Digestive symptoms among patients with COVID-19 may be more common than previously thought, with a study from a Chinese cohort showing half of patients experienced loss of appetite, diarrhoea or vomiting.

The researchers suggest doctors should have a higher index of suspicion when at-risk patients present with fever and digestive symptoms, even in the absence of respiratory symptoms. 

“This is important because if clinicians solely monitor for respiratory symptoms to establish case definitions for COVID-19, they may miss cases initially presenting with extra-pulmonary symptoms, or the disease may not be diagnosed later until respiratory symptoms emerge,” they wrote.

The researchers drew on data from medical records of 204 patients diagnosed with COVID-19 (average age 53) who were admitted to three hospitals in China’s Hubei province between 18 January and 28 February, and followed until 5 March.