While symptoms of COVID-19 such as fever, dry cough, and shortness of breath are most common, digestive issues such as diarrhea, abdominal pain, anorexia, and vomiting are more prominent among coronavirus patients than previously thought. Almost half of the patients diagnosed with the disease in a new study issued complaints about those issues as their primary symptoms. Also, patients who suffered gastrointestinal problems had a higher risk of mortality than those who didn’t. The research has been published in The American Journal of Gastroenterology.
The authors wrote:
Clinicians must bear in mind that digestive symptoms, such as diarrhea, maybe a presenting feature of COVID-19, and that the index of suspicion may need to be raised earlier in these cases rather than waiting for respiratory symptoms to emerge.
The cross-sectional multicenter study was conducted by researchers from the Wuhan Medical Treatment Expert Group for COVID-19. They examined 204 early cases (107 men and 97 women) of COVID-19 in Wuhan, China, from three separate hospitals. The average age was 54.9 years.
Of the 204 cases, 99 (48.5%) of them had experienced digestive symptoms as their chief complaint that generally worsened over time. Some of the patients didn’t even present any respiratory symptoms at all. Anorexia (loss of appetite) was the most prominent symptom (83.8% of cases) followed by diarrhea (29.3%), then vomiting (0.8%), and lastly, abdominal pain (0.4%).
Patients without digestive issues were more likely to recover – 60% of those without gastrointestinal symptoms were discharged, compared to only 34.3% of patients with digestive symptoms.
Brennan M.R. Spiegel, MD, MSHS, FACG, Co-Editor-in-Chief of The American Journal of Gastroenterology, explained:
[Those with digestive symptoms had] a worse clinical outcome and a higher risk of mortality compared to those without digestive symptoms. [Therefore, I emphasize] the importance of including symptoms like diarrhea to suspect COVID-19 early in the disease course before respiratory symptoms develop. [That in itself could lead to an earlier diagnosis of COVID-19], which can lead to earlier treatment and more expeditious quarantine to minimize transmission.
Another thing the research revealed is that people with digestive symptoms took longer to seek medical care – an average of 9 days to be admitted versus 7.3 days for those without gastrointestinal issues. The researchers believe this may be because the people didn’t suspect the virus had infected them since they weren’t experiencing the commonly discussed respiratory symptoms. Therefore, they recommend that people present with digestive symptoms shouldn’t wait until respiratory symptoms emerge to get tested.
