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Question for someone with subject knowledge: Corona virus pathway is ACE-2 receptor. These receptors are located in numerous human cells -- but prominently in lungs. As to reports of patients with gastro-intestinal symptoms only -- there are ACE-2 receptors in stomach and small intestine. Would a corona infection acquired in the GI tract lead to a lung infection...
Hi ejbriel, thank you for your smart idea. That was exactly what I was thinking today. I have been suffering from gastrointestinal symptoms for three weeks now, after I had visited France near the Mulhouse Corona hotspot. No breathing, flu, fever, or coughing symptoms. However, I wondered why I am still suffering from prolongued GI problems and a (very)...
I have been reviewing my recent medical history and, in light of new theories about the coronavirus. I am thinking that it is very possible that I had contracted it back in January prior to testing. I am now wondering if I could be tested to see if that is the case. It would be very helpful for me...
I think an antibody test will eventually be available. That would tell you if you recovered from a COVID-19 infection and theoretically have immunity.
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Some never develop respiratory symptoms at all.
Some patients with COVID-19 experience gastrointestinal symptoms, particularly diarrhea , as the first sign of illness, according to a new study.
Among this subset of patients — who have mild disease overall — respiratory symptoms show up only later in the illness, and some never develop respiratory symptoms at all, the authors said.
The findings are important because those without classic symptoms of COVID-19 — such as cough, shortness of breath and fever — may go undiagnosed and could potentially spread the illness to others, the researchers said.
Still, they note that digestive problems are common overall and don't necessarily mean that a person has COVID-19. But doctors should recognize that sudden digestive symptoms in people with a possible COVID-19 contact "should at least prompt consideration of the illness," the authors wrote in their paper, published ahead of print Monday (March 30) in The American Journal of Gastroenterology . "Failure to recognize these patients early and often may lead to unwitting spread of the disease."
The study is not the first to report digestive symptoms as a sign of COVID-19. For example, a study posted March 18 in the same journal found that, among about 200 COVID-19 patients at three hospitals in Wuhan, China, around 50% reported at least one digestive symptom, and 18% reported diarrhea, vomiting or abdominal pain. However, that study and others have tended to focus on patients with severe illness, rather than those with mild disease.
In the new study, the researchers analyzed information from 206 patients at Union Hospital, Tongji Medical College in Wuhan, which was designated as a hospital for COVID-19 patients. To be included in the study, patients needed to have a mild illness, without difficulty breathing or low blood oxygen levels.
Overall, 48 patients (23%) were admitted with digestive symptoms only, 89 (43%) with respiratory symptoms only and 69 (33%) with both respiratory and digestive symptoms.
Among all patients with digestive symptoms (117 patients), about 67 (58%) had diarrhea, and of these, 13 (20%) experienced diarrhea as the first symptom of their illness. Patients' diarrhea lasted from one to 14 days, with an average duration of five days, the report said. About one-third of patients with digestive symptoms never experienced a fever .
Patients with digestive symptoms tended to seek health care later than those with respiratory symptoms, an average of 16 days from the start of their symptoms, compared with 11 days for those with respiratory symptoms, the study found. Those with digestive symptoms also took longer to clear the virus from their body (test negative for COVID-19), taking about 41 days on average, compared with 33 days for those with respiratory symptoms only.
Finally, those with digestive symptoms were much more likely to have the new coronavirus, SARS-CoV-2, detected in their stool , with about 73% having positive stool samples, compared with 14% of those with respiratory symptoms only. This finding suggests, but does not definitely confirm, that that virus infects the gastrointestinal tract, the authors said.
Overall, "these data emphasize that patients with new-onset diarrhea after a possible COVID-19 contact should be suspected for the illness, even in the absence of cough, shortness of breath, sore throat or even fever," the authors concluded. "Optimally, testing for COVID-19 should be performed using both respiratory and stool samples, if available."
The authors note that their study was relatively small, and larger studies are needed to further describe digestive symptoms in patients with mild COVID-19.
Originally published on Live Science .
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Diarrhea is first sign of illness for some COVID-19 patients | Live Science
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digestive disorders center Topic Guide
Causes of diarrhea include viral and bacterial infections , as well as parasites, intestinal disorders or diseases (such as irritable bowel syndrome [ IBS ]), reactions to medications, and food intolerance . The main symptom of diarrhea is watery, liquid stools. In addition, other symptoms of diarrhea include the following:
Diarrhea is usually diagnosed by the appearance of the symptoms, and no tests may need to be ordered. In some cases a doctor may order a stool culture, blood tests, a colonoscopy , or imaging tests such as X-rays or CT scans to determine an underlying cause.
In most cases, diarrhea can be treated at home and it will resolve itself in a few days. Drink plenty of fluids, and follow the "BRAT" diet (bananas, rice, applesauce, and toast) to help ease symptoms. Take care to ensure infants and children stay hydrated. Electrolyte solutions such as Pedialyte can be helpful.
Over-the-counter (OTC) antidiarrheal medications may provide some relief of symptoms, including loperamide (Imodium) and bismuth subsalicylate ( Pepto-Bismol , Kaopectate , etc.). Consult your doctor before treating diarrhea with these drugs, as some people may need to avoid them. Do not give them to children under 5 years of age. The prognosis for diarrhea is generally good and in most cases symptoms will resolve in a few days.
Diarrhea is the frequent passage of loose, watery, soft stools with or without abdominal bloating, pressure, and cramps commonly referred to as gas. It can come on suddenly, run its course, and be helped with home care to prevent complications such as dehydration.
