Carried out by researchers at Stanford Medicine, the new study analysed data gathered from 116 patients with a median age of 50 who tested positive for Covid-19 at Stanford Health Care from March 4 to 24.
The majority of the patients were treated in a hospital emergency room or a clinic before being released, however, 33 of the patients were hospitalised, with eight ending up in an intensive care unit, and one of the patients died.
The researchers found that 94.8% of patients had a cough, 76.7% had a fever, 58% experienced shortness of breath and 52.2% had muscle aches.
However, in addition to these classic symptoms associated with Covid-19, 31.9% also reported gastrointestinal symptoms, with the majority of these patients describing the symptoms as mild.
In addition, 22% experienced loss of appetite, 22% had nausea and vomiting, and 12% had diarrhoea.
“Covid-19 is probably not just respiratory symptoms like a cough,” said co-lead author Dr Alexander Podboy.
“A third of the patients we studied had gastrointestinal symptoms. It’s possible we may be missing a significant portion of patients sick with the coronavirus due to our current testing strategies focusing on respiratory symptoms alone.”
“We also noticed that 40% of patients had elevated levels of an abnormal liver enzyme, and that those with high levels required more hospitalisation,” co-lead author Dr. George Cholankeril said.
The study, published in the journal Gastroenterology, is one of the earliest to investigate US patients with the coronavirus, and while researchers note that their data is taken from an early stage in the current pandemic, and just from one single institution, they add that the findings do suggest that those exposed to the coronavirus and who are experiencing gastrointestinal symptoms should also be tested.
The team also point out that there is a growing body of evidence in China and Singapore that Covid-19 patients also experience gastrointestinal symptoms and not just respiratory problems.
“In our current cohort of patients, all patients had respiratory symptoms prior to the development of gastrointestinal symptoms,” Podboy said. “No patients had gastrointestinal symptoms prior to the development of respiratory symptoms or as their only manifestation of Covid-19.”
He added, “However, that may be a product of who we were testing. Currently, testing is only offered for patients that meet specific criteria — criteria that often require the presence of pulmonary symptoms.”