COVID-19 is primarily known for its respiratory impact, causing symptoms like cough and shortness of breath. However, the virus can also affect other parts of the body, including the digestive tract. This article explores the connection between COVID-19 and digestive symptoms, including its underlying causes, management strategies, and how it differs from other common digestive issues.
Diarrhea as a COVID-19 Indicator
Diarrhea is a recognized symptom of COVID-19, although its prevalence can vary across studies, ranging from approximately 10% to 20% of infected individuals. It is often described as non-bloody, watery, and mild to moderate in severity. For some individuals, diarrhea may even be one of the first symptoms to appear, sometimes preceding the more common respiratory signs like fever or cough.
The onset of COVID-19 related diarrhea usually occurs within a few days of other symptoms and generally resolves within two to six days. In some instances, it can be the sole symptom of infection, though this is less common. Its duration can be prolonged in certain cases.
How COVID-19 Causes Diarrhea
The SARS-CoV-2 virus can directly infect cells in the gastrointestinal tract. This is primarily due to the presence of angiotensin-converting enzyme 2 (ACE2) receptors, which are abundant on the surface of cells lining the intestines. The virus uses its spike protein to bind to these ACE2 receptors, allowing it to enter and infect the cells.
Once inside the intestinal cells, the virus can disrupt the normal functioning of the gut lining and trigger an inflammatory response. This inflammation and cellular damage can lead to impaired absorption of nutrients and water, contributing to the development of diarrhea. Additionally, the virus’s presence may alter the balance of gut bacteria, further contributing to digestive issues.
Managing Diarrhea and When to Seek Medical Attention
For most people, COVID-19-related diarrhea is mild and can be managed at home with supportive care. Adequate hydration is important, as diarrhea can lead to fluid and electrolyte loss. Drinking water, broth, or oral rehydration solutions is recommended. Bland foods, such as the “BRAT” diet (bananas, rice, applesauce, and toast), can also help firm up stool and alleviate symptoms.
While many cases improve on their own, it is important to know when to seek medical attention. You should contact a doctor if diarrhea persists for more than two to three days or worsens. Immediate medical care is necessary if you experience signs of severe dehydration, such as:
Dizziness
Rapid heartbeat
Dry mouth
Dark urine
Other concerning symptoms that warrant prompt medical evaluation include severe abdominal pain, high fever (over 102°F), or blood or black, tarry stool.
Differentiating COVID-19 Diarrhea
Distinguishing COVID-19 diarrhea from other common causes can be challenging based solely on digestive symptoms. However, COVID-19 diarrhea often occurs alongside other symptoms commonly associated with the virus, even if they are subtle. These may include:
Fever
Cough
Fatigue
Headache
Loss of taste or smell
COVID-19 diarrhea is watery and can appear yellowish or greenish.
Diarrhea can also be a symptom of “Long COVID,” where digestive issues persist for weeks or even months after the initial acute infection has resolved. If you suspect you have been exposed to COVID-19 or are experiencing a combination of respiratory and digestive symptoms, getting tested for the virus is advisable to confirm the diagnosis.