{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:53:20Z","timestamp":1787064800824,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T00:00:00Z","timestamp":1599868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Coronavirus disease 19 (COVID\u201019) has caused over 200\u2009000 deaths worldwide. Thailand announced the first confirmed case outside mainland China in January 2020. The disease also spread widely across Association of Southeast Asian Nations (ASEAN). Gastrointestinal manifestations could be presenting symptoms of COVID\u201019. This study aimed to determine the prevalence of gastrointestinal manifestations of COVID\u201019 patients in Thailand and review important aspects of this disease in ASEAN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thai patients diagnosed with COVID\u201019 at Thammasat University Hospital, Thailand, were evaluated between 1 January 2020 and 30 April 2020. Patients' data, clinical presentation, exposure risk, past medical history, laboratory results, and treatment outcomes were extensively reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 352 COVID\u201019 tests were performed, and 40 patients with positive tests were studied. The mean age was 30.5\u2009years, and 55% were female. Most (82.5%) had no underlying diseases. Comorbidities were associated with severe COVID\u201019 (odds ratio [OR] 29.93; 95% confidence interval [CI] 2.31\u2013388.40,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.009). Gastrointestinal symptoms were present in 12 patients (30%). The most common presenting symptoms were anorexia (17.5%) and diarrhea (15%). Gastrointestinal symptoms developed before (9.1%), concurrent with (63.6%), and after (27.3%) respiratory symptoms. Diarrhea was significantly associated with severe COVID\u201019 (OR 38.52; 95% CI 3.11\u2013476.70,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.004). Twenty\u2010four patients (60%) received antiviral drugs; 40% had only supportive care. Only one patient required intensive care. No patient died.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Gastrointestinal manifestations in COVID\u201019 patients are common symptoms and can occur anytime during the disease course. Patients presenting with only gastrointestinal symptoms should raise clinical suspicion for COVID\u201019 in areas with high disease incidence. Clinically severe COVID\u201019 was associated with comorbidities and diarrhea.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgh3.12394","type":"journal-article","created":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T05:01:12Z","timestamp":1601182872000},"page":"1096-1101","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Gastrointestinal manifestation as clinical predictor of severe\n                    <scp>COVID<\/scp>\n                    \u201019: A retrospective experience and literature review of\n                    <scp>COVID<\/scp>\n                    \u201019 in Association of Southeast Asian Nations (\n                    <scp>ASEAN)<\/scp>"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6496-0284","authenticated-orcid":false,"given":"Natsuda","family":"Aumpan","sequence":"first","affiliation":[{"name":"Gastroenterology Unit, Department of Medicine, Faculty of Medicine Thammasat University Hospital  Khlong Nueng Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pongjarat","family":"Nunanan","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medicine, Faculty of Medicine Thammasat University Hospital  Khlong Nueng Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4298-9331","authenticated-orcid":false,"given":"Ratha\u2010korn","family":"Vilaichone","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medicine, Faculty of Medicine Thammasat University Hospital  Khlong Nueng Thailand"},{"name":"Department of Medicine Chulabhorn International College of Medicine (CICM), Thammasat University  Khlong Nueng Thailand"},{"name":"Digestive Diseases Research Center (DRC) Thammasat University Hospital  Khlong Nueng Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-020-0695-z"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1585"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.12358"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.12362"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15731"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.02.055"},{"key":"e_1_2_6_9_1","first-page":"1","article-title":"Digestive system is a potential route of COVID\u201019: an analysis of single\u2010cell coexpression pattern of key proteins in viral entry process","volume":"0","author":"Zhang H","year":"2020","journal-title":"Gut"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.12364"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000000774"},{"key":"e_1_2_6_12_1","unstructured":"World Health Organization.Novel Coronavirus \u2013 Thailand (ex\u2010China). Cited 5 May 2020. Available from URL:https:\/\/www.who.int\/csr\/don\/14-january-2020-novel-coronavirus-thailand-ex-china\/en\/"},{"key":"e_1_2_6_13_1","unstructured":"Center of Disease Control and Prevention.Interim Guidelines for Collecting Handling and Testing Clinical Specimens from Persons for Coronavirus Disease 2019 (COVID\u201019). Cited 7 May 2020. Available from URL:https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/lab\/guidelines-clinical-specimens.html"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqaa036"},{"key":"e_1_2_6_15_1","unstructured":"World Health Organization.Coronavirus Disease 2019 (COVID\u201019): Situation Report\u201073. Cited 30 Jun 2020. Available from URL:https:\/\/www.who.int\/docs\/default\u2010source\/coronaviruse\/situation\u2010reports\/20200402\u2010sitrep\u201073\u2010covid\u201019.pdf?sfvrsn=5ae25bc7_6"},{"key":"e_1_2_6_16_1","unstructured":"Department of Medical Services. Practice Guideline for Diagnosis Treatment and Prevention of Nosocomial Transmission of COVID\u201019. Revision 1 May 1 2020 (in Thai). Cited 7 May 2020. Available from URL:https:\/\/covid19.dms.go.th\/Content\/Select_Landding_page?contentId=69."},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2020201160"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1301069"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2607.200598"},{"key":"e_1_2_6_20_1","unstructured":"Department of Disease Control.Coronavirus Disease 2019 (COVID\u201019)(in Thai). Cited 7 May 2020. Available from URL:https:\/\/ddc.moph.go.th\/viralpneumonia\/file\/g_km\/handout001_12032020.pdf"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30528-6"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.3204"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa322"},{"key":"e_1_2_6_24_1","first-page":"68","article-title":"The importance of chest CT scan in COVID\u201019","volume":"52","author":"Tenda ED","year":"2020","journal-title":"Acta Med. Indones."},{"key":"e_1_2_6_25_1","first-page":"63","article-title":"Gastrointestinal presentation in COVID\u201019 in Indonesia: a case report","volume":"52","author":"Azwar MK","year":"2020","journal-title":"Acta Med. Indones."},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.03.049"},{"key":"e_1_2_6_27_1","first-page":"30106","article-title":"Management of mild cases of COVID\u201019 in low\u2010resource countries: an experience in Vietnam","volume":"1684","author":"Than HM","year":"2020","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature11228"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000664"}],"container-title":["JGH Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.12394","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jgh3.12394","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.12394","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T06:29:25Z","timestamp":1693808965000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jgh3.12394"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,12]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1002\/jgh3.12394"],"URL":"https:\/\/doi.org\/10.1002\/jgh3.12394","archive":["Portico"],"relation":{},"ISSN":["2397-9070","2397-9070"],"issn-type":[{"value":"2397-9070","type":"print"},{"value":"2397-9070","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,12]]},"assertion":[{"value":"2020-06-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}