A new descriptive, cross-sectional multicenter study from the Wuhan Medical Treatment Expert Group for COVID-19 in China was published on March 18 in The American Journal of Gastroenterology. According to the study of 204 Covid-19 patients, nearly half of them had shown digestive symptoms before exhibiting any of the known respiratory symptoms of the disease.
This is a major step towards earlier diagnosis. The authors of the study point out that “Clinicians must bear in mind that digestive symptoms, such as diarrhea, may be a presenting feature of COVID-19, and that the index of suspicion may need to be raised earlier in these cases rather than waiting for respiratory symptoms to emerge,”
What are the gastrointestinal symptoms to look out for?
29.3% of the affected people experienced diarrhea, 83.8% experienced varying degrees of anorexia (loss of appetite), 0.8% experienced vomiting, and 0.4% had abdominal pains.
“If clinicians solely monitor for respiratory symptoms to establish case definitions for COVID-19, they may miss cases initially presenting with extra-pulmonary symptoms, or the disease may not be diagnosed later until respiratory symptoms emerge.”
Digestive Issues Increase Mortality
In the study, Covid-19 patients with digestive symptoms were much less likely to be cured and discharged from the hospital than those without – 34.3% to 60%.
It’s also worth mentioning that ~3.5% of the Covid-19 patients (7 out of 204 people) had pronounced gastrointestinal problems but no respiratory issues whatsoever.
Brennan M.R. Spiegel, MD, MSHS, FACG, Co-Editor-in-Chief of The American Journal of Gastroenterology also goes on to say that
“In this study, COVID-19 patients with digestive symptoms have a worse clinical outcome and higher risk of mortality compared to those without digestive symptoms, emphasizing the importance of including symptoms like diarrhea to suspect COVID-19 early in the disease course before respiratory symptoms develop. This may lead to earlier diagnosis of COVID-19, which can lead to earlier treatment and more expeditious quarantine to minimize transmission from people who otherwise remain undiagnosed.”