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Review: Nearly One in Five With SARS-CoV-2 Has GI Manifestations

FRIDAY, Nov. 6, 2020 — Gastrointestinal manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection occur in about 18 percent of patients and can include loss of appetite, nausea, vomiting, and diarrhea, according to a review recently published in Abdominal Radiology.

Kevin Lui, from the University of Alberta in Edmonton, Canada, and colleagues conducted a systematic review that included case reports and series discussing radiologic manifestations of SARS-CoV-2 infection in abdominal imaging studies. Data from 36 studies were included in a qualitative synthesis.

The researchers found that the prevalence of gastrointestinal symptoms was about 18 percent; symptoms included loss of appetite, nausea, vomiting, diarrhea, and abdominal pain. Of COVID-19 cases, 16 percent may only present with gastrointestinal symptoms. Many patients who only present with gastrointestinal symptoms show incidental evidence of COVID-19 through abdominal computed tomography imaging at the lung bases. Abdominal imaging findings reported to date include small and large bowel wall thickening, fluid-filled colon, pneumatosis intestinalis, pneumoperitoneum, intussusception, and ascites.

“Gastrointestinal manifestations of COVID-19 have been increasingly recognized,” the authors write. “Identifying these features on abdominal imaging highlight the need to consider and evaluate for other manifestations of COVID-19 such as lung parenchymal findings.”

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