COVID-19 presenting with diarrhea, loss of appetite have a higher risk of death

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Diarrhoea and loss of appetite could be early signs of coronavirus as scientists find almost half of patients experience one or more digestive symptoms

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• Study of 204 Wuhan residents reveals 48.5 per cent had digestive symptoms

• Most also had the normal respiratory issues but seven people did not

• Those with digestive symptoms are less likely to be successfully treated and discharged compared to those with just respiratory symptoms

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The study, conducted by Chinese researchers, has been scrutinised by other academics and published this week in the American Journal of Gastroenterology.

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Researchers studied 107 men and 94 women with an average age of 55 that had all tested positive for COVID-19 between January 18 and February 28.

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Ninety-nine had digestive symptoms and 92 of these also suffered with respiratory problems as a result of the infection.

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The researchers add: ‘Among the 105 patients without digestive symptoms, 85 presented only with respiratory symptoms, and 20 neither had respiratory nor digestive symptoms as their chief complain.’

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The study also found the digestive issues worsened as the severity of the disease increased.

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Patients without digestive symptoms in this study were more likely to be cured and discharged than patients with digestive symptoms, the scientists say.

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Around a third (34.3 per cent) of patients that did experience digestive problems were discharged by March 5, when the study stopped collecting data.

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This figure for successful treatment rises to 60 per cent for people who did not experience digestive symptoms.

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The researchers write in their research: ‘We found that digestive symptoms are a common presenting complaint in patients with COVID-19.

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‘Compared to patients without digestive symptoms, those presenting with digestive symptoms have a longer time from onset to admission and a worse prognosis.

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Dr Brennan Spiegel, Professor of Medicine and Public Health at UCLA and co-editor of the journal the study was published in, said in a statement accompanying the release of the research: ‘In this study, COVID-19 patients with digestive symptoms have a worse clinical outcome and higher risk of [death] compared to those without digestive symptoms, emphasising the importance of including symptoms like diarrhoea to suspect COVID-19 early in the disease course before respiratory symptoms develop.’

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WHY DOES CORONAVIRUS CAUSE DIGESTIVE SYMPTOMS?

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Chinese researchers believe COVID-19 appears to cause digestive symptoms because SARS-CoV-2 is similar to SARS-CoV and can invade the human body by binding to the human angiotensin converting enzyme 2 (ACE-2) receptor.

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This can cause liver tissue injury by making too many liver cells, called hepatocytes, derived from ells in the bile duct.

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Secondly, SARS-CoV-2 indirectly or directly damages the digestive system through an inflammatory response.

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The chain reaction may injure the digestive system.

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