A COVID-19 study shows that gastrointestinal symptoms may lead to worse outcomes

A Chinese study on COVID-19 has shown that those suffering from gastrointestinal (GI) symptoms, such as diarrhoea and vomiting may have worse clinical outcomes than those with respiratory symptoms. The cross-sectional, multicenter study involved 204 patients in the Hubei district who had tested positive for the virus between January 18 and February 28.   [caption id=“attachment_7921371” align=“alignleft” width=“380”]  Representational image. Image source: Getty Images.[/caption] The study also showed that contrary to popular belief, half the novel coronavirus patients displayed GI symptoms. GI symptoms are considered quite rare in comparison to respiratory issues and fever. Additionally, a small number of patients in the study presented no other symptoms other than gastric distress.  

What were the findings of the study?

The average age of the patients was around 55. It was found that those who presented with GI symptoms took a longer time to get admitted to the hospital as compared to those displaying classical symptoms - 9 days as opposed to 7. The researchers hypothesized that this may be because the patients didn’t realize they were suffering from COVID-19 until their symptoms become worse. This is because of the lack of awareness surrounding these possibilities.   A large number of the patients (30% of all patients with GI symptoms) exhibited anorexia and were rendered sick enough to not eat. Another 29.3% of those patients had diarrhoea and a small number had vomiting as well.   Alarmingly, 34% of the ones with GI symptoms recovered compared to 60% of those with respiratory symptoms.   The authors of the study underlined that acknowledging GI symptoms was crucial; they worsened as the disease got more severe and timely intervention may have saved lives.

Why do GI symptoms lead to worse outcomes?

To begin with, some commentators have suggested that anorexia may have skewed the findings since its causes are ‘very nonspecific’. Disregarding those suffering from anorexia would mean that around 30% of the patients in the study had GI symptoms - still a little higher than was previously assumed.   The virus enters cells using the ACE2 receptor. ACE2 is present in lung cells but is also in other cells as well including the one is the GI tract. The virus can get swallowed and attack the epithelial cells that line the gut.   Previous studies have shown that the virus can wreak havoc in the stomach and intestines. Prognosis may be worse for those suffering from GI symptoms as the virus penetrates more of the body. This is a provisional explanation - more studies need to be carried out to understand the mechanisms involved. Further, the sample size of the study was small, so more research needs to be carried out to ascertain just how worse GI symptoms can be.  

What can be taken from the findings?

Digestive issues can happen for many reasons, and the vast majority of them will have nothing to do with COVID-19. However, it may be advisable to call your doctor (avoid going in and meeting your doctor in person for the time being) if you are experiencing fever, respiratory distress along with diarrhoea. New information is flooding in all the time, so stay informed on the developments and follow general health advisories issued by health officials.   For more tips, read our article on   Coronavirus Infection: Symptoms, Types, Diagnosis and Treatment_._ Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.