Digestive Issues With COVID-19 Is a Surprisingly Common Symptom

One study found that over half of patients tested experienced this.

By Erin Hays
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March 27, 2020 - 3 p.m. EST

We have all heard the typical symptoms of COVID-19: the telltale dry cough, high fever, exhaustion, and in severe cases, difficulty breathing. But there’s another common symptom that one study found; about half of patients tested with COVID-19 are reporting digestive issues. 

This new study reports that patients and physicians should now be on the lookout for digestive symptoms, including diarrhea, lack of appetite, vomiting, and even abdominal pain, as potential signs of COVID-19. It was even found that in a small amount of patients, digestive issues were the only symptoms present.

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This information comes from a small study released Mar. 18, 2020  in the American Journal of Gastroenterology, which examined 204 patients with COVID-19 at three hospitals in the Hubei province of China, where the initial COVID-19 outbreak happened. Of these patients, 103 (50.5%) were found to have one or more digestive symptoms, from the list mentioned above. Furthermore, six of these patients only had digestive symptoms. The most common digestive symptom found in these patients was lack of appetite, followed by diarrhea, vomiting, and a small number with abdominal pain.

It is important to note that in this study, respiratory issues were still the most common symptom among these patients, and 97 of the 103 patients with digestive symptoms had accompanying respiratory symptoms as well.

What’s interesting is, according to the study, patients with digestive symptoms took longer to get to the hospital after the onset of their symptoms when compared to patients without digestive symptoms. In addition, patients with digestive symptoms had more severe signs of disease in some respects than those without digestive symptoms. For example, patients with digestive symptoms had higher liver enzymes than those without digestive symptoms, suggesting liver was affected as well. In addition, patients with digestive symptoms were more likely to receive antibiotic treatment than those without. “Clinicians must bear in mind that digestive symptoms, such as diarrhea, may be 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,” write the authors.

It is important to remember that this is a relatively small study. As more information becomes available, this data may change.

Should I Worry If I’m Having Digestive Problems? 

If you are experiencing digestive problems, call your doctor to voice your concerns.The Centers for Disease Control recommends staying home if you have any COVID-19 symptoms unless you need urgent medical care. People who are mildly ill with COVID-19 can recover at home.

In addition, you should monitor your symptoms and stay in touch with your doctor. They will advise you on if they think you need to get tested and where you can go to do so. If you do think you need to get medical care, always call first so your provider can protect themselves and others in the event that you do have COVID-19. If you develop emergency warning signs including trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, or bluish lips of face consult your doctor immediately or call 911. 

Erin Hays is a fourth year medical student at the University of Maryland. She will begin her urology residency at Georgetown in June 2020. 

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Article written by Erin Hays