[논문]Review article: gastrointestinal features in COVID‐19 and the possibility of faecal transmission

Tian, Yuan; Rong, Long; Nian, Weidong; He, Yan

doi:10.1111/apt.15731

Review article: gastrointestinal features in COVID‐19 and the possibility of faecal transmission 원문보기

Alimentary pharmacology & therapeutics, v.51 no.9, 2020년, pp.843 - 851

Tian, Yuan (Department of Endoscopy Center, Peking University First Hospital, Beijing, China) , Rong, Long (Department of Endoscopy Center, Peking University First Hospital, Beijing, China) , Nian, Weidong (Department of Endoscopy Center, Peking University First Hospital, Beijing, China) , He, Yan (Department of Endoscopy Center, Peking University First Hospital, Beijing, China)

Abstract ▼ AI-Helper

SummaryBackgroundThere is little published evidence on the gastrointestinal features of COVID‐19.AimsTo report on the gastrointestinal manifestations and pathological findings of patients with COVID‐19, and to discuss the possibility of faecal transmission.MethodsWe have reviewed gastrointestinal features of, and faecal test results in, COVID‐19 from case reports and retrospective clinical studies relating to the digestive system published since the outbreak.ResultsWith an incidence of 3% (1/41)‐79% (159/201), gastrointestinal symptoms of COVID‐19 included anorexia 39.9% (55/138)‐50.2% (101/201), diarrhoea 2% (2/99)‐49.5% (146/295), vomiting 3.6% (5/138)‐66.7% (4/6), nausea 1% (1/99)‐29.4% (59/201), abdominal pain 2.2% (3/138)‐6.0% (12/201) and gastrointestinal bleeding 4% (2/52)‐13.7% (10/73). Diarrhoea was the most common gastrointestinal symptom in children and adults, with a mean duration of 4.1 ± 2.5 days, and was observed before and after diagnosis. Vomiting was more prominent in children. About 3.6% (5/138)‐15.9% (32/201) of adult and 6.5% (2/31)‐66.7% (4/6) of children patients presented vomiting. Adult and children patients can present with digestive symptoms in the absence of respiratory symptoms. The incidence of digestive manifestations was higher in the later than in the early stage of the epidemic, but no differences in digestive symptoms among different regions were found. Among the group of patients with a higher proportion of severe cases, the proportion of gastrointestinal symptoms in severe patients was higher than that in nonsevere patients (anorexia 66.7% vs 30.4%; abdominal pain 8.3% vs 0%); while in the group of patients with a lower severe rate, the proportion with gastrointestinal symptoms was similar in severe and nonsevere cases (nausea and vomiting 6.9% vs 4.6%; diarrhoea 5.8% vs 3.5%). Angiotensin converting enzyme 2 and virus nucleocapsid protein were detected in gastrointestinal epithelial cells, and infectious virus particles were isolated from faeces. Faecal PCR testing was as accurate as respiratory specimen PCR detection. In 36% (5/14)‐53% (39/73) faecal PCR became positive, 2‐5 days later than sputum PCR positive. Faecal excretion persisted after sputum excretion in 23% (17/73)‐82% (54/66) patients for 1‐11 days.ConclusionsGastrointestinal symptoms are common in patients with COVID‐19, and had an increased prevalence in the later stage of the recent epidemic in China. SARS‐CoV‐2 enters gastrointestinal epithelial cells, and the faeces of COVID‐19 patients are potentially infectious.

