Coronavirus symptoms: Gastrointestinal signs occur in 20 percent of COVID patients – why?

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An outbreak of COVID-19 caused by severe acute respiratory syndrome and has rapidly spread from China affecting nearly 100,000 people across 199 countries. Whereas typical presentations of COVID-19 include fever, cough, myalgia, fatigue and pneumonia, are well recognised, early studies reported low incidence of typical gastrointestinal symptoms. Why would a person suffer with gastrointestinal issues caused by COVID-19?

Almost one in five patients with COVID-19 may show gastrointestinal symptoms such as nausea, vomiting and diarrhoea, according to a review of studies.

Gastrointestinal symptoms associated with COVID-19 vary widely but can include loss of appetite, nausea, vomiting, diarrhoea and generalised abdominal pain.

A study, published in the journal Abdominal Radiology, found that 18 percent of patients presented with such symptoms, while 16 percent of COVID-19 cases may only present with gastrointestinal symptoms.

Radiologist Mitch Wilson from the University of Alberta, Canada said: “There’s a growing amount of literature showing that abdominal symptomatology is a common presentation for COVID-19.”

The researchers examined findings from 36 studies to reach their conclusions.

Issues including diarrhoea, nausea, vomiting and abdominal pain have all been reported in some COVID-19 patients.

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Why COVID-19 would create gastrointestinal issues

In a study published in BMJ, COVID-19 and the gastrointestinal tract was further investigated.

The study noted: “In GUT several articles report on GI symptoms, detection of the virus in faeces and potential pathophysiological aspects including viral receptor expression in the GI tract.

“What remains less clear is why and how SARS-CoV-2 induces GI symptoms and second whether SARS-CoV-2 can be transmitted through the GI tract other than the respiratory tract.

“In about 50 percent of COVID-19 cases, the presence of SARS-CoV-2 in faecal samples and detection of SARS-CoV-2 in intestinal mucosa of infected patients suggest that enteric symptoms could be caused by invasion of ACE2 expressing enterocytes and the GI tract may be an alternative route of infection.

“In conclusion, these studies provide new insights into our understanding of the prevalence, aetiology and potential mechanisms of COVID-19 in the GI tract crucial for defining prevention measures, clinical care and treatment strategies.

“Unanswered questions and challenges remain, such as the significance of virus detection in the stool/rectal swabs of asymptomatic subjects, whether ACE2 is a direct mediator for SARS-CoV-2 entry into the GI tract and how the virus could survive passage through extreme pH environment of the digestive system.”

To have a healthy gut is an indicator of having a good immunity against infectious disease such as the deadly virus sweeping across the world.

To help maintain good microbiome diversity in the gut, people are advised to consume high-quality plant-based foods that are rich in fibre and avoid the consumption of processed foods as much as possible.

Include more probiotics in the diet which helps with the development of good bacteria. Eating more foods such as yoghurt, cheese and kefir will help with good gut health.

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