Wednesday, November 30, 2022

Can Diarrhea Be An Initial Symptom Of Covid-19

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How Do Boosters Work

Diarrhea, loss of smell and appetite commonly reported in coronavirus patients

As your immune response to the first round of vaccination wanes, the first things to go are the short-run antibodies that stop the coronavirus from latching on and infecting new cells. The booster shot puts the immune system back on high alert, said Arline, producing short-term antibodies designed to hunt down the coronavirus.

Putative Mechanisms Of Gastrointestinal Symptoms

SARS-CoV-2 enters the mucous membranes through its well-documented functional receptor angiotensin-converting enzyme-2 . While it can make its way to the gastric lumen via salivary secretions, it is subjected to the adverse effect of the acidic environment of the stomach. A pH of < 2 significantly affects the life of the virus . Patients with hypochlorhydria are susceptible to get a viral infection because of a higher viral load entering the small intestine . ACE-2 receptor concentrations differ among different GI tissues, with high expression noted in ileal enterocytes . Once SARS-CoV-2 enters the enterocytes, viral synthesis, replication can continue, and a cytopathic effect is noted . The virus can continue its journey from here to other organs via the portal circulation. These changes can potentially lead to stool viral RNA positivity. If the presence of viral RNA in the stool is indicative of cytopathic changes or just a bystander needs further validation .

Figure 1. Schematic representation of various gastrointestinal manifestations with their mechanisms. SARS-CoV-2 gains entry via mucous membranes of the oral cavity enters the stomach and small intestine to exert its cytopathic effect. Additionally, gut inflammation, altered gut flora, drug-induced changes, worsening of pre-existing GI condition, and secondary infections could contribute to these symptoms.

When Should You Worry About Your Diarrhea

The CDC defines diarrhea as 3 or more loose stool events in 24 hours, or a rate of these events thats unusual for you. If you experience this, in the current climate, you might want to consider isolating yourself as you would if you developed a more common COVID-19 symptom.

The time to call your doctor is if you have blood in your stool, says Peter Chin-Hong, M.D., professor of medicine and an infectious disease specialist at the University of California, San Francisco. That would be a red flag, he says, as would having five or more bowel movements a day. If that happens, you should probably contact somebody, he says.

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When To See A Doctor

If your symptoms are mild, stay home and minimize contact with other people. More than 80 percent of people with COVID-19 will develop mild symptoms.

If you want to get in touch with a doctor, many clinics offer phone or video appointments to reduce the spread of the virus. Itâs a good idea to avoid going to the hospital. Even if you have mild symptoms, you can still transmit the disease to other people, including healthcare workers.

Medical Emergency

What Side Effects Should I Expect After My Booster Shot

Diarrhea, nausea or vomiting may be first coronavirus ...

Side effects after the boosters appear to be similar to those after the second dose of the Pfizer and Moderna vaccine.

The most commonly reported booster side effects were pain at the injection site, tiredness, headache, muscle and joint pain, chills, nausea and vomiting, and fever, the Food and Drug Administration reported. Additionally, swollen lymph nodes in the underarm of the injection site were observed more frequently following the booster than after the primary two-dose series.

Side effects mean that your immune system is responding to the vaccine, Arline said. Thats the signal that your immune system is waking up and responding to the foreign intruder.

But dont worry if you dont have serious side effects, she said. Weve seen people with very minor side effects still have a wonderful immune response to the vaccine.

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Diarrhea: Is It Covid

Medically reviewed by Dr. Kenneth Knowles, MD on November 24th, 2020

Despite several months passing since the initial outbreak of COVID-19, there is still a great deal of uncertainty surrounding the virus. This is largely due to the fact that not everyone who contracts the virus experiences the same symptoms. And while the CDC has formed a fairly comprehensive list of symptoms associated with the coronavirus, it can still be difficult to know whether certain symptoms are a direct result of COVID-19, such as diarrhea, or something else.

What Is Diarrhoea Like In Covid

Even though diarrhoea is a less well-known symptom of COVID-19, it affects a reasonable proportion of people during their illness.

Having COVID-19 diarrhoea alongside many other symptoms is associated with an increased risk of needing hospital support.

Diarrhoea caused by COVID-19 is similar to the upset tummy you might get from a regular stomach bug, such as rotavirus or norovirus. Diarrhoea is common in children and adults and usually clears up by itself.

We think COVID-19 causes diarrhoea because the virus can invade cells in the gut and disrupt its normal function.

COVID-19 can be transmitted through poo and contaminated surfaces or hands. Itâs critically important to wash your hands thoroughly and regularly clean bathrooms if you, anyone you live with, or someone youâre caring for has diarrhoea, to prevent the infection spreading.

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Another Study Found That Nausea & Vomiting Only Occurred In 5% Of Covid

The article Clinical Characteristics of Coronavirus Disease 2019 in China was published in the New England Journal of Medicine. That article noted, During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. Thus, although fever is often cited as a leading indicator of coronavirus, an absence of a fever does not mean that you dont have it, either.