참고문헌 (34)

1 Wu F , Zhao S , Yu B . et al. A new coronavirus associated with human respiratory disease in China . Nature . 2020 . Published online Feb 3. doi: 10.1038/s41586-020-2008-3

상세보기
2 Zhang H , Kang Z , Gong H . et al. The digestive system is a potential route of 2019nCov infection: a bioinformatics analysis based on singlecell transcriptomes . BioRxiv 927806. Post online Jan 31. 10.1101/2020.01.30.927806
3 Peiris J , Chu CM , Cheng V , et al. Clinical progression and viral load in a community outbreak of coronavirusassociated SARS pneumonia: a prospective study . Lancet . 2003 ; 361 : 1767 ？ 1772 . 12781535
4 Fang D , Ma J , Guan J . et al. Manifestations of digestive system in hospitalized patients with novel coronavirus pneumonia in Wuhan, China: a singlecenter, descriptive study . Chin J Dig . 2020 ,40: Epub ahead of print (in Chinese). 10.3760/cma.j.issn.0254-1432.2020.0005
5 Huang C , Wang Y , Li X , et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China . Lancet . 2020 ; 395 : 497 ？ 506 . 31986264
6 Yang X , Yu Y , Xu J . et al Clinical course and outcomes of critically ill patients with SARSCoV2 pneumonia in Wuhan, China: a singlecentered, retrospective, observational study . Lancet Resp Med . 2020 . Published online Feb 24. doi: 10.1016/S2213-2600(20)30079-5

상세보기
7 Liu W , Zhang Q , Chen J . et al. Detection of Covid19 in children in early January 2020 in Wuhan, China . N Engl J Med . 2020 Published online Mar 12. 10.1056/NEJMc2003717

상세보기
8 Chen N , Zhou M , Dong X , et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study . Lancet . 2020 ; 395 : 507 ？ 513 . 32007143
9 Wang D , Hu B , Hu C . et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirusinfected pneumonia in Wuhan, China . JAMA . 2020 ; 323 : 1061 . Published online Feb 7.

상세보기
10 Ping A , Hongbin C , Xiaoda J , Honggang Y . Clinical features of 2019 novel coronavirus pneumonia presented gastrointestinal symptoms but without fever onset . Preprints with the Lancet . 2020 https://ssrn.com/abstract=3532530
11 Xia W , Shao J , Guo Y , Peng X , Li Z , Hu D . Clinical and CT features in pediatric patients with COVID19 infection: different points from adults . Pediatr Pulmonol . 2020 Published online March 5. 10.1002/ppul.24718

상세보기
12 Chang Lin M , Wei L . et al. Epidemiologic and clinical characteristics of novel coronavirus infections involving 13 patients outside Wuhan, China . JAMA . 2020 ; 323 : 1092 Published online Feb 7. 10.1001/jama.2020.1623

상세보기
13 Guan W , Ni Z , Hu Y . et al. Clinical characteristics of coronavirus disease 2019 in China . N Engl J Med . 2020 Published online Feb 28. 10.1056/NEJMoa2002032

상세보기
14 Xu XW , Wu XX , Jiang XG , et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARSCov2) outside of Wuhan, China: retrospective case series . BMJ . 2020 ; 368 : m606 . 32075786

상세보기
15 Song F , Shi N , Shan F . et al. Emerging 2019 novel coronavirus (2019nCoV) pneumonia . Radiology . 2020 ; 295 : 210 ？ 217 . Published online Feb 6. 10.1148/radiol.2020200274 32027573

상세보기
16 Hu Z , Song C , Xu C . et al. Clinical characteristics of 24 asymptomatic infections with COVID19 screened among close contacts in Nanjing, China . Sci China Life Sci . 2020 : 1 ？ 6 . 10.1007/s11427-020-1661-4 31564034

상세보기
17 Wang D , Ju X , Xie F . et al. Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China . Zhonghua Er Ke Za Zhi 2020 ; 58 : E011 (in Chinese). 32118389
18 Xiao F , Tang M , Zheng X , Liu Y , Li X , Shan H . Evidence for gastrointestinal infection of SARSCoV2. Gastroenterology . 2020 Published online Mar 3. 10.1053/j.gastro.2020.02.055

