031570]
[13]
Yang, Y.; Yang, M.; Yuan, J.; Wang, F.; Wang, Z.; Li, J.; Zhang, M.; Xing, L.; Wei, J.; Peng, L.; Wong, G.; Zheng, H.; Wu, W.; Shen, C.; Liao, M.; Feng, K.; Li, J.; Yang, Q.; Zhao, J.; Liu, L.; Liu, Y. Laboratory diagnosis and monitoring the viral shedding of SARS-CoV-2 infection. Innovation, 2020, 1(3), 100061.
[http://dx.doi.org/10.1016/j.xinn.2020.100061] [PMID: 33169119]
[14]
Holshue, M.L.; DeBolt, C.; Lindquist, S.; Lofy, K.H.; Wiesman, J.; Bruce, H.; Spitters, C.; Ericson, K.; Wilkerson, S.; Tural, A.; Diaz, G.; Cohn, A.; Fox, L.; Patel, A.; Gerber, S.I.; Kim, L.; Tong, S.; Lu, X.; Lindstrom, S.; Pallansch, M.A.; Weldon, W.C.; Biggs, H.M.; Uyeki, T.M.; Pillai, S.K. First case of 2019 novel coronavirus in the United States. N. Engl. J. Med., 2020, 382(10), 929-936.
[http://dx.doi.org/10.1056/NEJMoa2001191] [PMID: 32004427]
[15]
Yang, X.; Yu, Y.; Xu, J.; Shu, H.; Xia, J.; Liu, H.; Wu, Y.; Zhang, L.; Yu, Z.; Fang, M.; Yu, T.; Wang, Y.; Pan, S.; Zou, X.; Yuan, S.; Shang, Y. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. Lancet Respir. Med., 2020, 8(5), 475-481.
[http://dx.doi.org/10.1016/S2213-2600(20)30079-5] [PMID: 32105632]
[16]
Diao, B. Diagnosis of acute respiratory syndrome coronavirus 2 infection by detection of nucleocapsid protein. MedRxiv, 2020.
[http://dx.doi.org/10.1101/2020.03.07.20032524]
[17]
Ai, T.; Yang, Z.; Hou, H.; Zhan, C.; Chen, C.; Lv, W.; Tao, Q.; Sun, Z.; Xia, L. Correlation of chest CT and RT-PCR testing for coronavirus disease 2019 (COVID-19) in China: A report of 1014 cases. Radiology, 2020, 296(2), E32-E40.
[http://dx.doi.org/10.1148/radiol.2020200642] [PMID: 32101510]
[18]
Zhou, P.; Yang, X.L.; Wang, X.G.; Hu, B.; Zhang, L.; Zhang, W.; Si, H.R.; Zhu, Y. Li, b.; Huang, CL.; Chen, H.D.; Chen, J.; Luo, Y.; Guo, H.; Jiang, R.D.; Liu, M.Q.; Chen, Y.; Shen, X.R.; Wang, X.; Zheng, X.H.; Zhao, K.; Chen, Q.J.; Deng, F.; Liu, L.L.; Yan, B.; Zhan, F.X.; Wang, Y.Y.; Xiao, G.; Shi, Z.L. Discovery of a novel coronavirus associated with the recent pneumonia outbreak in humans and its potential bat origin. BioRxiv, 2020.
[http://dx.doi.org/10.1101/2020.01.22.914952]
[19]
Luo, S.; Zhang, X.; Xu, H. Don’t overlook digestive symptoms in patients with 2019 novel coronavirus disease (COVID-19). Clin. Gastroenterol. Hepatol., 2020, 18(7), 1636-1637.
[http://dx.doi.org/10.1016/j.cgh.2020.03.043] [PMID: 32205220]
[20]
Wang, H.; Li, G. A selective review on random survival forests for high dimensional data. Quant. Biosci., 2017, 36(2), 85-96.
[http://dx.doi.org/10.22283/qbs.2017.36.2.85] [PMID: 30740388]
[21]
Nachtigall, I.; Lenga, P.; Jóźwiak,, K.; Thürmann,, P.; Meier-Hellmann,, A.; Kuhlen,, R.; Brederlau,, J.; Bauer,, T.; Tebbenjohanns,, J.; Schwegmann,, K.; Hauptmann,, M.; Dengler,, J. Clinical course and factors associated with outcomes among 1904 patients hospitalized with COVID-19 in Germany: An observational study. Clin. Microbiol. Infect., 2020, 26(12), 1663-1669.
