Immuno-Inflammatory Characteristics in Low Severity COVID-19 Patients with Digestive Symptoms.

Caihan Duan,Wei Qian,Xiaohua Hou,Shengyan Zhang,Jian Wang,Chaoqun Han

doi:10.1155/2020/1063254

Caihan Duan, Wei Qian + Show 4 more

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https://doi.org/10.1155/2020/1063254

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Abstract

Aim The outbreak of Coronavirus Disease 2019 (COVID-19) has resulted in a global pandemic, with the main manifestations being of respiratory nature, including pneumonia. It is noteworthy that digestive symptoms are also observed in COVID-19 patients. In this article, we describe the immuno-inflammatory characteristics of low severity COVID-19 patients with digestive symptoms. Methods Patients with mild symptoms of COVID-19 were split into three groups based on the patients' symptoms. The first group displayed digestive symptoms only, the second group displayed respiratory symptoms only, and the last group displayed both digestive and respiratory symptoms. Patients were discharged based on negative results of rRT-PCR testing for SARS-CoV-2 from at least two sequential respiratory tract specimens collected ≥24 hours apart. Multiorgan function and immuno-inflammatory characteristics were analyzed for all of the three groups. Results Mild liver damage and activation of the immuno-inflammatory system were the most common abnormalities observed in patients with mild COVID-19 symptoms but no significant differences were found (P > 0.05). Patients with digestive symptoms were more likely to have slightly higher and later peak values of inflammatory cytokines during the subsequent course of disease (P < 0.05). In addition, a significant correlation between IL-2 and TNF level was found in the first group which included patients with digestive symptoms only (P < 0.05). Conclusions Patients with mild cases of COVID-19 only displaying digestive symptoms are a special subtype. Patients in this group were more likely to have slightly higher and delayed peak values of inflammatory cytokines during the subsequent course of the disease. Prevention and clinical management of this type should be taken into consideration.

Highlights

Coronavirus disease 2019 (COVID-19) has spread globally and has been declared an international public health emergency by the World Health Organization (WHO) [1, 2]
Viral nucleic acid was found in feces. 23.29% of patients had positive stool samples after negative respiratory samples, indicating patients who successfully recovered from COVID-19 based on the Reverse-Transcriptase Polymerase-Chain-Reaction (rRT-PCR) testing for respiratory tract specimens may still result in damage of the digestive system [7, 8]
We found that mild liver disorder and the activation of the immuno-inflammatory system were the most common abnormalities in mild patients

Summary

Introduction

Coronavirus disease 2019 (COVID-19) has spread globally and has been declared an international public health emergency by the World Health Organization (WHO) [1, 2]. Respiratory symptoms include coughing, shortness of breath, and dyspnea, which are considered the most common clinical manifestations of COVID-19 [3]. Recent research has reported additional digestive symptoms which include nausea, vomiting, and diarrhea, which were sometimes the only symptoms for patients [4, 5]. The virus targets the cell receptor AngiotensinConverting Enzyme 2 (ACE2), which is highly expressed in gastrointestinal organs such as the small intestine and duodenum providing the foundation of gastrointestinal infection [6]. Even though the virus is highly contagious/pandemic, 80.9% to 86.0% of patients were found to experience mild symptoms [9]. Patients with mild symptoms facilitate the rapid dissemination of 2019-nCoV and are the main cause of the spread of the infection [10]

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