A unique subgroup of patients who have COVID-19 with low severity disease experienced digestive symptoms, most notably diarrhea, according to a study published in The American Journal of Gastroenterology.
The authors, from Union Hospital and Tongji Medical College in Wuhan, China, report that these digestive ailments presented themselves as early symptoms of COVID-19 in some patients.
“This study is vital because it represents the 80% or more of patients who do not have severe or critical disease,” Brennan M.R. Spiegel, co-editor-in-chief of The American Journal of Gastroenterology, said in a statement. “This is about the more common scenario of people in the community struggling to figure out if they might have COVID-19 because of new-onset diarrhea, nausea, or vomiting.”
The analysis included 206 patients with low severity COVID-19, including 48 presenting with a digestive symptom alone, 69 with both digestive and respiratory symptoms, and 89 with respiratory symptoms alone.
Key Findings:
There is a unique subgroup of COVID-19 patients with low severity disease marked by presence of digestive symptoms.
These patients are more likely to test positive in stool for COVID-19 RNA, to have a longer delay before viral clearance, and to experience delayed diagnosis compared to patients with respiratory symptoms but no digestive symptoms.
In some cases, the digestive symptoms, particularly diarrhea, can be the initial presentation of COVID-19, and may only later or never present with respiratory symptoms or fever.
Importantly, only two-thirds of people in this study had a fever, meaning it is not even necessary to have a fever to suspect the diagnosis.
These data emphasize that patients with new-onset digestive symptoms after a possible COVID-19 contact must be suspected for the illness, even in the absence of cough, shortness of breath, sore throat, or fever.
