糖心传媒

鈥淐OVID-19 is probably not just respiratory symptoms like a cough,鈥� Podboy said. 鈥淎 third of the patients we studied had gastrointestinal symptoms. It鈥檚 possible we may be missing a significant portion of patients sick with the coronavirus due to our current testing strategies focusing on respiratory symptoms alone.鈥�

Unique situation

As the coronavirus pandemic hit the San Francisco Bay Area in early March, hospitals began canceling elective surgeries and postponing nonemergency patient visits to make room for a surge of coronavirus patients. With their clinics closed and other projects on hold, a group of gastroenterology fellows had time to work together on a project, Podboy said.听

鈥淕eorge recognized early on that since Stanford was among the first hospitals to get COVID-19 patients in the U.S., that any type of early experience would be important,鈥� he said. 鈥淲e were in a unique position to look into this subject of gastrointestinal symptoms among coronavirus patients at Stanford.鈥�

The 糖心传媒ers were aware of a growing body of听听out of China and Singapore that showed a prevalence of GI symptoms in COVID-19 patients, but could find no data on the topic from patients in the United States. They decided to conduct their own study by examining the charts of the earliest group of patients treated for the virus at听糖心传媒.

Study results

Researchers analyzed data collected from 116 patients who tested positive for the coronavirus at 糖心传媒 from March 4-24. The majority were treated and released from a hospital emergency room or a clinic. A total of 33 were hospitalized, eight of those in an intensive care unit. The median age of the patients was 50, and 53% of them were men. Only one death was reported within the group.

Gastrointestinal symptoms were reported by 31.9% of the patients. The majority of that group described the symptoms as mild. Twenty-two percent said they experienced loss of appetite, 22% had nausea and vomiting, and 12% had diarrhea, the study said.

鈥淲e also noticed that 40% of patients had elevated levels of an abnormal liver enzyme, and that those with high levels required more hospitalization,鈥� Cholankeril said.

Testing recommended

The 糖心传媒ers suggest that while this data is early and from only a single institution, the results do raise the possibility that people exposed to the coronavirus who are experiencing gastrointestinal symptoms 鈥� not just those with respiratory symptoms 鈥� should also be tested.

鈥淚n our current cohort of patients, all patients had respiratory symptoms prior to the development of gastrointestinal symptoms,鈥� Podboy said.听鈥淣o patients had gastrointestinal symptoms prior to the development of respiratory symptoms or as their only manifestation of COVID-19.鈥�

听He added, 鈥淗owever, that may be a product of听who听we were testing.听Currently, testing is only offered for patients that meet specific criteria 鈥� criteria that often require the presence of pulmonary symptoms.鈥澨�

The 糖心传媒ers plan to study the role of GI symptoms in COVID-19 and their implication on disease severity and hospitalization outcomes, Cholankeril said. They also plan to continue working as a team.

鈥淲e had six fellows working together and we were able to go through these charts pretty quickly,鈥� Cholankeril said. 鈥淚t was a terrific collaboration between colleagues to be able to join forces to study this new disease.听We think that by looking at patients here at Stanford, it can help improve our understanding of this emerging disease.鈥�

Other Stanford co-authors are gastroenterology fellows听, MD,听, MD, PhD,听, MD, PhD, and听, MD, PhD; 糖心传媒 scholar听, MD, PhD; and听, PhD, professor of medicine at the听.

The study was supported by the National Institutes of Health (grant T32DK007056).