Clinical characteristics and outcomes of 2019 novel coronavirus disease patients presenting with initial gastrointestinal symptoms in Wuhan, China: A retrospective cohort study
Clinical characteristics and outcomes of 2019 novel coronavirus disease patients presenting with initial gastrointestinal symptoms in Wuhan, China: A retrospective cohort study
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DOI：
10.1111/jgh.15199
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发表时间：
2020-08-18
影响因子：
4.1
通讯作者：
Xu, Haibo
中科院分区：
文献类型：
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作者：
Luo, Shihua;Deng, Zhiqing;Xu, Haibo
背景与目的2019年新型冠状病毒病(新冠肺炎)患者可出现无发热或呼吸道症状的胃肠道症状，易被医护人员忽视。我们旨在评估以胃肠道症状为首发症状的新冠肺炎的临床特征。方法对武汉大学中南医院2020年1月10日至2月29日收治的所有新冠肺炎确诊病例进行评估。我们将这些患者分为两组：以胃肠道症状为首发症状的患者(A组，n=183)和有呼吸综合征和/或发热的患者(B组，n=1228)。对其临床特征、放射学特征和实验室资料进行评估。结果两组患者的临床操作均经历了1~2周的上升期，3周后呈下降趋势，仅有不到5%的患者进展为危重病。两组患者平均白细胞计数(P=0.354)和淋巴细胞计数(P=0.386)均低于正常，C反应蛋白水平升高(P=0.412)。肝功能轻度损害(天冬氨酸氨基转移酶65.8+/-12.7vs67.4+/-9.3U/L，P=0.246；丙氨酸氨基转移酶66.4+/-13.2vs69.6+/-12.7U/L，P=0.352)，肾功能正常(血尿素氮6.4+/-2.5vs5.6+/-2.8mmolLP=0.358；肌酐85.7+/-37.2mU/m o l/L，P=0.297)。经一系列治疗后，A组176例稳定存活，B组1169例存活。两组间存活率差异无统计学意义(P=0.313)。结论以胃肠道症状为首发症状的新冠肺炎患者与以发热和呼吸道症状为首发症状的患者具有相似的临床特征和转归。
Background and Aim Patients with 2019 novel coronavirus disease (COVID-19) could present with gastrointestinal symptoms without fever or respiratory manifestations, which could be overlooked by health-care providers. We aimed to evaluate the clinical characteristics of COVID-19 in patients presenting with initial gastrointestinal symptoms. Methods We evaluated all confirmed cases of COVID-19 in Zhongnan Hospital of Wuhan University between January 10 and February 29, 2020. We divided these patients into two groups: patients with initial gastrointestinal symptoms (group A,n = 183) and patients with respiratory syndrome and/or fever (group B,n = 1228). The clinical characteristics, radiological features, and laboratory data were assessed. Results The clinical procedures of both groups underwent 1-2 weeks rising period and were downward trend at 3 weeks; less than 5% of patients progressed to critical illness. In both groups, mean leukocyte count (P = 0.354) and lymphocyte count (P = 0.386) were below normal, and C-reactive protein level was elevated (P = 0.412). There was mild liver function injury (aspartate aminotransferase, 65.8 +/- 12.7vs67.4 +/- 9.3 U/L,P = 0.246; alanine aminotransferase, 66.4 +/- 13.2vs69.6 +/- 12.7 U/L,P = 0.352), and normal renal function was intact (blood urea nitrogen 6.4 +/- 2.5vs5.6 +/- 2.8 mmol/LP = 0.358; creatinine 85.7 +/- 37.2, 91.2 +/- 32.6 mu mol/L,P = 0.297). After a series of treatment, 176 and 1169 were stable and alive in groups A and B, respectively. The survival rate did not differ significantly between the groups (P = 0.313). Conclusion COVID-19 patients presented with initial gastrointestinal symptoms had similar clinical characteristics and outcomes, when compared with patients with fever and respiratory symptoms.