High Prevalence of Gastrointestinal Manifestations of COVID-19 Infection in Hospitalized Patients with Cancer

Shilpa Grover, Walker D. Redd, Joyce C. Zhou, Cheikh Nije, Danny Wong, Kelly E. Hathorn, Thomas R. Mccarty, Ahmad N. Bazarbashi, Lin Shen, Walter W. Chan

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background and Aim:Gastrointestinal (GI) symptoms have been reported with SARS-CoV-2 infection, but data on the prevalence and severity of GI symptoms in patients with cancer are limited. We sought to characterize the GI manifestations of coronavirus disease-19 (COVID-19) in oncology patients.Materials and Methods:We performed a multicenter cohort study of adult patients hospitalized with COVID-19 in 9 Massachusetts medical centers and identified those with an active malignancy. We evaluated the prevalence and severity of GI symptoms among hospitalized COVID-19 patients with cancer.Results:Of 395 hospitalized patients with COVID-19, 36 (9%) had an active malignancy. Of the 36 cancer patients, 23 (63%) reported ≥1 new GI symptom. The most prevalent symptoms were anorexia (12, 52%), diarrhea (9, 39%), and vomiting (8, 35%). GI symptoms were the initial symptom in 4/36 (11%) patients, were the predominant symptom in 5/36 (14%) patients, and were severe in 4/23 (17%) patients. Four of 5 patients with GI symptoms at presentation reported concurrent fever; notably 1 patient had no fever or respiratory symptoms. Twelve (33%) patients had elevations in liver transaminases at presentation; patients with elevated transaminases were more likely to have associated GI symptoms (83% vs. 54%, P=0.04).Conclusions:Acute GI symptoms associated with COVID-19 are highly prevalent in hospitalized cancer patients and can occur as a presenting symptom without respiratory symptoms. Symptoms are severe in a small subset of patients.

Original languageEnglish
Pages (from-to)84-87
Number of pages4
JournalJournal of Clinical Gastroenterology
Issue number1
StatePublished - Jan 2021


  • cancer
  • COVID-19
  • diarrhea
  • elevated liver tests
  • gastrointestinal symptoms
  • SARS-CoV-2
  • transaminase elevations


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