COVID-19-related Diarrhea

COVID-19-related Diarrhea

What is COVID-19?

Coronavirus disease (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS­-CoV-2). COVID-19 affects people differently, causing mild symptoms to severe illness requiring hospitalization.

What is COVID-19?

Coronavirus disease (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-­CoV-2). COVID-19 affects people differently, causing mild symptoms to severe illness requiring hospitalization.

What are the symptoms?

COVID-19 symptoms include fever, chills, dry cough, shortness of breath, muscle aches, pneumonia, and sore throat. In addition, some patients experience gastrointestinal symptoms such as nausea and diarrhea.

Severe cases of COVID-19 can lead to pneumonia or organ failure.

Beyond the acute infection, people with COVID-19 may have symptoms that persist for more than 4 weeks or can recur following initial recovery. These post-COVID conditions, referred to as long-haul COVID,2 may include gastrointestinal distress (ie, diarrhea, constipation, nausea, pain), fatigue, brain fog, forgetfulness, cardiovascular effects, and arthritis, for an extended period after recovery. It is theorized that these symptoms may result when the immune system in COVID-19 survivors continues to overreact even though the infection has passed.

What are the symptoms?

COVID-19 symptoms include fever, chills, dry cough, shortness of breath, muscle aches, pneumonia, and sore throat. In addition, some patients experience gastrointestinal symptoms such as nausea and diarrhea.

Severe cases of COVID-19 can lead to pneumonia or organ failure.

Beyond the acute infection, people with COVID-19 may have symptoms that persist for more than 4 weeks or can recur following initial recovery. These post-COVID conditions, referred to as long-haul COVID2, may include gastrointestinal distress (ie, diarrhea, constipation, nausea, pain), fatigue, brain fog, forgetfulness, cardiovascular effects, and arthritis, for an extended period after recovery. It is theorized that these symptoms may result when the immune system in COVID-19 survivors continues to overreact even though the infection has passed.

Diarrhea in Patients with COVID-19

Studies have shown that up to 29% of patients with COVID-19 experience diarrhea.3 Diarrhea may also be correlated with disease severity and transmission.4

Patients may experience diarrhea 1 to 8 days after initial COVID-19 onset, lasting between 4 to 6 days and occurring three times a day on average.5 In some cases, diarrhea occurs in the absence of respiratory symptoms associated with COVID-19.6

In addition to diarrhea associated with acute infections, diarrhea may also persist in people with long-haul COVID.7 In a recent survey of over 3,700 patients experiencing illness lasting over 4 weeks, 60% of patients reported diarrhea.8

Diarrhea in Patients with COVID-19

Studies have shown that up to 29% of patients with COVID-19 experience diarrhea.3 Diarrhea may also be correlated with disease severity and transmission.4

Patients may experience diarrhea 1 to 8 days after initial COVID-19 onset, lasting between 4 to 6 days and occurring three times a day on average.5 In some cases, diarrhea occurs in the absence of respiratory symptoms associated with COVID-19.6

In addition to diarrhea associated with acute infections, diarrhea may also persist in people with long-haul COVID.7 In a recent survey of over 3,700 patients experiencing illness lasting over 4 weeks, 60% of patients reported diarrhea.8

In an article describing more than 300 long-haul COVID patients seen at New York City’s Mount Sinai Health System Center for post-COVID care, ~40% to 50% of patients reported symptoms such as gastrointestinal issues, headaches, and shortness of breath.9 Based on these figures, the long­-hauler population experiencing gastrointestinal distress could potentially range between 20 to 50 million people in Europe alone.

References

References

  1. Korab A. Dr. Fauci warns these COVID symptoms can last for months. Accessed February 17, 2021. https://www.newsbreak.com/news/2104072336660/dr-fauci-warns-these-COVID-symptoms-can-last-for-months
  2. Centers for Disease Control and Prevention. Post-COVID Conditions: Information for Healthcare Providers. April 8, 2021. Accessed April 13, 2021. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/post-covid-conditions.html
  3. Lee IC, Huo TI, Huang YH. Gastrointestinal and liver manifestations in patients with COVID-19. J Chin Med Assoc. 2020;83(6):521-523. doi:10.1097/JCMA.0000000000000319
  4. D’Amico F, Baumgart DC, Danese S, Peyrin-Biroulet L. Diarrhea during COVID-19 infection: pathogenesis, epidemiology, prevention, and management. Clin Gastroenterol Hepatol. 2020;18(8):1663-1672. doi:10.1016/j.cgh.2020.04.001
  5. Wang F, Zheng S, Zheng C, Sun X. Attaching clinical significance to COVID-19-associated diarrhea. Life Sci. 2020;260:118312. doi:10.1016/j.lfs.2020.118312
  6. Pan L, Mu M, Yang P, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Amer J Gastroenterol. 2020;115(5):766-773. doi:10.14309/ajg.0000000000000620
  7. Nath A. Long-haul COVID. Neurology. 2020;95(13):559-560. doi:10.1212/WNL.0000000000010640
  8. Davis HE, Assaf GS, McCorkell L, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. Accessed February 17, 2021. https://www.medrxiv.org/content/10.1101/2020.12.24.20248802v2
  9. Toy S, Reddy S, Hernandez D. Doctors begin to crack COVID’s mysterious long-term effects. Accessed February 17, 2021. https://www.wsj.com/articles/doctors-begin-to-crack-covids-mysterious-long-term-effects-11604252961