Study: Upset Stomach First Sign of Illness for Some COVID-19 Patients

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Some patients with the coronavirus experience upset stomachs, and diarrhea, as the first signs of illness, according to a new study conducted in China — though most typically experience cough, fever, and shortness of breath.

This group of patients had mild cases of the virus overall with respiratory problems showing up later, according to Dr. Brennan Spiegel, co-editor in chief of the American Journal of Gastroenterology, which published the study.



Spiegel says symptoms such as nausea and vomiting are common, often related to stress and anxiety, and it's best to do a reality check before jumping to conclusions that you have the virus.

"Just because I have diarrhea does not mean at all that I have COVID," he states. "In fact, I almost certainly don't have it if that's all you have is diarrhea. It's really a matter of trying to understand that this is one more piece of the puzzle and we're slowly trying to fill that puzzle in as we gain this new information."



This is the second study from China with the same findings. They're significant because folks without classic symptoms of COVID-19, such as cough, fever and shortness of breath, may go undiagnosed and could potentially spread the illness to others, Spiegel says.

But he points out that there is concern that if testing is suddenly expanded to include gastrointestinal symptoms, the demand will outstrip the supply.

"In contrast, if somebody has new-onset diarrhea and fever and they are concerned they've had a contact with somebody who's COVID-19 positive, that for me would be enough to consider testing even if they have not yet developed respiratory symptoms. But that is not yet a CDC guideline."

The study included 117 coronavirus patients. Almost 60% percent had diarrhea and 20% experienced it as a first symptom. About a third of patients with digestive symptoms never experienced a fever.

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