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{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7212965","sourcedb":"PMC","sourceid":"7212965","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7212965","text":"Diarrhea as the only presenting symptom in the absence of upper respiratory symptoms\nIn the 43 studies that informed our analysis on the prevalence of diarrhea, we extracted information on whether diarrhea was reported as the only presenting symptom.50 , 60 In only 2 studies, there was explicit reporting of diarrhea in the absence of upper respiratory infection symptoms. In a study by Luo et al50 of 1141 patients, 183 patients (16%) presented with GI symptoms only in the absence of respiratory symptoms. Of 1141 patients, loss of appetite (15.8%) and nausea or vomiting (11.7%) were the most common symptoms, but diarrhea was reported in 6.0% and abdominal pain in 3.9% of patients. Notably, the majority of patients (96%) had lung infiltrates on chest computed tomography. In the study by Jin et al60 of 651 hospitalized patients, 21 patients (3.2%) presented with GI symptoms only (and no respiratory symptoms of coughing or sputum production).60 GI symptoms were defined as at least 1 of the following symptoms: nausea, vomiting, and diarrhea. Conversely, in the US study of 116 patients with COVID-19, Cholankeril et al70 reported that 31.9% of patients had GI symptoms on admission (median duration, 1 day); diarrhea was reported in 10.3% (12 of 116), nausea and/or vomiting in 10.3% (12 of 116), and abdominal pain in 8.8% (10 of 116). The authors explicitly reported that none of the 116 patients had isolated GI symptoms as the only manifestation of 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