COVID-19 is widely recognized for its impact on the respiratory system. However, the virus can also affect other parts of the body, including the digestive system. Many people infected with SARS-CoV-2 experience gastrointestinal issues, including nausea and vomiting.
COVID-19’s Impact on the Digestive System
Gastrointestinal symptoms are a common part of the COVID-19 clinical picture, affecting a significant percentage of patients. Early reports indicated that up to half of individuals diagnosed with COVID-19 experienced some form of digestive upset. In one study of hospitalized adults, approximately two-thirds reported at least one gastrointestinal symptom. Nausea specifically affected about 26.4% of these patients.
These digestive issues can sometimes appear even before typical respiratory symptoms, or in some cases, without any respiratory symptoms at all. While loss of appetite and diarrhea are frequently reported, nausea and vomiting are also common. For some, these problems can persist as part of long COVID, lasting weeks or months after the initial infection.
Understanding the Mechanisms Behind Digestive Symptoms
The SARS-CoV-2 virus causes digestive symptoms like nausea and vomiting through several mechanisms. One involves direct infection of gut cells. The virus binds to the ACE2 receptor, abundant on enterocytes in the small intestine and colon. Inside these cells, the virus replicates, causing damage, inflammation, and disruption of normal gut function.
Beyond direct infection, systemic inflammation from the body’s immune response also affects the digestive tract. COVID-19 can induce a hyper-inflammatory state with elevated pro-inflammatory cytokines like IL-6. This widespread inflammation impacts various organs, including those in the gastrointestinal system. The gut-brain axis, a bidirectional communication pathway, also plays a role, as gut inflammation can send signals to the brain that trigger nausea and vomiting.
COVID-19 can also disrupt the gut microbiome. Studies show SARS-CoV-2 infection leads to an imbalance, with fewer beneficial bacteria and more harmful ones. This dysbiosis affects gut lining integrity and contributes to inflammation, potentially worsening digestive symptoms and influencing illness severity.
Managing Nausea and Vomiting During COVID-19
Managing COVID-19-related nausea and vomiting involves supportive care to alleviate discomfort. Staying well-hydrated is important, especially with vomiting. Small, frequent sips of water, clear broths, or electrolyte solutions help replenish fluids and minerals.
Dietary modifications can ease digestive distress. Opt for bland foods like bananas, rice, applesauce, and toast. Avoid spicy, fatty, or overly sweet foods, as these can worsen nausea. Eating smaller, more frequent meals is also beneficial. Rest allows the body to conserve energy and fight infection, and ginger, as tea or candy, can offer relief.
When to Seek Medical Attention
While many cases of COVID-19 with nausea and vomiting can be managed at home, certain signs indicate a need for medical evaluation. Dehydration is a concern; symptoms like decreased urination, extreme thirst, dry mouth, dizziness, or lightheadedness warrant attention. Inability to keep down fluids for an extended period also signals a need for intervention, as intravenous fluids may be required.
Other serious symptoms requiring immediate medical care include severe abdominal pain. Bloody vomit or black, tarry stools are also warning signs. Worsening or new severe symptoms beyond digestive issues, such as a high fever not responding to medication, or shortness of breath, should prompt immediate medical consultation.