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More recently, initially with case reports and some data that has now been coming out of China that there are a lot of patients who can have either recombinant GI symptoms, meaning they have lung symptoms and GI symptoms on top of that, but also there's a fraction of people, about a third, who are presenting just with gastrointestinal symptoms at presentation, and may not even have respiratory symptoms at that time and will just have GI symptoms.
The GI symptoms that we're seeing predominantly are diarrhea, nausea, and vomiting. Some studies are now showing that there are possibilities where the COVID-19 or coronavirus can be present in the stool and maybe absence in the respiratory tract. So this disease could be present in the stool first and then later on present in the respiratory tract. We do know from other diseases that bugs that are present in stool could have a fecal-oral spread. At this time, we don't know for sure if there's fecal-oral spread or not. But with caution, I think we should assume that if there is somebody who has COVID-19, their stool, just like their respiratory secretions, are potentially transferable and are potentially infectious.
We think that perhaps there may be some illnesses that could predispose people more to those. Certain people have an illness called common variable immunodeficiency, which predisposes them to getting more viral infections in the gut. And it's quite conceivable that inflammatory bowel disease patients could get this at a higher risk also.
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