상세보기
19 National Health Commission of the People's Republic of China . Guidance on coronavirus disease 2019 (COVID19), China (Vision 7) (in Chinese). Published online March 3. http://www.gov.cn/zhengce/zhengceku/2020-03/04/content_5486705.htm
20 Novel CPERE . The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID19) in China . Zhonghua Liu Xing Bing Xue Za Zhi 2020 ; 41 : 145 (in Chinese) 10.3760/cma.j.issn.0254-6450.2020.02.003 32064853
21 Liu Q , Wang R ., Qu G et al. Macroscopic autopsy findings in a patient with COVID19 . J Forensic Med . 2020 ; 36 : 1 ？ 3 (in Chinese)
22 Leung WK , To KF , Chan PKS , et al. Enteric involvement of severe acute respiratory syndromeassociated coronavirus infection . Gastroenterology . 2003 ; 125 : 1011 ？ 1017 . 14517783
23 Holshue ML , DeBolt C , Lindquist S , et al. First case of 2019 novel coronavirus in the United States . N Engl J Med . 2020 ; 382 : 929 ？ 936 . 32004427

상세보기
24 Yang Z , Li G , Dai X , Liu G , Li G , Jie Y . Three cases of novel coronavirus pneumonia with viral nucleic acids still positive in stool after throat swab detection turned negative . Chin J Dig . 2020 ; 40 : E002 ？ E002 (in Chinese). 10.3760/cma.j.issn.0254-1432.2020.0002
25 Ling Y , Xu SB , Lin YX . et al. Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients . Chin Med J (Engl) . 2020 Published online Feb 28. 10.1097/CM9.0000000000000774

상세보기
26 Zhang J , Wang S , Xue Y . Fecal specimen diagnosis 2019 novel coronavirusinfected pneumonia . J Med Virol . 2020. Published online Mar 3. 10.1002/jmv.25742

상세보기
27 Pan L , Mi M , Gang Ren H et al. Clinical characteristics of COVID19 patients with digestive symptoms in Hubei, China: a descriptive, crosssectional, multicenter study . https://journals.lww.com/ajg/Documents/COVID_Digestive_Symptoms_AJG_Preproof.pdf
28 Dong Y , Mo X , Hu Y . et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China . Pediatrics . 2020 March, e20200702. 10.1542/peds.2020-0702 . 10.1002/jmv.25742

상세보기
29 Ong SWX , Tan YK , Chia PY . et al. Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARSCoV2) from a symptomatic patient . JAMA . 2020 Published online Mar 4. 10.1001/jama.2020.3227

상세보기
30 van Doremalen N , Bushmaker T , Morris D . et al. Aerosol and surface stability of HCoV19 (SARSCoV2) compared to SARSCoV1 . medRxiv . 2020 Post online Mar 13. 10.1101/2020.03.09.20033217
31 Zou L , Ruan F , Huang M . et al. SARSCoV2 viral load in upper respiratory specimens of infected patients . N Engl J Med . 2020 Published online Feb 19. 10.1056/NEJMc2001737

상세보기
32 Bai Y , Yao L , Wei T . et al. Presumed asymptomatic carrier transmission of COVID19 . JAMA . 2020 Published online Feb 21. 10.1001/jama.2020.2565

상세보기
33 Tong Z , Tang A , Li K . et al. Potential presymptomatic transmission of SARSCoV2, Zhejiang Province, China, 2020 . Emerging Infect Dis 2020 ; 26 10.3201/eid2605.200198

상세보기
34 Zhou F , Yu T , Du R . et al. Clinical course and risk factors for mortality of adult inpatients with COVID19 in Wuhan, China: a retrospective cohort study . Lancet . 2020 ; 395 : 1054 ？ 1062 . Published online Mar 11. 10.1016/S0140-6736(20)30566-3 32171076

상세보기

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증

Review article: gastrointestinal features in COVID‐19 and the possibility of faecal transmission 원문보기

Abstract ▼ AI-Helper

참고문헌 (34)

이 논문을 인용한 문헌

관련 콘텐츠

원문 보기

원문 URL 링크

오픈액세스(OA) 유형

이 논문과 함께 이용한 콘텐츠

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

선택된 텍스트