Viral infections cause most cases of diarrhea and are typically associated with mild-to-moderate symptoms with frequent, watery bowel movements, abdominal cramps, and a low-grade fever. Viral diarrhea generally lasts approximately three to seven days.
The following are the common causes of diarrhea caused by viral infections (viral gastroenteritis):
Bacterial infections cause the more serious cases of infectious diarrhea. Typically, infection with bacteria occurs after eating contaminated food or drinks ( food poisoning ). Bacterial infections also cause severe symptoms, often with vomiting, fever, and severe abdominal cramps or abdominal pain . Bowel movements occur frequently and may be watery and individuals may experience "explosive diarrhea" which is a very forceful, almost violent, expulsion of loose, watery stool along with gas.
The following are examples of diarrhea caused by bacterial infections:
Parasites cause infection of the digestive system by the use of contaminated water. Common parasitic causes of diarrheal disease include Giardia lamblia , Entamoeba histolytica , and Cryptosporidium .
Intestinal disorders or diseases (including those that affect the small intestine or colon ) including inflammatory bowel disease including ulcerative colitis and Crohn's disease, irritable bowel syndrome ( IBS ), diverticulitis , microscopic colitis , and celiac disease , and malabsorption (trouble digesting certain nutrients) are non-infectious causes of chronic diarrhea. Many of these disorders can cause the diarrhea to be yellow in color.
Reaction to certain medications can cause drug-induced diarrhea including antibiotics, blood pressure medications, cancer drugs, gout medications, weight loss drugs, and antacids (especially those containing magnesium).
Intolerance or allergies to foods such as artificial sweeteners found in sugar -free foods and lactose intolerance (to the sugar found in milk) can cause chronic diarrhea.
Alcohol abuse can cause diarrhea. Both binge drinking and chronic alcoholism may lead to loose stools.
Laxative abuse is one of the biggest self-induced causes of diarrhea, by taking too many laxatives, or taking them too frequently.
Diabetic diarrhea can be a complication of diabetes .
Radiation therapy or chemotherapy may cause loose stools and the diarrhea may last for up to three weeks after treatment ends.
Some cancers are more likely to cause diarrhea, including carcinoid syndrome, colon cancer , lymphoma , medullary carcinoma of the thyroid, pancreatic cancer , and pheochromocytoma.
Digestive surgery including stomach or intestinal surgery may cause diarrhea.
Running can cause diarrhea (sometimes referred to as "runner's trots"). This usually happens after longer distances over 10K or particularly hard runs.
Diarrhea can usually be treated with home care. In some cases, it may become more severe. A person should go to a hospital emergency department in the following situations:
Call a doctor if a person has any of these complications:
For cases of chronic diarrhea, your primary care provider may consult with a gastroenterologist (a specialist in disease of the digestive tract).
In healthy people with diarrhea, and who appear well otherwise, the health-care professional may elect to do no tests at all. Stool cultures (when a sample of the stool is taken and examined in the lab for certain bacteria or parasites) are not usually necessary unless there is high fever, blood in the stool, recent travel, or prolonged disease.
Dehydration in children and toddlers can be a great concern. Loose stools are more common in breastfed newborns than in formula-fed babies , so check with your doctor about to expect for your child.
NOTE: If using remedies involving homeopathy, herbs, dietary and nutritional supplements , acupressure , aromatherapy, and other alternative or complementary methods, these products and techniques have not been scientifically proven to treat, prevent, or cure any disease. Side effects and serious interactions with prescription and nonprescription medications (OTC) are always a possibility. Tell your doctor about every prescription medication, OTC medication, vitamin , and supplement an individual uses, and seek medical advice for any health concerns prior to taking any medication or remedy. Keep a log of all medications and supplements (prescription or OTC), vitamins , supplements, and herbs in your wallet or purse in case of emergency.
The use of anti-motility medications, although controversial, may help get rid of diarrhea. These drugs slow down the intestinal movement and stop diarrhea symptoms. These medications include loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol, Kaopectate, etc).
Electrolyte solutions are available to prevent salt deficiency.
If a person has severe diarrhea, they should contact their doctor or go to an emergency department or urgent care center because medical treatment may be necessary.
To replace fluids, a health care professional will often start an IV line if the patient is dehydrated and can't eat or drink. IV solutions will replace the lost fluids and electrolytes and often brings quick relief. If the patient is able to drink, rehydration solutions may be given orally.
Diphenoxylate and atropine ( Lomotil ) is an anti-diarrheal medication that a doctor may prescribe.
Antibiotics will get not rid of diarrhea caused by viruses. Even the more severe diarrhea caused by bacteria will usually go away in a few days without antibiotics. Antibiotics appear to make some bacterial diarrhea worse, specifically those caused by the E coli bacterium (often a source of food poisoning ).
In some cases, antibiotics may benefit some adults with diarrhea. If selected carefully, antibiotics may decrease the severity of illness and shorten the duration of symptoms. If a person has recently traveled to another country or has been camping (and may have been exposed to contaminated water in the wilderness), a health care professional may prescribe specific medication used to treat traveler's diarrhea for certain intestinal parasites.
If a person has severe diarrhea, especially accompanied with dehydration, he or she may require hospitalization to receive IV fluids and to be observed.
Many cases of diarrhea are spread from person-to-person. The following precautions can help an individual avoid diarrhea and other viral or bacterial infections:
Practice safe food handling. Always wash hands before and after handling food.
The stomach flu, or medically referred to as gastroenteritis, can
be caused by a variety of things like viruses, bacteria, fungi, inflammation from medications (antibiotics), seafood, food allergies, and heavy metals. Common symptoms of the stomach flu include:
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