COVID-19 often features respiratory symptoms like cough, fever, and shortness of breath. However, the virus that causes the disease, SARS-CoV-2, can affect multiple systems in the body, including the digestive tract. Gastrointestinal issues are commonly reported, and vomiting and nausea are recognized symptoms of infection.
Gastrointestinal Symptoms and COVID-19
Vomiting and nausea are documented gastrointestinal symptoms of COVID-19, though reported less frequently than fever or cough. Studies indicate that the prevalence of vomiting in COVID-19 patients can vary widely. These digestive issues may appear before respiratory symptoms, sometimes preceding the onset of fever or breathing difficulties by several days.
Other digestive symptoms that frequently occur alongside vomiting include diarrhea, which is often the most common gastrointestinal complaint, and a general loss of appetite. When vomiting does occur, it is often short-lived, with the symptom typically resolving within 12 to 24 hours.
Biological Explanation for Digestive Issues
The SARS-CoV-2 virus triggers digestive upset through its mechanism of cellular entry. The virus uses a protein on the surface of human cells called Angiotensin-Converting Enzyme 2 (ACE2) as its main receptor. These ACE2 receptors are found in high concentrations in the cells lining the digestive tract, specifically in the stomach, small intestine, and colon.
Once the virus binds to the ACE2 receptor, it is able to enter and replicate within the intestinal cells. This viral activity causes localized inflammation and cellular disruption within the gastrointestinal lining. The resulting irritation, combined with the body’s immune response, can lead to the sensation of nausea and the physical act of vomiting. This inflammatory process and the direct viral damage to the gut cells are what drive the digestive symptoms experienced by some patients.
Recognizing and Managing Dehydration
Persistent vomiting or diarrhea can quickly lead to a loss of body fluids and electrolytes, creating a risk of dehydration. Recognizing the signs of fluid loss is necessary, with indicators including extreme thirst, dark-colored urine, and dizziness when standing up. Dry mouth and reduced frequency of urination are also common signs of mild to moderate dehydration.
To manage this, consuming fluids is the primary recommendation, focusing on small, frequent sips to avoid triggering further vomiting. Oral rehydration solutions, which contain a balanced mix of water, salts, and sugars, are particularly effective for replacing lost electrolytes. If a person is unable to keep any fluids down for more than a few hours, or if they experience severe symptoms like confusion, fainting, or an inability to urinate, immediate medical attention is necessary.