COVID-19 is widely recognized for its impact on the respiratory system, presenting symptoms such as cough, fever, and shortness of breath. However, the virus can also affect various other body systems, including the digestive tract.
Diarrhea: A Recognized COVID-19 Symptom
Diarrhea is a recognized symptom of COVID-19. Studies indicate that up to half of people with COVID-19 experience loose, watery stools. While prevalence estimates vary, a pooled analysis found an overall diarrhea rate of about 10.4% in COVID-19 patients, with some reports ranging from 2% to 50%.
The characteristics of COVID-19-related diarrhea often include watery, loose stools, sometimes described as yellowish or greenish in color. This digestive issue typically lasts for a short period, ranging from two to six days, and may be accompanied by cramping and bloating. For some individuals, diarrhea can be the initial or even the only symptom of COVID-19, appearing before or without respiratory symptoms.
How COVID-19 Impacts the Digestive System
The SARS-CoV-2 virus directly impacts the gastrointestinal tract. The virus enters human cells by binding to specific receptors known as angiotensin-converting enzyme 2 (ACE2). These ACE2 receptors are abundant not only in the respiratory tract but also in the cells lining the gut, specifically enterocytes in the small intestine and colon. When the virus binds to ACE2 receptors on enterocytes, it can directly infect these intestinal cells and replicate within them. This direct infection can lead to inflammation in the intestines, contributing to symptoms like diarrhea.
Beyond direct cellular infection, COVID-19 can also disrupt the delicate balance of the gut microbiome, the community of microorganisms residing in the intestines. Changes in the gut microbiome, often characterized by a decrease in beneficial bacteria and an increase in potentially harmful species, may contribute to systemic inflammation and influence disease severity. This disruption can affect the gut barrier, potentially allowing bacteria to enter the bloodstream and contributing to broader health issues.
Other Digestive Symptoms to Watch For
While diarrhea is a common digestive symptom, other gastrointestinal issues can also manifest. Nausea and vomiting are frequently reported, affecting about one in five people with the virus. These symptoms can arise from the virus attacking the digestive tract, causing inflammation and stimulating nerves connected to the brain.
Abdominal pain or discomfort is another possible symptom, though it is less common than nausea or diarrhea. This pain can stem from inflammation in the intestine due to the infection. Additionally, loss of appetite is a widespread symptom when sick with COVID-19, partly because the virus can affect taste and smell, making food less appealing.
Managing Digestive Symptoms During COVID-19
Managing digestive symptoms during COVID-19 primarily involves supportive home care to alleviate discomfort and prevent complications. Maintaining adequate hydration is paramount, as diarrhea and vomiting can lead to fluid and electrolyte loss. Drinking plenty of water, clear broths, and electrolyte-rich fluids is recommended to prevent dehydration.
Consuming a bland diet can help ease digestive distress. Foods like bananas, rice, applesauce, and toast are generally well-tolerated. Avoiding spicy foods, caffeine, and alcohol can prevent further irritation of the digestive system.
Getting sufficient rest allows the body to conserve energy and focus on healing. It is important to seek medical attention if symptoms worsen or if signs of dehydration appear, such as dark urine, extreme weakness, dry mouth, or dizziness. Other indicators to consult a healthcare professional include severe or worsening abdominal pain, persistent high fever, or the presence of blood in the stool. While over-the-counter remedies might offer some relief, professional medical advice should be sought before using them, particularly if symptoms are severe or persistent.