Is diarrhea a symptom of coronavirus?

Diarrhea and Other Confirmed Gastrointestinal Symptoms of COVID-19

Diarrhea. You know if you have THIS digestive condition. People who suffer from diarrhea experience loose, watery stools more frequently than normal and often experience a sense of urgency to go. Generally, there are two types of diarrhea, acute and chronic. Acute diarrhea lasts a short time, about three to 5 days. Chronic diarrhea is usually related to other digestive disorders such as irritable bowel syndrome or inflammatory bowel disease and may last for as long as you have the illness. Most recently, diarrhea has been added as a symptom of the coronavirus (COVID-19).

According to the World Health Organization, the most common symptoms of COVID-19 are:

  • Fever
  • Tiredness
  • Dry cough
  • Difficulty breathing

With some patients experiencing the following:

  • Aches and pains
  • Nasal congestion
  • Runny nose
  • Sore throat
  • Diarrhea

In April, the Centre for Disease Control and Prevention (CDC) in the United States stated six symptoms to its official list after they repeatedly appeared in people with the virus:

  • Loss of taste or smell
  • Chills
  • Shaking with chills
  • Muscle pain or aches
  • Sore throat
  • Headache

This week (July 13th, 2020), the CDC added three more:

  • Nausea
  • Diarrhea
  • Runny nose

Some people become infected but don’t develop any symptoms or feel unwell at all!

We’ve seen the most common list of COVID-19 symptoms repeatedly on the TV, in news articles, and from our friends and family. However, as doctors learn more about COVID-19, a new study has shown that digestive symptoms, in particular diarrhea, could be a symptom for people who have a mild form of COVID-19 (without difficulty breathing or low blood oxygen levels).  In this study published in the American Journal of Gastroenterology, patients in this unique sub-group showed that diarrhea can be the initial presentation of COVID-19, and patients may only later or never present respiratory symptoms or a fever.

In more detail, this study showed that 23% of patients were admitted with digestive symptoms, 43% with respiratory symptoms only, and 33% with both respiratory and gastrointestinal (gastro) symptoms. Among the patients with gastro symptoms, 67% of them had diarrhea, and 20% experienced diarrhea as the first symptom of their illness. Diarrhea lasted an average of 5 days, and about one-third of patients with gastro symptoms never experienced a fever. The study also found that those with gastrointestinal symptoms were much more likely to have the coronavirus (SARS-CoV-2) detected in their stool samples, with about 73% of patients testing positively compared with 14% of those with respiratory symptoms only. 

The authors of this study note that because gastro problems are so common, having diarrhea doesn’t necessarily mean that a person has COVID-19.  But this study does tell us that diarrhea can be a vital warning-sign. If patients experience new-onset gastrointestinal symptoms after possibly coming into contact with someone who has COVID-19, they should be suspected for the illness, EVEN in the absence of cough, shortness of breath, sore throat, or fever.

This study came about after previous research, also published in the American Journal of Gastroenterology found that 50% of a group of 200 patients with COVID-19 in Wuhan, China reported at least one gastro symptom, with 18% reporting diarrhea, vomiting, or abdominal pain. This study focused on patients with severe COVID-19, rather than a mild form.

It’s important to note that both studies were relatively small, so larger studies are needed to describe digestive symptoms in patients with COVID-19. We will update this article as new information becomes available.

Source: Canadian Digestive Health Foundation

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