Gastrointestinal symptoms as antecedent signs of severe acute respiratory syndrome coronavirus 2 infection

Introduction. The coronavirus disease 2019 (COVID‑19) is an acute infectious disease of the respiratory system caused by severe acute respiratory syndrome coronavirus (SARS‑CoV‑2). Most patients present with typical, respiratory symptoms. Common signs include cough, fever, dyspnea and shortness of breath. In this case we provide atypical indications of COVID-19, which may occur earlier than respiratory symptoms. Aim. This case is an example of an unusual course of SARS-CoV-2 infection. Description of the case. This article describes a case of a 63-year-old man and his wife, a 60-year old woman who were admitted to the emergency department with a few days’ history of gastrointestinal symptoms. Both patients presented with the digestive symptoms of nausea, diarrhea and loss of appetite. They denied abdominal pain and the loss of smell or taste. Due to suspicion of SARS-CoV-2 infection a nasopharyngeal swabs of both patients was taken. The results of real- time reverse transcriptase-polymerase chain reaction were positive. When the final diagnosis of COVID-19 was established they were transported to another hospital. Conclusion. COVID-19 may manifest with atypical indications such a nausea and diarrhea. An atypical indications of COVID-19 may occur earlier than respiratory symptoms. It is important for clinicians to remain alert.