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Clinical Characteristics of SARS-CoV-2 Infected Pneumonia with Diarrhea

24 Pages Posted: 10 Mar 2020

See all articles by Xiao-Shan Wei

Xiao-Shan Wei

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

Xuan Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

Yi-Ran Niu

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

Lin-Lin Ye

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

Wen-Bei Peng

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

Zi-Hao Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

Wei-Bing Yang

Independent

Bo-Han Yang

Independent

Jian-Chu Zhang

Independent

Wan-Li Ma

Independent

Xiao-Rong Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

Qiong Zhou

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

More...

Abstract

Background: The pneumonia associated with the novel coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2, SARS-CoV-2) is breaking out in Wuhan, China. We aimed to clarify the differences of clinical, laboratory, radiological, and outcome characteristics between SARS-CoV-2 infective pneumonia (Corona Virus Disease 2019, COVID-19) patients with diarrhea and those without.

Methods: In this retrospective, single-center study, we included 84 confirmed patients of SARS-CoV-2 pneumonia in Wuhan Union Hospital from Jan 19 to Feb 7. Patients were confirmed by Real-Time Reverse-Transcriptase–Polymerase-Chain-Reaction Testing in pharyngeal swab. The clinical manifestations, laboratory examinations, imaging manifestations and outcomes of patients with diarrhea and those without diarrhea were compared.

Findings: Of 84 patients with SARS-CoV-2 pneumonia, diarrhea occurred in 26 (31%) patients. Patients with diarrhea, compared to those without diarrhea, were more likely to have headache (57.7% vs 22.4%, p = 0.003), myalgia or fatigue (94.4% vs 50.0%,p = 0.010), cough(84.6% vs 44.8%, p < 0.001), sputum production(53.8% vs 20.7%, p = 0.0004), nausea(38.5% vs 10.3, p < 0.005) and vomiting(19.2% vs 1.7%, p = 0.010). The duration of fever and dyspnea in patients with diarrhea was significantly longer than those without diarrhea (10.5±4.7 vs 7.6±3.4(day), p = 0.005; 8.1±3.2 vs 4.7±2.3(day), p = 0.002; respectively). There are no differences in most of the laboratory findings between these two groups, including lymphocyte count, creatinine, lactate dehydrogenase and D-Dimer. The positive rate of testing SARS-CoV-2 from stool of COVID-19 patients with diarrhea was much higher than that of patients without (69.2% vs 17.2%, p < 0.001). As of Feb 19, the negative rate in retesting SARS-CoV-2 from throat swab of diarrhea group was significantly lower, as compared with non-diarrhea group (76.9% vs 96.6%, p = 0.010). Of 76 COVID-19 patients whose throat swab test have turn to be negative for SARS-CoV-2, the positive rate in retesting SARS-CoV-2 from stool was significantly higher in diarrhea group, as compared to non-diarrhea group (45.0% vs 19.6%, p = 0.039).

Interpretation: COVID-19 patients with diarrhea suffered discomfort longer, as compared with COVID-19 pneumonia patients without diarrhea. The elimination of SARS-CoV-2 from digestive system took much more time than that from respiratory system, in some COVID-19 patients with diarrhea.

Funding Statement: The authors stated: "None."

Declaration of Interests: All authors declare no competing interests.

Ethics Approval Statement: Data collection and analysis of cases and close contacts were determined by the National Health Commission of the People’s Republic of China to be part of a continuing public health outbreak investigation and were thus considered exempt from institutional review board approval.

Keywords: SARS-Cov-2; COVID-19; diarrhea

Suggested Citation

Wei, Xiao-Shan and Wang, Xuan and Niu, Yi-Ran and Ye, Lin-Lin and Peng, Wen-Bei and Wang, Zi-Hao and Yang, Wei-Bing and Yang, Bo-Han and Zhang, Jian-Chu and Ma, Wan-Li and Wang, Xiao-Rong and Zhou, Qiong, Clinical Characteristics of SARS-CoV-2 Infected Pneumonia with Diarrhea (2/26/2020). Available at SSRN: https://ssrn.com/abstract=3546120 or http://dx.doi.org/10.2139/ssrn.3546120

Xiao-Shan Wei

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

China

Xuan Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

China

Yi-Ran Niu

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

China

Lin-Lin Ye

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

China

Wen-Bei Peng

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

China

Zi-Hao Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

China

Wei-Bing Yang

Independent

No Address Available
United States

Bo-Han Yang

Independent

No Address Available
United States

Jian-Chu Zhang

Independent

No Address Available
United States

Wan-Li Ma

Independent

No Address Available
United States

Xiao-Rong Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine

China

Qiong Zhou (Contact Author)

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Department of Respiratory and Critical Care Medicine ( email )

China

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