COVID-19 gastrointestinal symptoms mimicking surgical presentations

Abstract

n 2020 the World Health Organization (WHO) declared COVID-19 caused by the severe acute respiratory syndrome coronavirus (SARSCoV-2) a global emergency [1]. At the time of writing, there have been over 6 million confirmed cases and 350 thousand deaths in over 200 countries worldwide caused by COVID-19 [2]. Internationally recognized symptoms of classical COVID-19 include fever and respiratory signs such as persistent cough and dyspnea on minimal exertion [2]. However, with the evolution of the pandemic an underestimated prevalence of gastrointestinal symptoms caused by COVID-19 has been identified [2]. Early reports from Wuhan, China described 2–10% of patients presenting with gastrointestinal symptoms such as diarrhea, reduced appetite, abdominal pain and vomiting, and notably 10% of patients describing nausea and diarrhea prior to, or independent of, respiratory symptoms [2]. A recent single center retrospective case series of 76 patients presenting with abdominal pain during the COVID19 pandemic identified nine patients with confirmed COVID-19 infection in the absence of respiratory symptoms [3]. In this cohort abdominal computed tomography (CT) scans were reported as either normal or with clear surgical diagnoses identified (ileus, cholecystitis, and appendicitis)