Abdominal pain can be a symptom of COVID-19. While primarily known for its respiratory effects, the virus can also impact the digestive system, leading to various gastrointestinal manifestations. This discomfort is a documented part of the illness.
Abdominal Pain as a Recognized COVID Symptom
Abdominal pain, along with other gastrointestinal issues like nausea, vomiting, and diarrhea, is a recognized symptom of COVID-19. While less common than respiratory symptoms such as fever or cough, it has been reported in a notable percentage of patients. The prevalence of gastrointestinal symptoms, including abdominal pain, can vary; during the pandemic, approximately 50% of people with COVID-19 reported some form. In some instances, these digestive symptoms, including abdominal pain, can be the initial or even the sole presentation of the infection, occurring before any respiratory signs.
Mechanisms Behind COVID-19 Abdominal Pain
The SARS-CoV-2 virus can cause abdominal pain through several biological mechanisms. A primary pathway involves direct infection of cells in the digestive tract. The virus uses ACE2 receptors to enter host cells, which are abundant on epithelial cells lining the small intestine. Direct viral replication within these cells can lead to cellular damage and inflammation, contributing to pain.
Beyond direct infection, systemic inflammation triggered by the virus also affects the digestive system. COVID-19 can induce a hyper-inflammatory state, where the body releases inflammatory chemicals. These chemicals can attack the protective barrier of the stomach and intestines, causing damage that manifests as pain, nausea, and diarrhea. This inflammatory response can also impact the liver and pancreas, potentially leading to abdominal discomfort.
Changes in the gut microbiome, known as dysbiosis, also play a role in COVID-19-related abdominal pain. SARS-CoV-2 infection can disrupt the balance of beneficial bacteria and increase opportunistic pathogens. This altered microbial composition can lead to intestinal inflammation and impaired gut barrier function, contributing to gastrointestinal symptoms.
Additionally, some medications used to treat COVID-19 can cause abdominal pain as a side effect. Antiviral drugs, such as Paxlovid, may lead to gastrointestinal issues including abdominal pain, nausea, and vomiting. These medication-induced effects contribute to the abdominal discomfort experienced by patients.
When to Seek Medical Care
Individuals experiencing abdominal pain potentially related to COVID-19 should monitor their symptoms and consider when to seek medical attention. While mild discomfort might resolve on its own, certain “red flag” symptoms warrant prompt medical evaluation. These include severe, intense, or worsening abdominal pain that does not subside; persistent vomiting or diarrhea leading to dehydration (e.g., extreme thirst, dry mouth, dizziness); or blood in stool or vomit. Additionally, if abdominal pain is accompanied by a high fever (over 101°F or 38.3°C), difficulty breathing, or yellowing of the skin or eyes, professional medical assessment is important. It is advisable to consult a healthcare provider for diagnosis and management.