A case of COVID-19 patient with the diarrhea as initial symptom and literature review

Abstract

Since Dec 2019, a cluster of pneumonia outbreak in Wuhan, Hubei province, China, and soon spread to all province of China. The pathogen was proved to be a novel betacoronavirus called 2019 novel coronavirus (officially named by the World Health Organization as COVID-19). The typical clinical manifestations were fever, cough, dyspnea, and myalgia or fatigue. Less common symptoms included headache, diarrhea, nausea and vomiting. However diarrhea as the first symptom is rarely reported. Here we reported a case of 2019 novel coronavirus-infected patient (NCIP) with diarrhea as the initial symptom. Image of CT scan and laboratory examination and careful collected as well as detection of viral RNA in pharynx. The case demonstrate that gastrointestinal symptoms ware not rare in NCIP, and diarrhea could be the initial symptom.

Keywords: Diarrhea; Novel coronavirus.

Figure 1

Picture A and B: Scaned on February 10, 2020; Picture C: Scaned on February 15,2020; Picture D: Scaned on February 20, 2020.

Figure 2

Abbreviation: WBC (10⁹/L): White blood cell, N#(10⁹/L): Absolute number of Neutrophil, L#(10⁹/L): Absolute number of Lymphocyte, B#(10⁹/L): Absolute number of Eosinophils, CRP(mg/L): C-reactive Protein, CD4/CD8: Ratio of CD4 cells to CD8 cells, IL-6(pg/ml): Interleukin-6, IL-2R(U/ml): Interleukin-2R, TNF-α(pg/ml): Tumor necrosis factor-α.