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.
“We also noticed that 40% of patients had elevated levels of an abnormal liver enzyme, and that those with high levels required more hospitalization,” Cholankeril said.
The researchers 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 — not just those with respiratory symptoms — should also be tested.
“In our current cohort of patients, all patients had respiratory symptoms prior to the development of gastrointestinal symptoms,” Podboy said. “No patients had gastrointestinal symptoms prior to the development of respiratory symptoms or as their only manifestation of COVID-19.”
He added, “However, that may be a product of who we were testing. Currently, testing is only offered for patients that meet specific criteria — criteria that often require the presence of pulmonary symptoms.”
The researchers 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.
“We had six fellows working together and we were able to go through these charts pretty quickly,” Cholankeril said. “It was a terrific collaboration between colleagues to be able to join forces to study this new disease. We think that by looking at patients here at Stanford, it can help improve our understanding of this emerging disease.”
Other Stanford co-authors are gastroenterology fellows Vasiliki Aivaliotis, MD, Branden Tarlow, MD, PhD, Edward Pham, MD, PhD, and Sean Spencer, MD, PhD; research scholar Donghee Kim, MD, PhD; and Ann Hsing, PhD, professor of medicine at the Stanford Prevention and Research Center.
The study was supported by the National Institutes of Health (grant T32DK007056).