Coronavirus disease 19 with gastrointestinal symptoms as initial manifestations: a case report

J Int Med Res. 2020 Sep;48(9):300060520952256. doi: 10.1177/0300060520952256.

Abstract

Since the outbreak of coronavirus disease 2019 (COVID-19) in December 2019, an epidemic has spread rapidly worldwide. COVID-19 is caused by the highly infectious severe acute respiratory syndrome coronavirus-2. A 42-year-old woman presented to hospital who was suffering from epigastric discomfort and dyspepsia for the past 5 days. Before the onset of symptoms, she was healthy, and had no travel history to Wuhan or contact with laboratory-confirmed COVID-19 cases. An examination showed chronic superficial gastritis with erosion and esophagitis. Enhanced magnetic resonance imaging of the abdomen showed a lesion in the right lower lobe of the lungs. Chest computed tomography showed multiple ground-glass opacity in the lungs. Reverse transcription-polymerase chain reaction was negative for severe acute respiratory syndrome coronavirus-2. There was no improvement after antibiotic treatment. Polymerase chain reaction performed 2 days later was positive and she was diagnosed with COVID-19. After several days of antiviral and symptomatic treatments, her symptoms improved and she was discharged. None of the medical staff were infected. Clinical manifestations of COVID-19 are nonspecific, making differentiating it from other diseases difficult. This case shows the sequence in which symptoms developed in a patient with COVID-19 with gastrointestinal symptoms as initial manifestations.

Keywords: COVID-19; angiotensin-converting enzyme 2; dyspepsia; gastrointestinal symptoms; lungs; reverse transcriptase-polymerase chain reaction; severe acute respiratory syndrome coronavirus-2.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / transmission
  • Coronavirus Infections / virology
  • Female
  • Gastrointestinal Diseases / diagnosis*
  • Gastrointestinal Diseases / pathology
  • Gastrointestinal Diseases / virology*
  • Humans
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / transmission
  • Pneumonia, Viral / virology
  • Prognosis
  • SARS-CoV-2