Gastroenterologists Reveal More Digestive Symptoms in COVID-19 Patients than Nongastroenterologists in Fever Clinic.
Gastroenterologists Reveal More Digestive Symptoms in COVID-19 Patients than Nongastroenterologists in Fever Clinic.
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在发热门诊中，胃肠病学家发现 COVID-19 患者的消化系统症状比非胃肠病学家更多
DOI：
10.1155/2020/8853922
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发表时间：
2020
影响因子：
2
通讯作者：
Hou X
中科院分区：
文献类型：
--
作者：
Jiang Y;Han C;Bai T;Zhang S;Song J;Hou X
当医生在发热门诊询问疑似COVID-19患者时，消化系统症状的发生率可能会因医生的专业背景而异。为了解不同专科医生对消化系统症状的询问特点，对2名消化科医生和6名非消化科医生的询问记录进行了回顾性分析。我们比较了这两组确诊的COVID-19患者中消化道症状（腹泻、呕吐、腹胀、厌食和腹痛）询问的差异。我们进一步比较了排除COVID-19的确诊患者和疑似病例之间消化道症状的差异。在495例确诊的COVID-19病例中（254例由胃肠科医生确诊，241例由非胃肠科医生确诊），22.83%的患者在胃肠科医生组中出现各种消化道症状，而只有4.47%的患者在非胃肠科医生组中报告消化道症状（p < 0.0001）。此外，在最初怀疑的611例患者中，消化科医生询问了类似的呼吸道症状，确诊病例的消化道症状频率远远高于排除病例（22.8% vs. 3.64%，p < 0.0001）。此外，确诊患者报告的水样腹泻百分比（56% vs. 36%，p < 0.0001）和呕吐频率（2.77 ± 0.97 vs. 1.80 ± 0.45/天，p = 0.041）高于排除病例。我们的结论是，胃肠病学家在发热门诊询问中可以检测到更大比例的COVID-19患者的胃肠道症状。此外，确诊的COVID-19患者比排除的病例更有可能出现更严重的消化道症状。因此，发热门诊医师应重视消化道症状的分诊。
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.
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