The most common symptoms at onset of illness were fever , fatigue , dry cough , myalgia , and dyspnea . Less common symptoms were headache, dizziness, abdominal pain, diarrhea, nausea, and vomiting. A total of 14 patients initially presented with diarrhea and nausea 1 to 2 days prior to development of fever and dyspnea.

This study found that, while gastrointestinal symptoms could occur in coronavirus patients, they were uncommon .

The median incubation period was 4 days . The median age of the patients was 47 years 0.9% of the patients were younger than 15 years of age. A total of 41.9% were female. Fever was present in 43.8% of the patients on admission but developed in 88.7% during hospitalization, the researchers reported. The second most common symptom was cough nausea or vomiting and diarrhea were uncommon. Among the overall population, 23.7% had at least one coexisting illness .

Defining A ‘classic’ Case Of Covid

Acute Diarrhea | Approach to Causes, Enterotoxic vs Invasive, Watery vs Bloody Diarrhea

Defining a typical progression of COVID-19 symptoms could help officials determine which public-health measures are particularly useful for preventing the virus’ spread.

“The order of the symptoms matters,” Joseph Larsen, the new study’s lead author, said in a statement. “Knowing that each illness progresses differently means that doctors can identify sooner whether someone likely has COVID-19, or another illness, which can help them make better treatment decisions.”

For example, since COVID-19 patients are now understood to be most infectious at the start of their illness, a fever may be a sign that a person is contagious . That means temperature checks could be a useful tool.

“Our results support the notion that fever should be used to screen for entry into facilities as regions begin to reopen,” the researchers wrote.

The new research also better enables medical professionals to differentiate between COVID-19, SARS, and MERS . With the latter two, patients also started off with a fever, followed by a cough, according to the study. But unlike COVID-19 patients, they tended to develop diarrhea before nausea or vomiting.

COVID-19 also starts differently than seasonal influenza: The researchers found that people with the flu develop a cough before a fever.

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How Can You Tell The Difference Between The Flu And Covid

Influenza and COVID-19 are both contagious respiratory illnesses and they have similar symptoms. It may be difficult to tell the difference based on symptoms alone, but there are two key differences, according to the CDC:

  • Those infected with COVID-19 sometimes experience change in or loss of taste and smell, which is not a symptom of the flu.
  • The USC researchers said the flu usually begins with a cough, whereas COVID-19 most often starts with a fever.
  • People infected with flu typically develop symptoms 1-4 days after infection. Those with COVID-19 typically develop symptoms 5 days after being infected. However, people infected with COVID-19 can show symptoms as early as 2 days or as late as 14 days after infection.

Headaches Dizziness And Confusion

Beyond loss of taste and smell, doctors are noting a growing list of neurological effects in COVID-19 patients. Other indicators of the illness include dizziness, headache and confusion.

In fact, a study in JAMA Neurology found that more than 36 percent of 214 patients in Wuhan, China, experienced neurological symptoms during their bout of COVID-19. More recent research published in Annals of Clinical and Translational Neurology found that neurological manifestations headaches, dizziness, confusion, etc. were present in 42 percent of patients at the onset of COVID-19 symptoms and in 82 percent of patients at any time during the disease course.

For older adults, in particular, these neurological effects can be just as devastating as the pulmonary impacts of a coronavirus infection, says XinQi Dong, M.D., director of the Institute for Health, Health Care Policy and Aging Research at Rutgers University-New Brunswick. They can also be easily overlooked or dismissed as dementia or other diseases common with aging.

Were trying to be very vigilant and broad in our thinking when a patient comes into the emergency room with confusion or change in mental status, say Neal Sikka, M.D., an associate professor of emergency medicine at George Washington University in Washington, D.C. That could be some other type of infection it definitely could also be a presentation of COVID. And so we are trying to do rapid testing on those patients to identify them early.

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We Are Trapped In Long Covid Say Patients

Long COVID has been called Post-COVID, or a “post-viral” illness, and it’s a bit of a misnomer. “We’re no longer ill, we’re post illness, but we’re not post anythingwe’re still in it,” said Nichols. “We’re still living it. So I think that’s an important distinction. Long COVID is called long COVID for a reason. So that’s one area that we can definitely do better in terms of language. The other is to discuss long COVID in an appropriate way. And what I mean by that is discussing it as it is happening, not talking about it in past tense. Many of us are living it. Not many of us have recovered from it. And in fact, I will tell you that the studies that the patient-led research collaborative or BODY POLITIC has done to show that patients actually deteriorate neurologically beyond six months, and have worsening symptoms. Sousing the term ‘survivor’ is a very loaded term and it doesn’t really capture what’s happening in our bodies and in our lives. It doesn’t validate our experiences calling his patients and calling us ‘Long COVID patients’ is really the most appropriate way to acknowledge this live reality that we are trapped in at the moment, without really any help or care.”

