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Background: Early detection is critical in limiting the spread of 2019 novel coronavirus (COVID-19). Although previous data revealed characteristics of GI symptoms in COVID-19, for patients with only GI symptoms onset, their diagnostic process and potential transmission risk are still unclear. Methods: We retrospectively reviewed 205 COVID-19 cases from January 16 to March 30, 2020, in Renmin Hospital of Wuhan University. All patients were confirmed by virus nuclei acid tests. The clinical features and laboratory and chest tomographic (CT) data were recorded and analyzed. Results: A total of 171 patients with classic symptoms (group A) and 34 patients with only GI symptoms (group B) were included. In patients with classical COVID-19 symptoms, GI symptoms occurred more frequently in severe cases compared to non-severe cases (20/43 vs. 91/128, respectively, p < 0.05). In group B, 91.2% (31/34) patients were non-severe, while 73.5% (25/34) patients had obvious infiltrates in their first CT scans. Compared to group A, group B patients had a prolonged time to clinic services (5.0 days vs. 2.6 days, p < 0.01) and a longer time to a positive viral swab normalized to the time of admission (6.9 days vs. 3.3 days, respectively, p < 0.01). Two patients in group B had family clusters of SARS-CoV-2 infection. Conclusion: Patients with only GI symptoms of COVID-19 may take a longer time to present to healthcare services and receive a confirmed diagnosis. In areas where infection is rampant, physicians must remain vigilant of patients presenting with acute gastrointestinal symptoms and should do appropriate personal protective equipment. [ABSTRACT FROM AUTHOR]

• Higher SES is associated with a lower risk of infection of COVID-19. • Higher SES reduces mental distress during the pandemic, particularly for individuals or family members confirmed or suspected with COVID-19. • SES shapes the risk of infection and mental distress primarily through three channels: access to daily essential and protective supplies, employment status, and the community environment. Although disasters such as pandemics are events that are random in nature, individuals' vulnerability to natural disasters is inequitable and is shaped by their socioeconomic status (SES). This study examines health inequality by SES amid the COVID-19 pandemic and its underlying mechanisms in Wuhan, China's epicenter. Using survey data collected in the city during the lockdown period from February 20 to March 6, 2020, we identify two ways in which SES shapes health inequalities—vulnerability and resilience to COVID-19. First, higher SES is associated with a lower risk of infection for both survey respondents and their family members. Second, higher SES reduces mental distress during the pandemic, and this protective effect is particularly strong for individuals who contract the virus or who have family members infected with the disease. Mediation analysis further illustrates that SES shapes the risk of infection and mental distress primarily through three channels: access to daily essential and protective supplies, employment status, and the community environment. These findings lend support to the fundamental cause theory that links socioeconomic differentials to health inequality in a unique context. The outbreak of COVID-19 magnifies pre-existing socioeconomic inequalities. [ABSTRACT FROM AUTHOR]