{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:41:14Z","timestamp":1790808074019,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T00:00:00Z","timestamp":1585612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is little published evidence on the gastrointestinal features of COVID\u201019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To report on the gastrointestinal manifestations and pathological findings of patients with COVID\u201019, and to discuss the possibility of faecal transmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We have reviewed gastrointestinal features of, and faecal test results in, COVID\u201019 from case reports and retrospective clinical studies relating to the digestive system published since the outbreak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>With an incidence of 3% (1\/41)\u201079% (159\/201), gastrointestinal symptoms of COVID\u201019 included anorexia 39.9% (55\/138)\u201050.2% (101\/201), diarrhoea 2% (2\/99)\u201049.5% (146\/295), vomiting 3.6% (5\/138)\u201066.7% (4\/6), nausea 1% (1\/99)\u201029.4% (59\/201), abdominal pain 2.2% (3\/138)\u20106.0% (12\/201) and gastrointestinal bleeding 4% (2\/52)\u201013.7% (10\/73). Diarrhoea was the most common gastrointestinal symptom in children and adults, with a mean duration of 4.1\u00a0\u00b1\u00a02.5\u00a0days, and was observed before and after diagnosis. Vomiting was more prominent in children. About 3.6% (5\/138)\u201015.9% (32\/201) of adult and 6.5% (2\/31)\u201066.7% (4\/6) of children patients presented vomiting. Adult and children patients can present with digestive symptoms in the absence of respiratory symptoms. The incidence of digestive manifestations was higher in the later than in the early stage of the epidemic, but no differences in digestive symptoms among different regions were found. Among the group of patients with a higher proportion of severe cases, the proportion of gastrointestinal symptoms in severe patients was higher than that in nonsevere patients (anorexia 66.7% vs 30.4%; abdominal pain 8.3% vs 0%); while in the group of patients with a lower severe rate, the proportion with gastrointestinal symptoms was similar in severe and nonsevere cases (nausea and vomiting 6.9% vs 4.6%; diarrhoea 5.8% vs 3.5%). Angiotensin converting enzyme 2 and virus nucleocapsid protein were detected in gastrointestinal epithelial cells, and infectious virus particles were isolated from faeces. Faecal PCR testing was as accurate as respiratory specimen PCR detection. In 36% (5\/14)\u201053% (39\/73) faecal PCR became positive, 2\u20105\u00a0days later than sputum PCR positive. Faecal excretion persisted after sputum excretion in 23% (17\/73)\u201082% (54\/66) patients for 1\u201011 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Gastrointestinal symptoms are common in patients with COVID\u201019, and had an increased prevalence in the later stage of the recent epidemic in China. SARS\u2010CoV\u20102 enters gastrointestinal epithelial cells, and the faeces of COVID\u201019 patients are potentially infectious.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.15731","type":"journal-article","created":{"date-parts":[[2020,3,29]],"date-time":"2020-03-29T09:19:10Z","timestamp":1585473550000},"page":"843-851","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":655,"title":["Review article: gastrointestinal features in COVID\u201019 and the possibility of faecal transmission"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0192-3037","authenticated-orcid":false,"given":"Yuan","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Endoscopy Center Peking University First Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5450-0535","authenticated-orcid":false,"given":"Long","family":"Rong","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Center Peking University First Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weidong","family":"Nian","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Center Peking University First Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Center Peking University First Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,31]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2008-3"},{"key":"e_1_2_7_3_1","article-title":"The digestive system is a potential route of 2019\u2010nCov infection: a bioinformatics analysis based on single\u2010cell transcriptomes","author":"Zhang H","journal-title":"BioRxiv"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13412-5"},{"key":"e_1_2_7_5_1","article-title":"Manifestations of digestive system in hospitalized patients with novel coronavirus pneumonia in Wuhan, China: a single\u2010center, descriptive study","author":"Fang D","year":"2020","journal-title":"Chin J Dig"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30079-5"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2003717"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30211-7"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1585"},{"key":"e_1_2_7_11_1","article-title":"Clinical features of 2019 novel coronavirus pneumonia presented gastrointestinal symptoms but without fever onset","author":"Ping A","year":"2020","journal-title":"Lancet"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24718"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1623"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m606"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2020200274"},{"key":"e_1_2_7_17_1","first-page":"1","article-title":"Clinical characteristics of 24 asymptomatic infections with COVID\u201019 screened among close contacts in Nanjing, China","author":"Hu Z","year":"2020","journal-title":"Sci China Life Sci"},{"key":"e_1_2_7_18_1","first-page":"E011","article-title":"Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China","volume":"58","author":"Wang D","year":"2020","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.02.055"},{"key":"e_1_2_7_20_1","unstructured":"National Health Commission of the People's Republic of China.Guidance on coronavirus disease 2019 (COVID\u201019) China (Vision 7)(in Chinese). 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