Nausea and diarrhea may be early symptoms of Covid-19, before you have a fever and cough

A new study by Chinese scientists shows that: Nearly half of the Covid-19 patients they surveyed developed symptoms of nausea, vomiting and diarrhea before they had a fever. This suggests that these may be early onset symptoms of a new corona virus infection, also known as SARS-CoV-2.

" Clinicians must remember that gastrointestinal symptoms, such as diarrhea, may be a feature of Covid-19. Doubt may need to be raised earlier in these cases, rather because of waiting for respiratory symptoms to appear, " said the authors of the study in Wuhan.

Nausea and diarrhea may be early symptoms of Covid-19, before you have a fever and cough Picture 1

Nausea and diarrhea may be early symptoms of Covid-19, before you have a fever and cough

Do not ignore digestive symptoms

The new study, published in the American Journal of Gastroenterology, describes data from 204 Covid-19 patients in Hubei province, China. All were of middle age and were hospitalized for treatment between January 18 and February 28.

" We found that 99 patients (48.5%) went to the hospital for primary gastrointestinal symptoms," the study authors wrote. " Patients with gastrointestinal symptoms with many different manifestations, such as anorexia (83 cases equivalent to 83.8%), diarrhea (29 cases equivalent to 29.3%), vomiting (8 cases equivalent to 8%) and abdominal pain (4 cases equals 4%) ".

In particular, 7 patients showed only gastrointestinal symptoms without respiratory symptoms. That means they can go to the gastroenterology clinic and not think they have Covid-19.

Patients with gastrointestinal symptoms appear to have an earlier onset than patients without them. They had " a significantly longer period from onset to admission, compared to patients with no gastrointestinal symptoms (that's 9 days versus 7.3 days), " the researchers wrote. .

They argue that this may have caused some doctors to miss the opportunity to diagnose early and monitor patients in Covid-19.

" If clinicians only monitor respiratory symptoms for the diagnosis of Covid-19, they may miss cases where the patient develops the initial symptoms outside the lungs, then the patient may not. be diagnosed, until late respiratory symptoms appear, "the study wrote.

Late diagnosis may cause patients with Covid-19 infection with early gastrointestinal symptoms to receive treatment later. This can make them worse and harder to recover.

In their study, scientists in Wuhan showed that only 34.3% of patients with Covid-19 with gastrointestinal symptoms were cured. The number of patients with no gastrointestinal symptoms is 60%.

Nausea and diarrhea may be early symptoms of Covid-19, before you have a fever and cough Picture 2

The new strain of SARS-CoV-2 virus, which causes a disease called Covid-19, has spread from Wuhan City, China to more than 156 countries and territories. As of Friday 20/3, the disease has infected more than 234,000 people worldwide and killed 9,862 people.

SARS-CoV-2 virus is a member of the corona virus group, often causing respiratory diseases such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) . Patients often have pneumonia-like symptoms, especially fever, cough and shortness of breath.

However, the gastrointestinal symptoms of SARS-CoV-2 infection have been documented in several studies. A study published in the Journal of the American Medical Association identified 14 patients with SARS-CoV-2 who had diarrhea and nausea before they had a fever or had respiratory symptoms. That's 10% of the sample size, including data from 138 people in the study.

One of these Covid-19 patients was even taken to the operating room because they had only abdominal symptoms. Doctors did not expect that it was due to the new corona virus. As a result, this patient has transmitted the virus to at least 10 health workers and 4 patients with only other gastrointestinal diseases in the same room.

The researchers found SARS-CoV-2 virus in the stool

The first patient in the US who was infected with Covid-19 after being hospitalized reported abdominal pain and diarrhea. According to a report published in the New England Journal of Medicine, the researchers then took a sample of this patient's stool for testing and found the RNA of SARS-CoV-2 virus in it.

Another study shared on biorXiv, a platform for publishing pre-published scientific articles, discovered the corona virus enzyme markers in the colon and colon cells of patients.

Some people with Covid-19 in Vietnam also report that they have diarrhea, vomiting or nausea.

However, these symptoms may be relatively rare: A study published on the publication of a scientific article prior to the publication of medRxiv looked at data from 1,099 Covid-19 patients. Less than 4% of these people have diarrhea and about 5% experience vomiting.

These uncommon symptoms were not emphasized in the official guidelines issued to the public by the US Centers for Disease Control and Prevention (CDC).

But the CDC guidelines for healthcare professionals briefly mention diarrhea as an uncommon Covid-19 symptom, along with " a general feeling of being unwell" to help doctors recognize. face this sign.

Watch for symptoms of nausea, vomiting and diarrhea

This is not the first time scientists have found a strain of corona virus in a patient's stool. Previous research showed that a 2003 SARS patient with diarrhea spread the virus in faeces through sewage, and exposed an entire apartment complex in Hong Kong.

Dr. Susan Kline, a spokesman for the American Association of Infectious Diseases, told MedPage Today that gastrointestinal symptoms were " not uncommon " in SARS patients during the 2003 deadly outbreak of the virus.

Kline says that many illnesses cause nausea, diarrhea and vomiting, even if they are not the main symptoms. Attention to gastrointestinal symptoms can be a very important note during the outbreak of Covid-19, as with previous SARS and Ebola outbreaks.

"These symptoms will be helpful for clinicians, at least they can consider that a patient with coronary virus may have vomiting or diarrhea ," Kline said. And thanks to these symptoms, patients can be monitored, quarantined early and treated earlier.

Refer to Businessinsider