1. Virus discharge and initial gastrointestinal involvement are inversely associated with circulating lymphocyte count in COVID-19
- Author
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Saiduo Liu, Wei Chen, Zengpei Qiao, Chao Xing, Chongyong Xu, and Kenneth I. Zheng
- Subjects
Adult ,Male ,medicine.medical_specialty ,Gastrointestinal Diseases ,Lymphocyte ,Gastroenterology ,Virus ,Feces ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Lymphocyte Count ,Respiratory system ,Retrospective Studies ,Gastrointestinal tract ,SARS-CoV-2 ,business.industry ,circulating lymphocyte count ,COVID-19 ,Retrospective cohort study ,General Medicine ,Middle Aged ,Diarrhea ,medicine.anatomical_structure ,Vomiting ,CRP, stool, emergency ,Biomarker (medicine) ,Female ,030211 gastroenterology & hepatology ,gastrointestinal tract ,medicine.symptom ,business ,Research Paper - Abstract
Background: It's reported SARS-CoV-2 could transmit via gastrointestinal tract, with or without pulmonary symptoms. However, as far as we know, there is no effective marker to predict the virus discharge in stool and initial gastrointestinal involvement of COVID-19 patients. Aims: We aimed to investigate the likely biomarker predicting virus discharge in stool and initial gastrointestinal involvement of COVID-19, which may assist the clinicians in better preventing COVID-19 spread. Methods: The patients complained of gastrointestinal symptoms, including vomiting, diarrhea, with or without respiratory symptoms, attending the Sixth People's Hospital of Wenzhou, and the Second Affiliated Hospital of Wenzhou Medical University, were screened by qRT-PCR for SARS-CoV-2. The confirmed COVID-19 patients, without any history of intaking contaminated food or water, were all enrolled to investigate the association between circulating lymphocyte count and virus discharge, initial gastrointestinal involvement. Results: Seventy-six COVID-19 patients were included in the final analysis (mean age of 44.5 years, male 44.7%), with 24 (31.5%) complained of initial gastrointestinal symptoms. Significantly lower circulating lymphocyte count was found in the patients with positive results of qRT-PCR on stool (p = 0.012). Patients were divided into tertile groups by circulating lymphocyte count: lymphocyte ≤0.88*10^9/l ( n = 25 ), 0.88*10^9/l -1.2*10^9/l ( n = 28 ), and >1.2*10^9/l ( n = 23 ), respectively. When circulating lymphocyte count increased from 1st tertile to the 2nd and 3rd tertiles, the risk of initial gastrointestinal symptoms decreased by nearly 75% (OR = 0.25, 95% CI: 0.07, 0.98, p = 0.047), 83% (OR = 0.17, 95% CI: 0.05, 0.63, p = 0.008), after adjusting for likely confounders. Conclusions: The circulating lymphocyte count is inversely associated with virus discharge in stool, and the risk of initial gastrointestinal involvement in COVID-19 patients.
- Published
- 2021
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