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Clinical Features of 2019 Novel Coronavirus Pneumonia Presented Gastrointestinal Symptoms But Without Fever Onset

19 Pages Posted: 6 Feb 2020

See all articles by Ping An

Ping An

Wuhan University - Department of Gastroenterology

Hongbin Chen

Wuhan University - Department of Respiratory Medicine

Xiaoda Jiang

Wuhan University - Key Laboratory of Hubei Province for Digestive System Disease

Juan Su

Wuhan University - Department of Gastroenterology

Yong Xiao

Wuhan University - Department of Gastroenterology

Yijuan Ding

Wuhan University - Department of Gastroenterology

Haixia Ren

Wuhan University - Department of Gastroenterology

Mengyao Ji

Wuhan University - Key Laboratory of Hubei Province for Digestive System Disease

Yifei Chen

Wuhan University - Department of Nephrology

Wei Chen

Wuhan University - Department of Gastroenterology

Xiaoguang Lv

Wuhan University - Department of Gastroenterology

Lei Shen

Wuhan University - Department of Gastroenterology

Mingkai Chen

Wuhan University - Department of Gastroenterology

Jiao Li

Wuhan University - Department of Gastroenterology

Anning Yin

Wuhan University - Department of Gastroenterology

Jian Kang

Wuhan University - Department of Gastroenterology

Shuzhong Liu

Wuhan University - Department of Gastroenterology

Wei Tan

Wuhan University - Department of Gastroenterology

Lianlian Wu

Wuhan University - Department of Gastroenterology

Weiguo Dong

Wuhan University - Department of Gastroenterology

Jiwang Cao

Wuhan University - Department of Gastroenterology

Zhongyin Zhou

Wuhan University - Department of Gastroenterology

Shiyun Tan

Wuhan University - Department of Gastroenterology

Guozhong Chen

Wuhan University - Department of Respiratory Medicine

Jing Zhou

Wuhan University - Department of Gastroenterology

Yanning Yang

Wuhan University - Eye Center

Honggang yu

Wuhan University - Department of Gastroenterology

More...

Abstract

Background: Early detection of infected patients is one of the most important steps to mitigate spreading of 2019 novel coronavirus (2019-nCoV). Here, we report a set of atypical 2019-nCoV pneumonia cases with gastrointestinal symptoms onset but without fever or other respiratory symptoms.

Methods: We retrospectively reviewed data of admitted patients of 2019-nCoV pneumonia with only digestive symptoms and no fever on the onset from January 17-24, 2019 in Renmin Hospital of Wuhan University. The patients’ history, clinical features, physical findings, complete blood count, biochemical results, chest X-ray imaging, microbiological investigation and viral pathogens results were recorded and analyzed.

Findings: From January 17 to 24, 2020, nine admitted patients with only digestive symptoms and no fever on the onset had been identified as 2019-nCoV infection. None of the patients had history of contact with animals or visited to the Huanan seafood wholesale market in Wuhan, while they all had exposure history of confirmed or suspected 2019-nCoV-infected patients. Six patients had anorexia (66.7%). Other symptoms include nausea, vomit and diarrhea. All presented digestive symptoms occurred 1-3 days (median time: 2.1 days) before the patients’ visit. None of the cases had fever on onset while 5 patients occurred fever and/or respiratory symptoms 2-5 days after initial non-specific presentations. Other 4 patients never presented respiratory symptoms or fever in the following admissions. Pulmonary infiltrates including multifocal patchy ground-glass opacities were detected on CT scans in all cases at the day of their first clinic visit. All nine patients were admitted to hospital under isolation, supportive care, remained stable and none of them was transferred to ICU as of Feb 2, 2020.

Interpretation: Patients with recent gastrointestinal symptoms as well as confirmed or suspected 2019-nCoV pneumonia exposure history are potential 2019-nCoV pneumonia candidates. It is significant to take atypical symptoms into account to avoid missed diagnosis, and important for gastroenterologists to strengthen protection to avoid possible infection.

Funding: Project of Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision (Grant No. 2018BCC337); Hubei Province Major Science and Technology Innovation Project (Grant No. 2018-916-000-008 to Honggang Yu); The National Natural Science Foundation of China [Grant Nos. 81672387 to Honggang Yu]; The National Natural Science Foundation of China [Grant Nos. 81302131 to Ping An].

Declaration of Interest: All authors declared no conflict of interest.

Ethical Approval: The study protocol was approved by the ethics committee of Renmin Hospital of Wuhan University.

Keywords: 2019 novel coronavirus, Clinical features, Gastrointestinal

Suggested Citation

An, Ping and Chen, Hongbin and Jiang, Xiaoda and Su, Juan and Xiao, Yong and Ding, Yijuan and Ren, Haixia and Ji, Mengyao and Chen, Yifei and Chen, Wei and Lv, Xiaoguang and Shen, Lei and Chen, Mingkai and Li, Jiao and Yin, Anning and Kang, Jian and Liu, Shuzhong and Tan, Wei and Wu, Lianlian and Dong, Weiguo and Cao, Jiwang and Zhou, Zhongyin and Tan, Shiyun and Chen, Guozhong and Zhou, Jing and Yang, Yanning and yu, Honggang, Clinical Features of 2019 Novel Coronavirus Pneumonia Presented Gastrointestinal Symptoms But Without Fever Onset (2/2/2020). Available at SSRN: https://ssrn.com/abstract=3532530

Ping An

Wuhan University - Department of Gastroenterology

China

Hongbin Chen

Wuhan University - Department of Respiratory Medicine

Wuhan
China

Xiaoda Jiang

Wuhan University - Key Laboratory of Hubei Province for Digestive System Disease

China

Juan Su

Wuhan University - Department of Gastroenterology

China

Yong Xiao

Wuhan University - Department of Gastroenterology

China

Yijuan Ding

Wuhan University - Department of Gastroenterology

China

Haixia Ren

Wuhan University - Department of Gastroenterology

China

Mengyao Ji

Wuhan University - Key Laboratory of Hubei Province for Digestive System Disease

China

Yifei Chen

Wuhan University - Department of Nephrology

Wuhan
China

Wei Chen

Wuhan University - Department of Gastroenterology

China

Xiaoguang Lv

Wuhan University - Department of Gastroenterology

China

Lei Shen

Wuhan University - Department of Gastroenterology

China

Mingkai Chen

Wuhan University - Department of Gastroenterology

China

Jiao Li

Wuhan University - Department of Gastroenterology

China

Anning Yin

Wuhan University - Department of Gastroenterology

China

Jian Kang

Wuhan University - Department of Gastroenterology

China

Shuzhong Liu

Wuhan University - Department of Gastroenterology

China

Wei Tan

Wuhan University - Department of Gastroenterology

China

Lianlian Wu

Wuhan University - Department of Gastroenterology

China

Weiguo Dong

Wuhan University - Department of Gastroenterology ( email )

China

Jiwang Cao

Wuhan University - Department of Gastroenterology

China

Zhongyin Zhou

Wuhan University - Department of Gastroenterology

China

Shiyun Tan

Wuhan University - Department of Gastroenterology ( email )

China

Guozhong Chen

Wuhan University - Department of Respiratory Medicine

Wuhan
China

Jing Zhou

Wuhan University - Department of Gastroenterology

China

Yanning Yang

Wuhan University - Eye Center ( email )

99 Zhangzhidong Road
Wuhan, 430060
China

Honggang Yu (Contact Author)

Wuhan University - Department of Gastroenterology ( email )

China

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