[http://dx.doi.org/10.1016/j.cmi.2020.08.011] [PMID: 32822883]
[22]
Grasselli, G.; Greco, M.; Zanella, A.; Albano, G.; Antonelli, M.; Bellani, G.; Bonanomi, E.; Cabrini, L.; Carlesso, E.; Castelli, G.; Cattaneo, S.; Cereda, D.; Colombo, S.; Coluccello, A.; Crescini, G.; Forastieri Molinari, A.; Foti, G.; Fumagalli, R.; Iotti, G.A.; Langer, T.; Latronico, N.; Lorini, F.L.; Mojoli, F.; Natalini, G.; Pessina, C.M.; Ranieri, V.M.; Rech, R.; Scudeller, L.; Rosano, A.; Storti, E.; Thompson, B.T.; Tirani, M.; Villani, P.G.; Pesenti, A.; Cecconi, M.; Agosteo, E.; Albano, G.; Albertin, A.; Alborghetti, A.; Aldegheri, G.; Antonini, B.; Barbara, E.; Bardelloni, G.; Basilico, S.; Belgiorno, N.; Bellani, G.; Beretta, E.; Berselli, A.; Bianciardi, L.; Bonanomi, E.; Bonazzi, S.; Borelli, M.; Bottino, N.; Bronzini, N.; Brusatori, S.; Cabrini, L.; Capra, C.; Carnevale, L.; Castelli, G.; Catena, E.; Cattaneo, S.; Cecconi, M.; Celotti, S.; Cerutti, S.; Chiumello, D.; Cirri, S.; Citerio, G.; Colombo, S.; Coluccello, A.; Coppini, D.; Corona, A.; Cortellazzi, P.; Costantini, E.; Covello, R.D.; Crescini, G.; De Filippi, G.; Dei Poli, M.; Dughi, P.; Fieni, F.; Florio, G.; Forastieri Molinari, A.; Foti, G.; Fumagalli, R.; Galletti, M.; Gallioli, G.A.; Gay, H.; Gemma, M.; Gnesin, P.; Grasselli, G.; Greco, S.; Greco, M.; Grosso, P.; Guatteri, L.; Guzzon, D.; Iotti, G.A.; Keim, R.; Langer, T.; Latronico, N.; Lombardo, A.; Lorini, F.L.; Mamprin, F.; Marino, G.; Marino, F.; Merli, G.; Micucci, A.; Militano, C.R.; Mojoli, F.; Monti, G.; Muttini, S.; Nadalin, S.; Natalini, G.; Perazzo, P.; Perego, G.B.; Perotti, L.; Pesenti, A.; Pessina, C.M.; Petrucci, N.; Pezzi, A.; Piva, S.; Portella, G.; Protti, A.; Racagni, M.; Radrizzani, D.; Raimondi, M.; Ranucci, M.; Rech, R.; Riccio, M.; Rosano, A.; Ruggeri, P.; Sala, G.; Salvi, L.; Sebastiano, P.; Severgnini, P.; Sigurtà, D.; Stocchetti, N.; Storti, E.; Subert, M.; Tavola, M.; Todaro, S.; Torriglia, F.; Tubiolo, D.; Valsecchi, R.; Villani, P.G.; Viola, U.; Vitale, G.; Zambon, M.; Zanella, A.; Zoia, E. Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Intern. Med., 2020, 180(10), 1345-1355.
[http://dx.doi.org/10.1001/jamainternmed.2020.3539] [PMID: 32667669]
[23]
Wang, Y.; Shi, L.; Wang, Y.; Yang, H. An updated meta-analysis of AST and ALT levels and the mortality of COVID-19 patients. Am. J. Emerg. Med., 2021, 40, 208-209.
[http://dx.doi.org/10.1016/j.ajem.2020.05.063] [PMID: 32475764]
[24]
Wang, Y.; Shi, L.; Wang, Y.; Duan, G.; Yang, H. Albumin and total bilirubin for severity and mortality in coronavirus disease 2019 patients. J. Clin. Lab. Anal., 2020, 34(7), e23412.
[http://dx.doi.org/10.1002/jcla.23412] [PMID: 32745325]
[25]
Henry, B.M.; Aggarwal, G.; Wong, J.; Benoit, S.; Vikse, J.; Plebani, M.; Lippi, G. Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severity and mortality: A pooled analysis. Am. J. Emerg. Med., 2020, 38(9), 1722-1726.
[http://dx.doi.org/10.1016/j.ajem.2020.05.073] [PMID: 32738466]
[26]
Trevisan, C.; Miconi, L.; Barbierato, E.; Marinaro, G.; Targhetta, S.; D’agata, M.; Rinaldi, D. Labile PT-INR in a COVID-19 patient under long-term vitamin K antagonist therapy: A case report. SN Compr. Clin. Med., 2020, 2(9), 1680-1682.
