There is evolving information regarding the novel coronavirus, COVID-19, which has affected multiple countries worldwide. Patients with COVID-19 commonly present with symptoms of a dry cough, shortness of breath and fever. However, aside from respiratory symptoms, there is a new study from the American Journal of Gastroenterology that shows digestive symptoms, specifically diarrhea, can be the initial signs of the disease.
The study followed 206 patients in China confirmed with mild cases of COVID-19. The patients were categorized into subgroups: 48 patients with digestive symptoms alone, 69 patients with both digestive and respiratory symptoms, and 89 patients with respiratory symptoms alone. Within the two subgroups experiencing GI symptoms, 67 patients had diarrhea, with 13 of those patients experiencing diarrhea as their first symptom.
These patients may or may never develop respiratory symptoms and fever. Therefore, these patients would be diagnosed later than other patients who present with the classic respiratory symptoms.
Even though such gastrointestinal problems are overall common, it is important for doctors to recognize that acute digestive symptoms, aside from the respiratory symptoms, should prompt the consideration of a possible COVID-19 diagnosis. As the researchers said, “failure to recognize these patients early and often may lead to the unwitting spread of the disease among outpatients with mild illness who remain undiagnosed and unaware of their potential to infect others.”
Nearly everyone experiences occasional “loose bowels” in daily life. Especially right now in this high-level stress environment due to the coronavirus outbreak, the increased stress and anxiety can cause GI symptoms, such as diarrhea. Thus, having such GI symptoms is not a cause for panic but should be evaluated by a gastroenterologist. We have to consider other factors and causes before jumping straight to the conclusion that diarrhea means you have COVID-19.
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Author Fiona Miao Patient Care Coordinator