The University of Louisville Journal of Respiratory Infections


Introduction: Though coronavirus disease 2019 (COVID-19) is predominantly a respiratory illness, a growing number of studies reported gastrointestinal (GI) symptoms among these patients. We examined the incidence of GI symptoms in patients with COVID-19 and the GI symptoms as the initial presentation of the disease.

Methods: We examined peer reviewed studies in English of patients with COVID-19 that reported GI symptoms. We searched PubMed and Google Scholar for articles published up to June 30, 2020 by using the keywords ‘COVID-19’, ‘Coronavirus’, severe acute respiratory syndrome coronavirus 2 ‘SARS-CoV-2’, ‘gastrointestinal tract’, ‘gastrointestinal diseases’, ‘gastrointestinal symptoms and signs’. Studies with less than 30 patients and also those studies that did not report nausea, vomiting and diarrhea were excluded.

Results: We reviewed 26 studies that reported GI symptoms among patients with COVID-19. Twenty-three studies were from China and the three remaining studies were from three different countries: US, France and South Korea. The mean age of patients was 47.2 years and 50.3% were females. From a total of 7,212 patients, 672 patients had nausea or/and vomiting (8.7%) and 732 (9.5%) had diarrhea. 6.8% of patients had GI symptoms as the initial presentation of COVID-19.

Conclusion: GI symptoms are not common in COVID-19 patients. However, the recognition of GI symptoms may significantly help in implementing steps for preventing SARS CoV-2 transmission. Testing for COVID-19 in patients presenting with only GI symptoms may help detect and prevent spreading of the COVID-19.


The authors received no specific funding for this work



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