Diarrheal syndrome in SARS CoV2 infection

SARS-CoV-2 is a new virus belonging to the Betacoronaviruses genus, from the Coronavirus family. The main clinical symptoms encountered in COVID 19 are fever, cough and shortness of breath and they have been affecting more than 80% of patients. Compared to the patients that are infected with MERS Co-V or SARS-Co-V, where diarrheal syndrome was present in approximately 25% of cases, in SARS-Co-V 2 infection, diarrhea syndrome is present in less than 10% of cases.

Clinical case: A 59-year-old patient, smoker, known to have a history of cardiovascular disease and type II Diabetes, presented to the emergency unit with fever, productive mucopurulent cough and multiple diarrhea stools. Pulmonary radiography was performed and showed multiple oval opacities with a tendency to confluence disseminated basally bilateral. A RT-PCR SARSCo-V-2 test was performed with a positive result. The patient was admitted to the hospital and received specialized treatment during which the previous symptoms gradually recovered, including diarrhea syndrome. After 4 days of treatment, the diarrhea of the stools reappeared, and it was decided to investigate for Clostridium Difficile. The test proved to be positive. Treatment was established according to the protocol with favorable clinical and biological evolution.

Conclusions: The newly diagnosed diarrhea syndrome in a hospitalized patient should constantly raise the suspicion of a Clostridium Difficile infection, which may worsen the prognosis of patients infected with SARS-CoV-2.