Implications of COVID-19 for patients with pre-existing digestive diseases

The outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first reported in China, in December, 2019, now affects the whole world. As of March 8, 2020, more than 105 000 laboratory-confirmed cases and more than 3500 deaths in over 100 countries had been reported. Since SARS-CoV-2 RNA was first detected in a stool specimen of the first reported COVID-19 case in the USA,1 much attention has been paid to the study and reporting of gastrointestinal tract infection of SARS-CoV-2. According to a study2 including 1099 patients with laboratory-confirmed COVID-19 from 552 hospitals in China as of Jan 29, 2020, nausea or vomiting, or both, and diarrhoea were reported in 55 (5·6%) and 42 (3·8%) patients. Autopsy studies are crucial to help understand the involvement of COVID-19 in the digestive system; however, to date, there has been only one autopsy report3 for a man aged 85 years with COVID-19, which showed segmental dilatation and stenosis in the small intestine. Whether this finding is secondary to COVID-19 or a pre-existing gastrointestinal comorbidity is unknown.