A new study has highlighted the prevalence of gastrointestinal symptoms in people with COVID-19 and what signs abdominal radiologists should look out for.

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In a new study, researchers have synthesized evidence from 36 scientific articles to highlight the prevalence of gastrointestinal symptoms in people with COVID-19.

The study, appearing in the journal Abdominal Radiology, also identifies some of the signs abdominal radiologists should look out for when imaging people.

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One of the challenges of the COVID-19 pandemic has been the fact that SARS-CoV-2 is a novel coronavirus. While sharing some similarities with the previous severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV-2 also has many differences.

As time progresses, scientists can conduct research on the virus to discover some of these unknowns and therefore help inform effective policy decisions and clinical practices. This has been the case with the symptoms of COVID-19.

While scientists have been aware of the most common symptoms — fever, coughing, loss of smell or taste, and shortness of breath — for some time, they have only recently identified other less common but significant symptoms.

As Dr. Mitch Wilson, a radiologist and clinical lecturer at the University of Alberta’s Faculty of Medicine & Dentistry and co-author of the study points out, “[t]here’s a growing amount of literature showing that abdominal symptomatology is a common presentation for COVID-19.”

In the present article, a team of researchers focused on the growing evidence of people presenting with gastrointestinal issues linked to COVID-19.

To do this, the researchers conducted a study to highlight trends, issues, or areas that require more research.

The team searched through popular scientific databases using variations of the keywords “COVID-19,” “gastrointestinal,” and “imaging.” This resulted in 614 potentially relevant articles. The team identified a further 21 articles from other sources.

The researchers then removed duplicate articles and began screening the articles’ abstracts and titles for relevance, identifying 137 articles.

The researchers then conducted a full-text screening, limiting the studies to those that included findings related to abdominal imaging in people who had received a diagnosis of COVID-19.

The team included 36 articles in their study.

After synthesizing the evidence from these 36 studies, the researchers identified two key findings.

First, gastrointestinal symptoms are a significant aspect of COVID-19 and may be present in the absence of other more well-known symptoms.

The researchers highlighted a meta-analysis covering more than 4,200 people that found 17.6% had gastrointestinal symptoms. In another study of 1,141 people, 16% presented with only gastrointestinal symptoms.

Second, the researchers identified a series of signs that an abdominal radiologist should look out for when imaging people — particularly because doctors have reported the incidental identification of COVID-19 in a substantial proportion of individuals with gastrointestinal symptoms.

The signs that the researchers suggest abdominal radiologists should look out for include:

  • bowel inflammation,
  • air within the bowel wall,
  • bowel perforation.

However, these signs are relatively rare in people with COVID-19. As Dr. Wilson points out, “[s]eeing these things is not necessarily telling us a patient has COVID-19. It could be from a variety of potential causes.”

“But one of those potential causes is infection from the virus, and in an environment where COVID-19 is very prevalent, it’s something to consider and potentially raise as a possibility to the referring physician.”

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