Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection

Gut. 2020 Jun;69(6):997-1001. doi: 10.1136/gutjnl-2020-321013. Epub 2020 Apr 2.


Objective: To study the GI symptoms in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients.

Design: We analysed epidemiological, demographic, clinical and laboratory data of 95 cases with SARS-CoV-2 caused coronavirus disease 2019. Real-time reverse transcriptase PCR was used to detect the presence of SARS-CoV-2 in faeces and GI tissues.

Results: Among the 95 patients, 58 cases exhibited GI symptoms of which 11 (11.6%) occurred on admission and 47 (49.5%) developed during hospitalisation. Diarrhoea (24.2%), anorexia (17.9%) and nausea (17.9%) were the main symptoms with five (5.3%), five (5.3%) and three (3.2%) cases occurred on the illness onset, respectively. A substantial proportion of patients developed diarrhoea during hospitalisation, potentially aggravated by various drugs including antibiotics. Faecal samples of 65 hospitalised patients were tested for the presence of SARS-CoV-2, including 42 with and 23 without GI symptoms, of which 22 (52.4%) and 9 (39.1%) were positive, respectively. Six patients with GI symptoms were subjected to endoscopy, revealing oesophageal bleeding with erosions and ulcers in one severe patient. SARS-CoV-2 RNA was detected in oesophagus, stomach, duodenum and rectum specimens for both two severe patients. In contrast, only duodenum was positive in one of the four non-severe patients.

Conclusions: GI tract may be a potential transmission route and target organ of SARS-CoV-2.

Keywords: gastric diseases; gastrointestinal pathology; gastrointestinal tract.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / physiopathology
  • Female
  • Gastrointestinal Tract* / physiopathology
  • Gastrointestinal Tract* / virology
  • Humans
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / physiopathology
  • SARS-CoV-2