[http://dx.doi.org/10.1007/s42399-020-00460-4] [PMID: 32839751]
[27]
Jin, X.; Duan, Y.; Bao, T.; Gu, J.; Chen, Y.; Li, Y.; Mao, S.; Chen, Y.; Xie, W. The values of coagulation function in COVID-19 patients. PLoS One, 2020, 15(10), e0241329.
[http://dx.doi.org/10.1371/journal.pone.0241329] [PMID: 33119703]
[28]
Belice, T.; Demir, I.; Yüksel, A. Role of neutrophil-lymphocyte-ratio in the mortality of males diagnosed with COVID-19. Iran. J. Microbiol., 2020, 12(3), 194-197.
[http://dx.doi.org/10.18502/ijm.v12i3.3235] [PMID: 32685114]
[29]
Du, R-H.; Liang, L.R.; Yang, C.Q.; Wang, W.; Cao, T.Z.; Li, M.; Guo, G.Y.; Du, J.; Zheng, C.L.; Zhu, Q.; Hu, M.; Li, X.Y.; Peng, P.; Shi, H.Z. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: A prospective cohort study. Eur. Respir. J., 2020, 55(5), 2000524.
[http://dx.doi.org/10.1183/13993003.00524-2020] [PMID: 32269088]
[30]
Xie, J. Association between hypoxemia and mortality in patients with COVID-19. Mayo Clin. Proc., 2020, 95(6), 1138-1147.
[http://dx.doi.org/10.1016/j.mayocp.2020.04.006]
[31]
Huang, I.; Pranata, R.; Lim, M.A.; Oehadian, A.; Alisjahbana, B. C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: A meta-analysis. Ther. Adv. Respir. Dis., 2020, 14, 1753466620937175.
[http://dx.doi.org/10.1177/1753466620937175] [PMID: 32615866]
[32]
Cheng, Y.; Luo, R.; Wang, K.; Zhang, M.; Wang, Z.; Dong, L.; Li, J.; Yao, Y.; Ge, S.; Xu, G. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int., 2020, 97(5), 829-838.
[http://dx.doi.org/10.1016/j.kint.2020.03.005] [PMID: 32247631]
[33]
Hong, X.W.; Chi, Z.P.; Liu, G.Y.; Huang, H.; Guo, S.Q.; Fan, J.R.; Lin, X.W.; Qu, L.Z.; Chen, R.L.; Wu, L.J.; Wang, L.Y.; Zhang, Q.C.; Wu, S.W.; Pan, Z.Q.; Lin, H.; Zhou, Y.H.; Zhang, Y.H. Characteristics of renal function in patients diagnosed with COVID-19: An observational study. Front. Med. (Lausanne), 2020, 7, 409.
[http://dx.doi.org/10.3389/fmed.2020.00409] [PMID: 32754610]
[34]
Sadr, S. SeyedAlinaghi, S.; Ghiasvand, F.; Hassan Nezhad, M.; Javadian, N.; Hossienzade, R.; Jafari, F. Isolated severe thrombocytopenia in a patient with COVID-19: A case report. IDCases, 2020, 21, e00820.
[http://dx.doi.org/10.1016/j.idcr.2020.e00820] [PMID: 32483524]
[35]
Xu, P.; Zhou, Q.; Xu, J. Mechanism of thrombocytopenia in COVID-19 patients. Ann. Hematol., 2020, 99(6), 1205-1208.
[http://dx.doi.org/10.1007/s00277-020-04019-0] [PMID: 32296910]
[36]
Thachil, J. What do monitoring platelet counts in COVID-19 teach us? J. Thromb. Haemost., 2020, 18(8), 2071-2072.
[http://dx.doi.org/10.1111/jth.14879] [PMID: 32344467]
[37]
Yang, C.; Ma, X.; Wu, J.; Han, J.; Zheng, Z.; Duan, H.; Liu, Q.; Wu, C.; Dong, Y.; Dong, L. Low serum calcium and phosphorus and their clinical performance in detecting COVID-19 patients. J. Med. Virol., 2021, 93(3), 1639-1651.
[http://dx.doi.org/10.1002/jmv.26515] [PMID: 32926424]
[38]
Xue, X. Correlation between hypophosphatemia and the severity of Corona Virus Disease 2019 patients. MedRxiv, 2020.
[http://dx.doi.org/10.1101/2020.03.27.20040816]
[39]
Shi, L.; Wang, Y.; Wang, Y.; Duan, G.; Yang, H. Meta-analysis of relation of creatine kinase-MB to risk of mortality in coronavirus disease 2019 patients. Am. J. Cardiol., 2020, 130, 163-165.
