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Almost 20% of COVID-19 Patients Present with Only Gastrointestinal Symptoms

ABDOMINAL radiologists are being urged to remain vigilant for signs of coronavirus disease (COVID-19) after a review of published academic studies has found that as many as one in five patients with COVID-19 may only display gastrointestinal symptoms.

Researchers at the University of Alberta Faculty of Medicine and Dentistry, Edmonton, Canada examined the results of 36 radiology studies on COVID-19 that had been published up to July 15th 2020 and analysed the reported data. It was found that 18% of patients presented with gastrointestinal symptoms such as loss of appetite, nausea, vomiting, diarrhoea, and generalised abdominal pain. Of note, 16% of the COVID-19 cases presented with only abdominal symptoms.

“There’s a growing amount of literature showing that abdominal symptomatology is a common presentation for COVID-19,” said Dr Mitch Wilson, a radiologist and clinical lecturer at the University of Alberta.

Alongside their findings, the research team verified potential clinical signs of the viral infection that abdominal radiologists should be keenly aware of when conducting imaging. For example, inflammation of the small and large bowel, air within the bowel wall (pneumatosis), and bowel perforation (pneumoperitoneum) are all signs that could indicate advanced COVID-19.

Dr Wilson explained these results: “Seeing these things is not necessarily telling us a patient has COVID-19. It could be from a variety of potential causes. But one of those potential causes is infection from the virus, and in an environment where COVID-19 is very prevalent, it’s something to consider and potentially raise as a possibility to the referring physician.”