LAUSR

The emergence of coronavirus disease 2019 (COVID-19), which caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has put unprecedented challenges on the public health [1, 2]. It is wellknown that most of the infected patients presented with fever or respiratory manifestations, while a portion of patients presented with gastrointestinal (GI) symptoms [2]. In early published study from the USA, SARS-CoV-2 viral RNA has been present in the feces of the illness [3]. However, part of COVID-19 patients present GI symptoms at the onset of diseases may be overlooked by clinicians [4]. Our experience was conducted in Ningbo First Hospital, Jingzhou Central Hospital, and Hubei Provincial Hospital of Integrated Chinese & Western Medicine. One hundred fifty-seven patients we treated were diagnosed as COVID-19 according to the World Health Organization interim guidance [5]. Nasopharyngeal swabs and chest computed tomography were collected from all patients. Demographic data, symptoms, laboratory values, comorbidities, and clinical outcomes were collected from the electronic medical records. Of 157 patients with COVID-19, 63 (40.1%) presented with 1 or more GI symptoms (anorexia, nausea, or diarrhea). The mean age of 157 patients was 49.3 years (standard deviation, SD, 14.5), and 74 (47.1%) were male. Of the 63 patients, 21 (33.3%) had nausea, 47 (74.6%) had anorexia, and 25 (39.7%) had diarrhea. The mean age of those patients was 51.9 years (SD, 14.9). Twentyfour (38.1%) were male, and 24 (38.1%) had chronic diseases. The most common symptoms were cough, fatigue, fever, and muscle soreness. Neither the median white blood cell nor lymphocyte counts were different between patients with and without GI symptoms (Table 1). There was no significant difference in viral shedding, the time to clinical recovery, or hospitalization duration between patients with and without GI symptoms (Table 1). Among patients with GI symptoms, 63.5% received corticosteroids treatment, which is much lower than patients without GI symptoms group (63.5% vs 76.6%; p = 0.0751). Moreover, less patients with GI symptoms developed into severe cases compared with those without GI symptoms (12.7% vs 35.1%; p = 0.0016). In our experience, 4 out of 10 patients with COVID19 have significant GI symptoms. There was no significant difference in gender, age, and comorbidities between patients with and without GI symptoms. Leukocyte and lymphocyte counts were similar between the two groups. Besides, there was no significant difference in viral shedding, the time to clinical recovery, or hospitalization duration between patients with and