COVID-19 is primarily known as a respiratory illness, but the virus, SARS-CoV-2, affects multiple body systems. While cough and fever are the most recognized signs of infection, the disease can also manifest through gastrointestinal (GI) symptoms. Understanding the full spectrum of possible effects is important for identifying the illness and seeking appropriate care. This article clarifies the role of GI symptoms, specifically vomiting, in the presentation of COVID-19.
Vomiting and Nausea as COVID Indicators
Vomiting is a recognized symptom of COVID-19, though it is generally less frequent than the more commonly reported respiratory complaints. Medical studies have indicated that the prevalence of vomiting in adult cases typically falls between 4.5% and 7% of patients. Vomiting is often reported alongside nausea, which may occur in up to 10% of cases, making the combination a relevant indicator of infection.
These digestive symptoms are usually mild and tend to resolve within a few days. Nausea and vomiting can sometimes be one of the first signs of COVID-19, appearing before the characteristic fever or cough. Recognizing these early, non-respiratory complaints aids in early isolation and testing.
Other Common Gastrointestinal Symptoms
The virus causes GI distress because the angiotensin-converting enzyme 2 (ACE2) receptor is highly expressed in the cells lining the digestive tract. SARS-CoV-2 uses this receptor to enter intestinal cells, making the digestive system a target of the infection. This viral activity can lead to inflammation and damage to the intestinal lining.
Diarrhea is the most common GI symptom associated with COVID-19, affecting up to 12% to 15% of patients. This symptom often presents as watery stool and can occur multiple times a day. Abdominal pain or discomfort is also reported, typically affecting 3% to 6% of patients.
The presence of these digestive issues, including a loss of appetite, highlights that COVID-19 is not strictly a pulmonary disease. In some cases, GI symptoms may be the only manifestation, making it difficult to distinguish from a common stomach bug without testing.
When to Seek Medical Attention for GI Distress
While most COVID-19-related GI symptoms are self-limiting, persistent vomiting and diarrhea carry a risk of dehydration. Signs of dehydration include:
- An inability to urinate.
- Extreme thirst.
- A dry mouth.
- Dizziness or lightheadedness.
These signs indicate a loss of fluids and electrolytes that needs prompt attention.
Individuals should contact a healthcare provider if they are unable to keep any fluids down for a full 24-hour period. Immediate medical attention is warranted for severe abdominal pain that does not subside or if there is evidence of blood in the vomit or stool.