Immuno-inflammatory Characters in Low Severity COVID-19 Patients with Digestive Symptoms (preprint)

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is an emerged infection raised widely concerns for pneumonia and respiratory manifestations. It is noteworthy that digestive symptoms are frequently observed in COVID-19 patients. We sought to describe the immune-inflammatory characteristics of COVID-19 patients with digestive symptoms and mild disease severity.Methods: We designated enrolled mild patients into three subtypes depending on the patients with or without digestive symptoms, including Digestive only (digestive symptoms only), Respiratory only (respiratory symptoms only) and Digestive+ Respiratory (Both digestive and respiratory symptoms). Patient discharge was based on negative results of rRT-PCR testing for SARS-CoV-2 from at least two sequential respiratory tract specimens collected ≥24 hours apart. The multiorgan function, immune-inflammatory characteristics were analyzed among three groups.Results: Mild liver damage and the activation of immuno-inflammatory system are the most abnormalities in mild patients but no significant differences were found (p＞0.05). Compared with the Respiratory only group, patients with digestive symptoms were more likely to have slightly higher and later peak values of inflammatory cytokines during the subsequent course of disease(P＜0.05). Additionally, we also found that there was a significant correlation between IL-2 and TNF level in the Digestive only cases (P＜0.05). Conclusions: Mild patients only/accompanied with digestive symptoms are a special subtype of COVID-19. Patients in this group were more likely to have slightly higher and later peak values of inflammatory cytokines during the subsequent course of disease. The prevention and clinical management of this type should be taken into consideration.