Clinical characteristics of coronavirus disease 2019 patients with diarrhea in Daegu

Background/aims: Coronavirus disease 2019 (COVID-19) can reportedly cause gastrointestinal symptoms. Therefore, we investigated the clinical characteristics of COVID-19 patients with diarrhea.

Methods: We included 118 COVID-19 patients admitted to a single hospital from February 20 to March 31, 2020. Medical records with clinical characteristics, laboratory data, treatment course, and clinical outcomes were compared based on the presence or absence of diarrhea. Prognostic factors for disease severity and mortality in COVID-19 were also assessed.

Results: Among patients, 54 (45.8%) had diarrhea, whereas 7 (5.9%) had only diarrhea. The median age of patients with diarrhea was 59 years (44-64), and 22 (40.7%) were male. Systemic steroid use, intensive care unit admission, septic shock, and acute respiratory distress syndrome were less frequent in the diarrhea group than in the non-diarrhea group. No significant differences were observed in total hospital stay and mortality between groups. On multivariate analysis, age (OR 1.06, 95% CI 1.01-1.12, p = 0.044), diabetes (OR 3.00, 95% CI 1.25-20.47, p = 0.042), and dyspnea (OR 41.19, 95% CI 6.60-823.16, p < 0.001) were independent risk factors for septic shock. On Cox regression analysis, diabetes (HR 4.82, 95% CI 0.89-26.03, p = 0.043) and chronic obstructive pulmonary disease (HR 16.58, 95% CI 3.10-88.70, p = 0.044) were risk factors for mortality.

Conclusion: Diarrhea was present in 45.8% of patients and was a common symptom of COVID-19. Although patients with diarrhea showed less severe clinical features, diarrhea was not associated with disease severity or mortality.

Keywords: Coronavirus disease 2019; diarrhea; disease severity; mortality.