Wahyu Widiastana, Teguh Kristian Perdamaian, Sutaryanu Dermoredjo


Background: The Coronavirus 2019 disease (COVID-19) is transmitted through droplet and aerosol from the respiratory tract of an infected person; and fomites from infected linen and surface. On August 1, 2020, in Yogyakarta, there were 741 confirmed positive cases of COVID-19, and it is still possible to increase. In the time of understanding COVID-19, there are many cases with atypical presentation, including gastrointestinal symptoms.
Objective: To describe a COVID-19 case without respiratory symptoms and the role of radiology in detecting COVID-19.
Case Description: A 55-year-old male patient came to the hospital complaining of nausea and loss of appetite. Based on the results of the physical examination, there was flatulence. Initial investigations revealed a non-reactive SARS CoV 2 IgG and IgM result. Further non-contrast MSCT Thorax showed infiltrates with bilateral sub-pleural posterolateral consolidation, particularly the left, showing typical pneumonia. Multiple blebs were also found, denoting bronchiectasis. Confirmatory RT-PCR result was positive for SARS CoV 2.
Conclusion: COVID-19 usually presents with common respiratory symptoms. However, some patients also experience gastrointestinal symptoms that initially were not detected as COVID-19. In time of COVID-19 pandemic, persistent gastrointestinal symptoms in a high-risk patients warrant further chest imaging and RT-PCR of SARS CoV-2 to detect or exclude the possibility of COVID-19 diagnosis.


COVID-19, Digestive Signs and Symptoms, X-ray Computed Tomography, Electrochemical Techniques, Reverse Transcriptase Polymerase Chain Reaction

Full Text:



Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382: 1708-1720.

Pormohammad A, Ghorbani S, Baradar B, Khatami A, Turner R, Mansournia MA, et al. Clinical characteristics, laboratory findings, radiographic signs and outcomes of 61,742 patients with confirmed COVID-19 infection: A systematic review and meta-analysis. Microbial pathogenesis. 2020; 147 (104390): 1-10.

Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat rev Cardiol. 2020 May; 17 (5);259-260.

Suresh Kumar VC, Mukherjee S, Harne PS, Subedi A, Ganapathy MK, Patthipati VS, et al. Novelty in the gut: a systematic review and meta-analysis of the gastrointestinal manifestations of COVID-19. BMJ open. 2020 May; 7 (1): e000417.

Hu Z, Song C, Xu C, Jin G, Chen Y, Xu X, et al. Clinical character-istics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Sci China Life Scie. 2020 May; 63 (5):706-711.

World Health Organisation. Coronavirus disease 2019 (COVID-19) Situation Report - 73 [Internet]. Geneva: World Health Organisation; 2020 Apr 2. 13p. Available from:

Yu X, Yang R. COVID-19 transmission through asymptom-atic carriers is a challenge to containment. Influenza other respir viruses. 2020 Ju; 14 (4): 474-475.

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020 Feb 20; 382 (8):727-722.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17; 323(11):1061-1069.

World Health Organisation. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) [Internet]. Geneva: World Health Organisation; 2020 Feb. Available from:

American College of Radiology. ACR Recommendations for the use of Chest Radiography and Computed Tomography (CT) for Suspected COVID-19 Infection [Internet]. Reston, VA: American College of Radiology; 2020 [updated 2020 Mar 22; cited 2020 Aug 1]. Available from:

Naully PG, Khairinisa G. Panduan Analisis Laboratorium Imunosero-logi untuk D3 Teknologi Labora-torium Medis. Cimahi: Stikes Jenderal Achmad Yani Cimahi; 2018.

World Health Organisation. Advice on the use of point-of-care immunodiagnostic tests for COVID-19: Scientific Brief [Internet]. Geneva: World Health Organisation. 2020 Apr. Available from:

The Royal Australian and New Zealand College of Radiologists. COVID-19 Updates [Internet]. Sydney: RANZCR; 2020. Available from:

The Royal College of Radiologists. The role of CT in patients suspected with COVID-19 infection [Internet]. London: RCR; 2020 [updated 2020 Mar 12]. Available from:

Canadian Association of Radiologists. Canadian Society of Thoracic Radiology and Canadian Association of Radiologists' Statement on COVID -19 [Internet]. Ottawa: CAR; 2020 [updated 2020 Mar 26]. Available from:

Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020 Aug; 296 (2): E115-E117.

Perlman, S. Another Decade, Another Coronavirus. N Engl J Med. 2020; 382: 760-762.

Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH. Essentials for Radiologists on COVID-19: An Update-Radiology Scientific Expert Panel. Radiology. 2020 Aug;296(2):E113-E114.

Rodrigues JCL, Hare SS, Edey A, Devaraj A, Jacob J, Johnstone A, et al. An update on COVID-19 for the radiologist - A British society of Thoracic Imaging statement. Clin Radiol. 2020 May;75(5):323-325.

Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19). Radiology. 2020 Jun;295(3):715-721.

Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020 Apr;20(4):425-434.

Lee EYP, Ng MY, Khong PL. COVID-19 pneumonia: what has CT taught us? Lancet Infect Dis. 2020 Apr;20(4):384-385.

Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study. AJR Am J Roentgenol. 2020 May;214(5):1072-1077.

Indonesian Medical Association. PBIDI memberi penjelasan tentang penyakit pneumonia (Virus Corona) [Internet]. Jakarta: Indonesian Medical Association; 2020 [Updated 2020 Jan 27]. Available from:

Wong HYF, Lam HYS, Fong AH, Leung ST, Chin TW, Lo CSY, et al. Frequency and Distribution of Chest Radiographic Findings in Patients Positive for COVID-19. Radiology. 2020 Aug;296(2): E72-E78.



  • There are currently no refbacks.

Copyright (c) 2020 Berkala Ilmiah Kedokteran Duta Wacana

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.