GI symptoms as early signs of COVID-19 in hospitalised Italian patients

Correspondence to Dr Elisabetta Buscarini, Gastroenterology Department, Maggiore Hospital ASST Crema, Largo Dossena 2, Crema 26013, Italy; elisabetta.buscarini@asst-crema.it In their recent publication in Gut, Lin et al report 11% of patients infected with SARS-CoV-2 (COVID-19) to present at admission with GI symptoms1; early observations reported that COVID-19 could present with GI symptoms in 3% of patients.2 3 Diarrhoea, nausea, vomiting and/or abdominal pain or discomfort have been described at disease onset or even before respiratory symptoms.4–7 We investigated all consecutive individuals suspected to harbour COVID-19 and admitted at the General Hospital of Crema between 21 February and 13 March 2020 to assess prevalence and features of GI symptoms in COVID-19 patients and their correlation with medical history, disease course and outcome. Among 411 consecutive COVID-19 patients (with positive RT-PCR), 42 (10.2%, 15 females and 27 males, mean age 68.2±14.2) reported GI symptoms including nausea (18, 4.3%), vomiting (16, 3.8%), diarrhoea (15, 3.6%) or abdominal pain (5, 1.2%). Table 1 shows correlation of GI symptoms with outcomes as either CPAP/NIV or ICU admission or death.Table 1 Correlation of GI symptoms with CPAP/NIV, ICU admission or death GI symptoms Non-GI symptoms P value CPAP/NIV, n (%) 9 (21.4) 103 (27.9) 0.37 ICU, n (%) 1 (2.4) 27 (7.3) 0.23 Death, n (%) 4 (9.5) 68 (18.4) 0.15 CPAP, continuous positive airway pressure; ICU, intensive care unit; NIV, non-invasive ventilation.