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Gastrointestinal Symptoms Not Uncommon With COVID-19

Viral shedding in feces raises concerns for possible fecal-oral route of transmission

MONDAY, June 15, 2020 (HealthDay News) -- Approximately 12 percent of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection report gastrointestinal symptoms, according to a review published online June 11 in JAMA Network Open.

Sravanthi Parasa, M.D., from the Swedish Medical Center in Seattle, and colleagues pooled prior studies to estimate gastrointestinal symptoms, liver enzyme levels outside reference ranges, and fecal tests positive for SARS-CoV-2 among patients with COVID-19.

The researchers identified 23 published and six preprint studies (4,805 patients; mean age, 52.2 years; 33.2 percent women). In a pooled analysis, 7.4 percent of patients reported diarrhea and 4.6 percent of patients reported nausea or vomiting. Twenty percent of patients had aspartate aminotransferase levels outside reference ranges, while 14.6 percent had alanine aminotransferase levels outside reference ranges. Eight studies reported fecal tests positive for SARS-CoV-2, with viral RNA shedding detected in feces in 40.5 percent of patients. The investigators observed no statistically significant publication bias, but noted a high level of heterogeneity.

"These findings suggest that patients with SARS-CoV-2 infection can present with gastrointestinal symptoms with possible fecal-oral route of transmission due to the presence of viral RNA in stool," the authors write.

One author disclosed financial ties to the pharmaceutical and medical device industries.

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