Clinical characteristics of patients with COVID-19 presenting with gastrointestinal symptoms as initial symptoms: Retrospective case series

BACKGROUND A large number of pneumonia cases due to coronavirus disease 2019(COVID-19)have been first reported in China.Meanwhile,the virus is sweeping all around the world and has infected millions of people.Fever and pulmonary symptoms have been noticed as major and early signs of infection,whereas gastrointestinal symptoms were also observed in a significant portion of patients.The clinical investigation of disease onset was underestimated,especially due to the neglection of cases presenting with gastrointestinal symptoms.AIM To characterize the clinical features of coronavirus-infected patients with gastrointestinal symptoms as initial symptoms.METHODS This is a retrospective,single-center case series of the general consecutive hospitalized patients with confirmed COVID-19 at Wuhan Union Hospital from February 2,2020 to February 13,2020.According to their initial symptoms,these patients were classified into two groups.Patients in group one presented with pulmonary symptoms(PS)as initial symptoms,and group two presented with gastrointestinal symptoms(GS).Epidemiological,demographic,clinical,laboratory,and treatment data were collected for analysis.RESULTS Among the 50 patients recruited,no patient has been admitted to intensive care units,and no patient died during the study.The duration of hospitalization was longer in the GS group than in the PS group(12.13±2.44 vs 10.00±2.13,P<0.01).All of the 50 patients exhibited decreased lymphocytes.However,lymphocytes in the GS group were significantly lower compared to those in the PS group(0.94±0.06 vs 1.04±0.15,P<0.01).Procalcitonin and hs-CRP were both significantly higher in the GS group than in the PS group.Accordingly,the duration of viral shedding was significantly longer in the GS group compared to the PS group(10.22±1.93 vs 8.15±1.87,P<0.01).CONCLUSION COVID-19 patients presenting with gastrointestinal symptoms as initial symptoms need more days of viral shedding and hospitalization than the patients presenting with pulmonary symptoms.

Combining photo-cleavable and hydrogen-abstracting groups in quinoxaline with thioether bond as hybrid photoinitiator

We synthesized four diphenylquinoxaline derivatives（SQs） with phenyl-thioether units, which combine photo-cleavable and hydrogen-abstracting groups in one molecule. The photochemistry and photopolymerization of SQs were investigated. SQs possess suitable UV-vis absorption in the range of 350-400 nm with high extinction coefficients. UV-vis and HPLC-MS spectra revealed that C–S bond in phenyl-thioether group of SQs can be broken by irradiation of UV-light. Photolysis and photopolymerization experiments showed that SQs can be used as photo-cleavable photointiators,their photoinitiating efficiency can be enhanced by hydrogen donor. As photo-cleavable photoinitiators,SQs could initiate hexamethylene diacrylate（HDDA） very efficiently with the double bond conversion（DBC） of 80%. In the presence of ethyl-4-（dimethylamino） benzoate（EDB） as coinitiator, photoinitiator systems initiated photopolymerization of commercial acrylate monomers with higher double bond conversion than 90%. These characteristics make SQs potential photoinitiators in photo-curing field.