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Research Article
Virus discharge and initial gastrointestinal involvement are negatively associated with circulating lymphocyte count in COVID-19
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- This study involved human subjects.
- The author confirmed that all appropriate ethical guidelines for the use of human subjects have been followed, any necessary IRB and/or ethics committee review has been obtained, and information about the IRB/ethics committee is included in the manuscript.
- The author has confirmed that all necessary patient/participant consent or assent has been obtained and the appropriate institutional forms have been archived. If the IRB/ethics committee waived the requirement for patient/participant consent or assent, an explanation for the waiver is included in the text.
- The author has confirmed that a statement listing potential conflicts of interest or lack thereof is included in the text.
Background: It’s reported SARS-CoV-2 could transmit via gastrointestinal tract, with or without pulmonary symptoms. However, as far as we know, there is no convenient marker to predict the virus discharge in stool and initial gastrointestinal involvement of COVID-19.
Aims: We aimed to investigate the biomarker predicting virus discharge in stool and initial gastrointestinal involvement of COVID-19, which may assist the clinicians to better combat and prevent COVID-19.
Methods: The patients complained of initial gastrointestinal involvement, including vomiting, diarrhea, with or without respiratory symptoms, attending the Sixth People’s Hospital of Wenzhou, and the Second Affiliated Hospital of Wenzhou Medical University, were screened by qRT-PCR for SARS-CoV-2. The Confirmed COVID-19 patients without contaminated ingestion were all enrolled to investigate the association between circulating lymphocyte count and virus discharge, initial gastrointestinal involvement.
Results: 76 COVID-19 patients were finally enrolled in this study (mean age 44.5, male 44.7%), with 24 (31.5%) complained of initial gastrointestinal symptoms. Significantly lower circulating lymphocyte count was found in the patients with positive results of qRT-PCR on stool (p = 0.012). Furthermore, when the circulating lymphocyte count increased from bottom tertile to the 2nd and 3rd tertiles, the risk of initial gastrointestinal involvement decreased by nearly 75% (OR = 0.25, 95% CI: 0.07, 0.98, p = 0.047), 83% (OR = 0.17, 95% CI: 0.05, 0.63, p = 0.008), adjusted for possible confounders.
Conclusions: The circulating lymphocyte count is negatively associated with virus discharge in stool in COVID-19 patients, and the risk of initial gastrointestinal involvement also.
Keywords
circulating lymphocyte count, COVID-19, gastrointestinal tract, CRP, stool
Bang
commented on 08 July, 2020
Biomarker of COVID-19 is very helpful for monitoring and diagnosing SARS-CoV. But yet there is no convenient marker currently to be used during clinical therapy. This study shows that circulating lymphocyte count is a promising parameter for diagnose initial gastrointestinal involvement and virus discharge of COVID-19, providing a novel strategy for predicting the stages of COVID-19 development. It should be very beneficial in both research and clinical community in combating COVID-19.
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Liang Wang
ORCiDcommented on 08 July, 2020
This research is informative in combating and preventing COVID-19. Indeed, it’s difficult to predict virus discharge via gastrointestinal tract, a convenient marker is urgently needed in clinics. As mentioned in the manuscript, the receptor for SARS-CoV is widely expressed in the site of mucosal membrane, leading gastrointestinal tract involved initially in the process of COVID-19. Therefore, a biomarker predicting initial gastrointestinal involvement is called for by clinicians. Overall, I recommend acceptance of the manuscript.
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Citation
Wei Chen, Kenneth I. Zheng, Saiduo Liu et al. Virus discharge and initial gastrointestinal involvement are negatively associated with circulating lymphocyte count in COVID-19, 07 July 2020, PREPRINT (Version 1) available at Research Square [+https://doi.org/10.21203/rs.3.rs-40462/v1+]
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CURRENT STATUS: Posted
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Posted 07 Jul, 2020
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