Objective The SARS-CoV-2-infected disease (COVID-19) outbreak is a major threat to human beings. Previous studies mainly focused on Wuhan and typical symptoms. We analysed 74 confirmed COVID-19 cases with GI symptoms in the Zhejiang province to determine epidemiological, clinical and virological characteristics. Design COVID-19 hospital patients were admitted in the Zhejiang province from 17 January 2020 to 8 February 2020. Epidemiological, demographic, clinical, laboratory, management and outcome data of patients with GI symptoms were analysed using multivariate analysis for risk of severe/critical type. Bioinformatics were used to analyse features of SARS-CoV-2 from Zhejiang province. Results Among enrolled 651 patients, 74 (11.4%) presented with at least one GI symptom (nausea, vomiting or diarrhoea), average age of 46.14 years, 4-day incubation period and 10.8% had pre-existing liver disease. Of patients with COVID-19 with GI symptoms, 17 (22.97%) and 23 (31.08%) had severe/critical types and family clustering, respectively, significantly higher than those without GI symptoms, 47 (8.14%) and 118 (20.45%). Of patients with COVID-19 with GI symptoms, 29 (39.19%), 23 (31.08%), 8 (10.81%) and 16 (21.62%) had significantly higher rates of fever >38.5°C, fatigue, shortness of breath and headache, respectively. Low-dose glucocorticoids and antibiotics were administered to 14.86% and 41.89% of patients, respectively. Sputum production and increased lactate dehydrogenase/glucose levels were risk factors for severe/critical type. Bioinformatics showed sequence mutation of SARS-CoV-2 with m6A methylation and changed binding capacity with ACE2. Conclusion We report COVID-19 cases with GI symptoms with novel features outside Wuhan. Attention to patients with COVID-19 with non-classic symptoms should increase to protect health providers.

中文翻译：

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2019年冠状病毒感染症（COVID-19）74例胃肠道症状的流行病学、临床和病毒学特征

目的 SARS-CoV-2 感染性疾病 (COVID-19) 的爆发是对人类的主要威胁。以往的研究主要集中在武汉和典型症状上。我们分析了浙江省 74 例有胃肠道症状的 COVID-19 确诊病例，以确定流行病学、临床和病毒学特征。设计的 COVID-19 医院患者于 2020 年 1 月 17 日至 2020 年 2 月 8 日在浙江省收治。使用多变量分析对重症/危重症风险型患者的流行病学、人口统计学、临床、实验室、管理和结果数据进行分析. 生物信息学被用来分析来自浙江省的 SARS-CoV-2 的特征。结果 纳入的 651 例患者中，74 例（11.4%）出现至少一种胃肠道症状（恶心、呕吐或腹泻），平均年龄 46.14 岁，4 天的潜伏期和 10.8% 有预先存在的肝病。在有胃肠道症状的 COVID-19 患者中，分别有 17 例（22.97%）和 23 例（31.08%）具有重症/危重症和家族聚集性，显着高于没有胃肠道症状的患者，分别为 47 例（8.14%）和 118 例（20.45%） ）。在具有胃肠道症状的 COVID-19 患者中，29 (39.19%)、23 (31.08%)、8 (10.81%) 和 16 (21.62%) 的发烧率显着高于 38.5°C、疲劳、呼吸急促和头痛，分别。分别有 14.86% 和 41.89% 的患者接受了低剂量糖皮质激素和抗生素治疗。咳痰和乳酸脱氢酶/葡萄糖水平升高是重症/危重症的危险因素。生物信息学显示 SARS-CoV-2 的序列突变具有 m6A 甲基化，并改变了与 ACE2 的结合能力。结论 我们报告了武汉以外具有新特征的具有胃肠道症状的 COVID-19 病例。应增加对具有非典型症状的 COVID-19 患者的关注，以保护医疗服务提供者。