Abstract
The incidence of digestive symptoms may vary depending on doctors' professional backgrounds when they inquired suspected COVID-19 patients in a fever clinic. We sought to understand the characteristics of inquiries about digestive symptoms by doctors in different specialties; therefore, inquiry records of 2 gastroenterologists and 6 nongastroenterologists were reviewed. We compared the difference in inquiry of digestive symptoms (diarrhea, vomit, distension, anorexia, and abdominal pain) between these two groups among identified COVID-19 patients. And we further compared the difference of digestive symptoms between confirmed patients and suspected cases who excluded from COVID-19. Among 495 confirmed COVID-19 cases (254 cases by gastroenterologists and 241 cases by nongastroenterologists), 22.83% patients experienced various digestive symptoms in the gastroenterologists' group, while only 4.47% reported digestive symptoms by nongastroenterologists (p < 0.0001). Additionally, among initially suspected 611 patients who presented with similar respiratory symptoms inquired by gastroenterologists, confirmed cases presented far more frequency of digestive symptoms than excluded cases (22.8% vs. 3.64%, p < 0.0001). Furthermore, confirmed patients reported more percentage of watery diarrhea (56% vs. 36%, p < 0.0001) and higher frequent vomit (2.77 ± 0.97 vs. 1.80 ± 0.45 per day, p = 0.041) than excluded cases. We concluded that gastroenterologists could detect a greater proportion of gastrointestinal symptoms in COVID-19 patients during fever clinic inquiries. Moreover, confirmed COVID-19 patients are more likely to have higher severity in digestive symptoms than excluded cases. Therefore, physicians in fever clinic should pay more attention to the triage of gastrointestinal symptoms.
Highlights
The Coronavirus disease 2019 (COVID-19) has spread worldwide and has been declared an international public health emergency by the World Health Organization (WHO) [1]
40% of patients in the fever clinic were diagnosed with COVID-19
The study presents the clinical characteristics of inquiries about digestive symptoms by doctors in different specialties and found that gastroenterologists could detect a greater proportion of gastrointestinal symptoms in COVID-19 patients during fever clinic
Summary
The Coronavirus disease 2019 (COVID-19) has spread worldwide and has been declared an international public health emergency by the World Health Organization (WHO) [1]. Early screening and quarantine for COVID-19 patients has become a vital procedure to prevent further spread [2]. The typical clinical manifestations gained wide concerns for viral pneumonia and respiratory manifestations [3, 4]. Recent evidences indicated that the infection could present with only or accompanied with digestive symptoms such as diarrhea, vomit, nausea, etc. Our previous research showed that COVID-19 patients who had combined digestive symptoms shared longer hospital days and delayed recovery [8]. Viral nucleic acid could be detected in the feces and 23.29% of patients had positive stools after negative respiratory samples, indicating that “cured” patients may have the possibility of fecal-oral transmission of the virus [7].
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