[http://dx.doi.org/10.1016/j.amjcard.2020.06.004] [PMID: 32622501]
[40]
Li, L.; Zhou, Q.; Xu, J. Changes of laboratory cardiac markers and mechanisms of cardiac injury in coronavirus disease 2019. BioMed Res. Int., 2020, 2020, 7413673.
[http://dx.doi.org/10.1155/2020/7413673]
[41]
Li, G. Clinical characteristics of diabetic patients with COVID-19. J. Diabetes Res., 2020, 2020, 1652403.
[42]
Liu, Y.; Yang, Y.; Chen, Y.; Zhou, L.; Xiong, Q.; Xie, C. The relationship between hyperglycemia and the infection of COVID-19 in diabetic patients: A protocol for systematic review and meta-analysis. Medicine (Baltimore), 2020, 99(36), e21806.
[http://dx.doi.org/10.1097/MD.0000000000021806] [PMID: 32899010]
[43]
Wang, S.; Ma, P.; Zhang, S.; Song, S.; Wang, Z.; Ma, Y.; Xu, J.; Wu, F.; Duan, L.; Yin, Z.; Luo, H.; Xiong, N.; Xu, M.; Zeng, T.; Jin, Y. Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes: A multi-centre retrospective study. Diabetologia, 2020, 63(10), 2102-2111.
[http://dx.doi.org/10.1007/s00125-020-05209-1] [PMID: 32647915]
[44]
Rastad, H.; Karim, H.; Ejtahed, H.S.; Tajbakhsh, R.; Noorisepehr, M.; Babaei, M.; Azimzadeh, M.; Soleimani, A.; Inanloo, S.H.; Shafiabadi Hassani, N.; Rasanezhad, F.; Shahrestanaki, E.; Khodaparast, Z.; Golami, H.; Qorbani, M. Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease. Diabetol. Metab. Syndr., 2020, 12(1), 57.
[http://dx.doi.org/10.1186/s13098-020-00565-9] [PMID: 32641974]
[45]
Rubino, F.; Amiel, S.A.; Zimmet, P.; Alberti, G.; Bornstein, S.; Eckel, R.H.; Mingrone, G.; Boehm, B.; Cooper, M.E.; Chai, Z.; Del Prato, S.; Ji, L.; Hopkins, D.; Herman, W.H.; Khunti, K.; Mbanya, J.C.; Renard, E. New-onset diabetes in COVID-19. N. Engl. J. Med., 2020, 383(8), 789-790.
[http://dx.doi.org/10.1056/NEJMc2018688] [PMID: 32530585]
[46]
Abdi, A. Diabetes and COVID-19: A systematic review on the current evidences. Diabetes Res. Clin. Pract., 2020, 166, 108347.
[47]
Masetti, C.; Generali, E.; Colapietro, F.; Voza, A.; Cecconi, M.; Messina, A.; Omodei, P.; Angelini, C.; Ciccarelli, M.; Badalamenti, S.; Canonica, G.W.; Lleo, A.; Aghemo, A. High mortality in COVID-19 patients with mild respiratory disease. Eur. J. Clin. Invest., 2020, 50(9), e13314.
[http://dx.doi.org/10.1111/eci.13314] [PMID: 32535885]
[48]
Mayer, K.P.; Sturgill, J.L.; Kalema, A.G.; Soper, M.K.; Seif, S.M.; Cassity, E.P.; Hatton Kolpek, J.; Dupont-Versteegden, E.E.; Montgomery-Yates, A.A.; Morris, P.E. Recovery from COVID-19 and acute respiratory distress syndrome: The potential role of an intensive care unit recovery clinic: A case report. J. Med. Case Rep., 2020, 14(1), 161.
[http://dx.doi.org/10.1186/s13256-020-02481-y] [PMID: 32912329]
[49]
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. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut, 2020, 69(6), 1002-1009.
[http://dx.doi.org/10.1136/gutjnl-2020-320926] [PMID: 32213556]
[50]
Lin, L.; Jiang, X.; Zhang, Z.; Huang, S.; Zhang, Z.; Fang, Z.; Gu, Z.; Gao, L.; Shi, H.; Mai, L.; Liu, Y.; Lin, X.; Lai, R.; Yan, Z.; Li, X.; Shan, H. Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection. Gut, 2020, 69(6), 997-1001.
[http://dx.doi.org/10.1136/gutjnl-2020-321013] [PMID: 32241899]
[51]
Xiao, F. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology, 2020, 158(6), 1831-1833.
[52]
Grassia, R.; Testa, S.; Pan, A.; Conti, C.B. SARS-CoV-2 and gastrointestinal tract: The dark side of the pandemic. Dig. Liver Dis., 2020, 52(7), 700-701.
[http://dx.doi.org/10.1016/j.dld.2020.04.028] [PMID: 32423849]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy