SonoSim
(855) 873-7666 Login
en English
enعربى zh-CN 中文 cs Czech de Deutsche en English es Español ru Français it Italiano ja 日本語 pl Polskie pt Português ru Русский
  • Home
  • Store
  • Our Solution
    • Our Ultrasound Training
    • The SonoSimulator®
    • Comparison Guide
    • Content Choices
    • Learning Benefits
  • Who We Train
  • For Groups
    • Group Ultrasound Training
    • SonoSim LiveScan®
    • SonoSim LiveScan CaseBuilder Feature
    • Performance Tracker
  • Company
    • About Us
    • Careers
    • Blog
    • International
    • Our Partners
  • Our Clients
    • Client List
    • Case Studies
    • Testimonials
  • Support
  • Contact
  • Languages
    • en English
      enعربى zh-CN 中文 cs Czech de Deutsche en English es Español ru Français it Italiano ja 日本語 pl Polskie pt Português ru Русский

Gastrointestinal Manifestations of COVID-19

Posted in: Announcements, Blog, COVID-19, Ultrasound Literature|April 14, 2020
Share Button

Documented gastrointestinal manifestations in coronavirus disease 2019 (COVID-19) patients include anorexia, nausea, vomiting, abdominal pain, and diarrhea. These gastrointestinal manifestations may predate more commonly described signs and symptoms, such as cough and fever, by several days (de Souza et al., Song et al., Wang et al.).

The prevalence of gastrointestinal symptoms in COVID-19 patients at the time of initial presentation for medical evaluation ranges between 1% to 17% (Chen et al., de Souza et al., Gu et al., Guan et al., Huang et al., Jin et al., Luo et al., Ng & Tilg, Young et al.). Table 1 profiles the relative prevalence of gastrointestinal symptoms and average transaminase values in 183 patients that initially presented with gastrointestinal symptoms only and were subsequently diagnosed with COVID-19 infection.

Importantly, up to 16% of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may present primarily with gastrointestinal symptoms and not initially exhibit fever or respiratory manifestations (Luo et al.). Mild-to-moderate elevations in serum transaminases (AST and ALT) were noted upon initial hospitalization (Chen et al., Huang et al., Luo et al., Parohan et al., Wang et al.). SARS-CoV-2 is the presumed pathogen causing these symptoms. Angiotensin converting enzyme 2 (ACE2) receptors have been identified as the attachment site for the spike protein of SARS-CoV-2 virus and facilitate cell entry. ACE2 receptors have been identified in the upper and stratified epithelial cells of the esophagus as well as the absorptive enterocytes of the ileum (Zhang et al.).

The pathophysiology and transmission routes of COVID-19–induced gastrointestinal disease is under active investigation. COVID-19 patients have been found to shed SARS-CoV-2 in throat swab and stool samples for up to 2 to 3 weeks (respectively) following initial diagnosis (Gu et al., Ng & Tilg, Tan et al., Young et al.).

To date, characteristic gastrointestinal ultrasound findings in COVID-19 infected patients have not been described. An important application of ultrasound in COVID-positive or rule-out COVID patients presenting with gastrointestinal symptoms is to identify alternative etiologies for these symptoms (e.g., small bowel obstruction).

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 Feb 15;395(10223):507-513. doi: 10.1016/S0140-6736(20)30211-7. Epub 2020 Jan 30.

de Souza TH, Nadal JA, Nogueira JN, et al. Clinical manifestations of children with covid-19: a systematic review. MedRxiv 2020.04.01.20049833 [Preprint]. 2020 [cited 2020 Apr 13]. Available from:  https://www.medrxiv.org/content/10.1101/2020.04.01.20049833v1 doi: https://doi.org/10.1101/2020.04.01.20049833

Gu J, Han B, Wang J. COVID-19: gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology. 2020 Mar 3. pii: S0016-5085(20)30281-X. doi: 10.1053/j.gastro.2020.02.054. [Epub ahead of print]

Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020 Feb 28. doi: 10.1056/NEJMoa2002032. [Epub ahead of print]

Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24.

Jin X, Lian J, Hu J, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. 2020 Mar 24. pii: gutjnl-2020-320926. doi: 10.1136/gutjnl-2020-320926. [Epub ahead of print]

Luo S, Zhang X, Xu H. Don’t overlook digestive symptoms in patients with 2019 novel coronavirus disease (COVID-19). Clin Gastroenterol Hepatol. 2020 Mar 20. pii: S1542-3565(20)30401-8. doi: 10.1016/j.cgh.2020.03.043. [Epub ahead of print]

Ng SC, Tilg H. COVID-19 and the gastrointestinal tract: more than meets the eye. Gut. 2020 Apr 9. pii: gutjnl-2020-321195. doi: 10.1136/gutjnl-2020-321195. [Epub ahead of print]

Parohan M, Yaghoubi S, Seraj A. Liver injury is associated with severe coronavirus disease 2019 (COVID‑19) infection: a systematic review and meta-analysis of retrospective studies. MedRxiv 2020.04.09.20056242 [Preprint]. 2020 [cited 2020 Apr 13]. Available from: https://www.medrxiv.org/content/10.1101/2020.04.09.20056242v1 doi: https://doi.org/10.1101/2020.04.09.20056242

Song Y, Liu P, Shi XL, et al. SARS-CoV-2 induced diarrhoea as onset symptom in patient with COVID-19. Gut. 2020 Mar 5. pii: gutjnl-2020-320891. doi: 10.1136/gutjnl-2020-320891. [Epub ahead of print]

Tan LV, Ngoc NM, That BTT, et al. Duration of viral detection in throat and rectum of a patient with COVID-19. MedRxiv 2020.03.07.20032052 [Preprint]. 2020 [cited 2020 Apr 13]. Available from:  https://www.medrxiv.org/content/10.1101/2020.03.07.20032052v1 doi: https://doi.org/10.1101/2020.03.07.20032052

Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020 Feb 7. doi: 10.1001/jama.2020.1585. [Epub ahead of print]

Young BE, Ong SWX, Kalimuddin S, et al. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA. 2020 Mar 3. doi: 10.1001/jama.2020.3204. [Epub ahead of print]

Zhang H, Kang Z, Gong H, et al. The digestive system is a potential route of 2019-nCov infection: a bioinformatics analysis based on single-cell transcriptomes. BioRxiv 2020.01.30.927806 [Preprint]. 2020 [cited 2020 Apr 13]. Available from: https://www.biorxiv.org/content/10.1101/2020.01.30.927806v1.article-info doi: https://doi.org/10.1101/2020.01.30.927806

*Information from this website is for informational and learning purposes. It is not a substitute for professional medical advice, diagnosis, or treatment, but is intended to share real-time case studies and academic articles within the medical education community.

May 4, 2020 Danielle Endaya

SonoSim Blog

  • Blog
    • Announcements
      • Trade Shows
    • COVID-19
    • International
      • International Partners
    • Newsletter
      • Newsletter 2014
      • Newsletter 2015
      • Newsletter 2016
      • Newsletter 2017
      • Newsletter 2018
      • Newsletter 2019
      • Newsletter 2020
    • SonoSim Case Studies
    • Ultrasound Literature
      • Clinical Studies
        • Cardiology Clinical Studies
        • Emergency Medicine Clinical Studies
        • Gynecology
        • Musculoskeletal
          • Ankle
          • Foot
          • Knee
          • Shoulder
          • Spine
          • Thigh
          • Wrist
        • OB/GYN – Clinical Studies
        • Ophthalmology
        • Point-of-Care
          • Pediatrics
        • Procedures
          • Arthrocentesis
          • FAST and E-FAST
          • Lumbar Puncture
          • Nerve Block
          • Reduction
          • RUSH Protocol Procedures
          • Vascular Access
        • Sports Medicine
        • Vascular
          • Inferior Vena Cava
      • Education & Policy
        • Emergency Medicine
        • Medical School
        • OB/GYN
        • Pediatric Emergency Medicine
        • Prehospital Care
      • Hospital & Group Practice
        • Patient Satisfaction
    • Ultrasound Video Challenge
      • Abdomen
      • Airway
      • Aorta/IVC
      • Bladder
      • Breast
      • Cardiology
      • FAST Scan
      • Genitourinary
      • Intestinal/Biliary
      • Musculoskeletal Ultrasound Video Challenge
      • OB/GYN – Ultrasound Video Challenge
      • Ocular
      • Pulmonary
      • Renal
      • RUSH Protocol
      • Soft Tissue
      • Vascular Ultrasound Video Challenge
  • Conferences
  • In the Press
    • Press Coverage
    • Press Releases
  • Information Archive
  • Newsletter Articles
  • SonoSim Partners
  • Testimonials Archive
  • Ultrasound Review

Search

Learn More About the SonoSim Ultrasound Training Solution

    Contact Us  
×

Product Inquiry and General Contact

Please complete this form and a representative will be in touch with you shortly.


* Denotes a required field.

Create a Support Ticket

Complete the form to receive technical assistance. For a personal session to overview product features, please write "Product Overview" as the subject.


* Denotes a required field.

UPID Tag The UPID is a four or five digit number that can be found on a small black tag attached to the cord of your SonoSim® Probe.


Previous Article Case Study: Subacute Ultrasound Findings in COVID-19 Patient Tuesday, April 7, 2020
Next Article Case Study: COVID-19 Rule-Out Patient Presenting with GI Symptoms Wednesday, April 15, 2020
SonoSim LogoSonoSim LogoTagline
The Easiest Way to Learn & Teach UltrasonographyTM
Social Media
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Instagram
Join the community for exclusive ultrasound tips and more!
Subscribe
X

Sign Up for the SonoSim Newsletter

Receive ultrasound tips, product updates, industry news, and more!

Ultrasound Courses

  • Echocardiography Training
  • Emergency Ultrasound Training
  • Musculoskeletal Ultrasound Training
  • OBGYN Ultrasound Training
  • POCUS Ultrasound Training
  • Ultrasound-Guided Procedures

Group Programs

  • Physician Groups & Residency Programs
  • Medical Schools
  • Simulation Centers
  • DMS Programs
  • Physician Associate Programs
  • Nursing Schools

Legal & Policies

  • Patents
  • Privacy
  • End User Agreement
  • Terms of Service
  • Security Overview
  • ar عربى
  • de Deutsche
  • en English
  • es Español
  • en Français
  • it Italiano
  • ru Русский
Copyright © SonoSim, Inc. All Rights Reserved. View Patents
We use cookies to enhance site navigation, analyze site usage, assist in marketing efforts, and improve our members’ experiences. Visit our Privacy Policy for more information.

Need Help?

Click here to chat!

1