How common are digestive symptoms in coronavirus?
Gastrointestinal (GI) symptoms are very common with coronavirus. A study from Wuhan, China, showed over 50% experienced digestive problems. These patients were admitted to the hospital with digestive problems such as nausea and diarrhea as their primary complaint. (3) Coronavirus causes GI symptoms such as:
Loss of appetite
Diarrhea
Abdominal pain
Nausea
The most common GI symptom of coronavirus was a loss of appetite, experienced by 84% of patients. Diarrhea was the second most common, in 29% of patients, and a smaller number reported vomiting and abdominal pain. (3)
Some coronavirus patients (less than 1%) suffered GI symptoms but no respiratory symptoms or fever. This was rare, however, as fever was common in almost 99% of cases. COVID-19 may cause a combination of respiratory and digestive problems, and should not be considered only as a condition of the lungs.
How does COVID-19 cause digestive issues?
Scientists do not know how the coronavirus causes gastrointestinal problems. However, three main theories have been put forward:
1) The virus binds to cells that signal the body to produce more liver cells, and the over-production of liver cells leads to inflammation and digestive problems. (4)
2) The virus causes an inflammatory response directly, and the chain reaction of inflammation affects the digestive tract to causes digestive problems. This is supported by viral DNA found in poo samples of patients (5, 6)
3) The virus disrupts ‘good’ bacteria in the intestines. These bacteria play important roles in digesting food, and disruption can cause symptoms of the digestive tract. (7)
The virus may also cause damage directly to the digestive system, however, more research is needed to clarify this point. (3)
Are digestive symptoms an early sign of Coronavirus?
Coronavirus may cause digestive symptoms that begin 2 days earlier than respiratory symptoms. Chinese scientists found that patients entered the hospital 9 days after digestive symptoms on average, compared to 7 days for respiratory symptoms. (3)
In response, scientists are recommending that doctors should test patients for digestive problems. Clinicians typically look for fever and cough to make a diagnosis, but adding an assessment of GI problems and testing stools can allow a diagnosis to occur earlier (8, 9)
On an individual level, those who develop unexplainable GI symptoms should consider self-isolating for 2-3 days and monitor the development of respiratory symptoms, to prevent infecting others before the onset of respiratory symptoms. By raising the ‘index of suspicion’ earlier, patients with coronavirus can be contained before the virus is able to spread further.
What kinds of GI tests for coronavirus are available?
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