As doctors learn more about the coronavirus, the range of symptoms reported to be associated with the virus has increased. In the early days, the most commonly reported symptoms were fever, dry cough and shortness of breath. While these are still the classic symptoms, others have since been reported.

For example, some people with the coronavirus have reported gastrointestinal (GI) symptoms including diarrhoea, nausea (feeling sick) and vomiting. Estimates of how common these symptoms vary widely, from 1% to more than half of patients. For some people, the symptoms may be caused by prescribed antibiotics that can cause diarrhoea as a side effect.

While symptoms like nausea and diarrhoea may be more common than originally thought in people with COVID-19, that does not mean this is a new or different disease.

GI symptoms such as diarrhoea can have many causes, so having them does not necessarily mean you have coronavirus. The key symptoms to look out for remain fever, a dry cough and tiredness.

Where did the story come from?

Several sources have reported on the possibility of gastric symptoms in the coronavirus. One author and historian has reported in the UK media the gastric symptoms she experienced.

The Metro in its coverage notes that while it’s possible that some people do have these symptoms “it’s not been officially confirmed that ‘gastro coronavirus’ exists”.

What is the basis for the claim?

A number of studies have investigated reports of GI symptoms in patients with COVID-19.

For example, a report in the specialist journal Gut, which focuses on gastrointestinal disease, summarises some of these studies. It says “early studies reported a low incidence of typical GI symptoms such as diarrhoea in the range of 1% to 3.8%” but later studies from China found higher rates.

One of these later studies in 95 hospitalised patients found that around 12% of patients had GI symptoms when they were admitted to hospital and about 50% of patients developed GI symptoms later on. In some of these cases, the patients were taking antibiotics, which can cause diarrhoea.

The report also said some studies have found the virus in stool samples and the lining of the gut, suggesting the virus may infect the intestine in some people. The report warns that the virus may persist for longer in the gut than in the respiratory tract. It is not yet clear whether the virus can be transmitted through poo (faeces).

Another study in hospitalised patients in China with mild COVID-19 found that some people who had GI symptoms did not have the typical respiratory symptoms, but the researchers did not estimate how common this pattern was.

These researchers point out that “Importantly, digestive symptoms are common in the community, and most instances of new-onset [diarrhoea], nausea, or vomiting are not from COVID-19”.

What do trusted sources say?

The World Health Organization (WHO) says: “The most common symptoms of COVID-19 are fever, dry cough, and tiredness. Some patients may have aches and pains, nasal congestion, sore throat or diarrhoea.” It does not mention “gastric coronavirus”.

The Joint Gastrointestinal Society in the US has stated that “The incidence of GI symptoms including nausea and/or [diarrhoea] are uncertain with some reports below 5% and others at 50%. There have been some reports of isolated [diarrhoea] preceding cough and fever.” They reinforce that the best protection against virus transmission includes washing hands, not touching your face, practising etiquette when you cough, social distancing and avoiding crowds.

Citation

  1. What is ‘gastro’ coronavirus and what are the symptoms? The Metro 23 April 2020. https://metro.co.uk/2020/04/23/coronavirus-uk-gastro-coronavirus-real-symptoms-12599449/?ito=cbshare (Accessed 30 April 2020)

 

Reading list

  1. Joint GI Society. COVID-19 Clinical Insights for Our Community of Gastroenterologists and Gastroenterology Care Providers. 15 March 2020. Available from:
  2. https://gi.org/2020/03/15/joint-gi-society-message-on-covid-19/ (Accessed 30 April 2020)
  3. Siew & Tilg. COVID-19 and the gastrointestinal tract: more than meets the eye. Gut. 9 May 2020 (Epub ahead of print). Available from: https://gut.bmj.com/content/early/2020/04/02/gutjnl-2020-321013
  4. Q&A on coronaviruses (COVID-19). 17 April 2020. https://www.who.int/news-room/q-a-detail/q-a-coronaviruses (Accessed 30 April 2020)