Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms
Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms
复制标题
74例伴有胃肠道症状的2019年冠状病毒感染症（COVID-19）病例的流行病学、临床和病毒学特征
DOI：
10.1136/gutjnl-2020-320926
复制
发表时间：
2020-06-01
期刊：
影响因子：
24.5
通讯作者：
Yang, Yida
中科院分区：
文献类型：
--
作者：
Jin, Xi;Lian, Jiang-Shan;Yang, Yida
目的SARS冠状病毒2型（SARS-CoV-2-infected disease，COVID-19）爆发是对人类的重大威胁。以往的研究主要集中在武汉和典型症状。我们分析了浙江省74例确诊的COVID-19胃肠道症状病例，以确定流行病学、临床和病毒学特征。设计2020年1月17日至2020年2月8日，浙江省收治的COVID-19住院患者。采用多变量分析重度/危重型风险，分析GI症状患者的流行病学、人口统计学、临床、实验室、管理和结局数据。结果651例SARS患者中，74例（11.4%）有至少一种胃肠道症状（恶心、呕吐或腹泻），平均年龄46.14岁，潜伏期4 d，既往有肝脏疾病者占10.8%。在有胃肠道症状的COVID-19患者中，重型/危重型和家族聚集型分别为17例（22.97%）和23例（31.08%），显著高于无胃肠道症状的患者47例（8.14%）和118例（20.45%）。在有胃肠道症状的COVID-19患者中，发热>38.5 ℃、乏力、呼吸急促和头痛的发生率分别为29例（39.19%）、23例（31.08%）、8例（10.81%）和16例（21.62%）。小剂量糖皮质激素和抗生素的使用率分别为14.86%和41.89%。痰液生成和乳酸脱氢酶/葡萄糖水平升高是重度/危重型的危险因素。生物信息学分析显示，SARS冠状病毒2基因序列发生了m（6）A甲基化突变，与ACE 2结合能力发生改变。应增加对具有非典型症状的COVID-19患者的关注，以保护医疗服务提供者。
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.