Patients with COVID-19 could present with gastrointestinal symptoms without fever or respiratory manifestations, which could be overlooked by health care providers. We aimed to evaluate the clinical characteristics of 2019 novel coronavirus disease (COVID-19) in patients presenting with initial gastrointestinal symptoms.
We evaluated all confirmed cases of COVID-19 in Zhongnan Hospital of Wuhan University between January 10, 2020 and February 29, 2020. We divided these patients into two groups: patients with initial gastrointestinal symptoms (group A, n=183); and patients with respiratory syndrome and/or fever (group B, n=1228). The clinical characteristics, radiological features and laboratory data were assessed.
The clinical procedure of both groups underwent 1-2 weeks rising period and were downward trend at 3 weeks, less than 5% of patients progressed to critical illness. In both groups, mean leukocyte count (p=0.354) and lymphocyte count (p=0.386) were below normal and C-reactive protein level was elevated (p=0.412). There was mild liver function injury (aspartate aminotransferase, 65.8±12.7 vs 67.4±9.3U/L, p=0.246; alanine aminotransferase, 66.4±13.2 vs 69.6±12.7U/L, p=0.352), and normal renal function was intact (blood urea nitrogen 6.4±2.5 vs 5.6±2.8mmol/L p=0.358; creatinine 85.7±37.2, 91.2±32.6μmol/L, p=0.297). After a series of treatment, 176 and 1169 were stable and alive in group A and group B, respectively. The survival rate did not differ significantly between the groups (p=0.313).
COVID-19 patients presented with initial gastrointestinal symptoms had similar clinical characteristics and outcomes, when compared to patients with fever and respiratory symptoms.

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