You May Feel These Symptoms Says The Cdc

New COVID

“Some people experience a range of new or ongoing symptoms that can last weeks or months after first being infected with the virus that causes COVID-19,” says the CDC. “Unlike some of the other types of post-COVID conditions that tend only to occur in people who have had severe illness, these symptoms can happen to anyone who has had COVID-19, even if the illness was mild, or if they had no initial symptoms. People commonly report experiencing different combinations of the following symptoms:

  • Difficulty breathing or shortness of breath
  • Tiredness or fatigue

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What Are The Most Common Symptoms Of Covid

Fever and cough are the most common COVID-19 symptoms in children, according to the CDC. “The symptoms of COVID-19 are similar in adults and children and can look like other common illnesses, like colds, strep throat, or allergies,” the CDC reports. In addition to the COVID-19 symptoms listed above, children may also experience stomachache, poor appetite or poor feeding, especially for babies under 1 year old. In some children, fever may be the only sign of COVID-19 infection.

Early Research Suggests That Gastrointestinal Distress Can Be An Early Warning Sign Of A Coronavirus Infection

Every person with a cough and fever may be asking themselves whether they have COVID-19, but research has shown that gastrointestinal problems can also be a sign of novel coronavirus infection.

In a preprint study from March 18, scientists found that nearly 20 percent of 204 COVID-19 patients from hospitals in Chinas Hubei province, where the outbreak began, had gastrointestinal issues like diarrhea, in addition to fever or respiratory symptoms.

Another analysis of COVID-19 patients in Wuhan, China, shows a distinct group of people with milder respiratory symptoms who experienced diarrhea, abdominal pain or nausea, says Brennan Spiegel, a gastroenterologist and director of Cedars-Sinai Health Services Research. Spiegel co-authored the analysis also still in the preprint stage showing about 20 percent of a patient group had diarrhea as their first symptom of infection.

And as we get further into the current pandemic, says Spiegel, were learning more about the 80 percent of people with COVID-19 who have milder symptoms, or are asymptomatic, and dont need to be hospitalized.

out in the community right now struggling to figure out if the symptoms theyre experiencing could be , in particular digestive symptoms like diarrhea, nausea and vomiting, he adds.

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Yes Diarrhea Can Be A Sign Of Coronavirus But Its Not The Most Common

First of all, just because you have gastrointestinal symptoms doesnt mean you have coronavirus. You might have the flu, a common cold, or something else. There might be something non-viral going on of concern. Or maybe its anxiety. Your doctor is better equipped to tell you that But credible research studies and governmental sites have outlined the common symptoms for coronavirus. Gastrointestinal issues, including diarrhea, are among them. Also be aware that the virus has an incubation stage and the symptoms themselves can take time to worsen . However, again, most people recover from COVID-19.

A new study from the Wuhan Medical Treatment Expert Group for COVID-19 appeared in The American Journal of Gastroenterology. It studied 204 people who received medical care for COVID-19. You can find the study here. The researchers found that digestive problems were far more common in coronavirus patients than other studies indicated, writing that half of patients in our cohort reported a digestive symptom. However, that statistic was inflated by including people reporting a loss of appetite.

This study found that 34 percent of people reported suffering from diarrhea.

They concluded: Although most patients presented to the hospital with fever or respiratory symptoms, we found that 103 patients reported a digestive symptom, including lack of appetite , diarrhea , vomiting , and abdominal pain .

The researchers noted:

Heres the symptom chart from that study:

Fever

Is Diarrhea A Covid

Mayo Clinic expert explains gastrointestinal symptoms related to COVID-19

âCovid is not just cough.”

At this stage of the Covid-19 pandemic, many of us have memorized the hallmark symptoms of the novel coronavirus. Namely, fever, fatigue, dry cough, and shortness of breath.

But new research suggests we may be overlooking other, major signs of Covid-19. Signs that have nothing to do with the respiratory system.

Armed with emerging data drawn from over 400 infected patients in Wuhan, China, scientists on a pair of new studies suggest it may be time to rethink Covid-19 as a strictly respiratory illness.

That’s because the coronavirusâ reach may extend beyond the lungs, jeopardizing the body’s gastrointestinal tract, too.

According to two preliminary studies, here and here, published this month in The American Journal of Gastroenterology , diarrhea, nausea, and lack of appetite may be significant symptoms of Covid-19, even in patients who never develop respiratory symptoms or fever.

âThis is, to me, becoming almost as much a GI condition as a pulmonary condition.”

The studies are not peer-reviewed, and so the findings need to be validated. But they jibe with emerging case reports from other localities outside China, including the United States, the researchers say. The results suggest that clinicians may have overlooked potential coronavirus patients who presented with GI, and not respiratory, symptoms of the virus. Covid-19 may be #NotJustCough.

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What To Do If You Have Gastrointestinal Symptoms

Gastrointestinal symptoms such as diarrhea, loss of appetite, or nausea can have many causes other than COVID-19. Experiencing any of these symptoms doesnât mean you have COVID-19, but they may be early warning signs.

You can treat the digestive symptoms of COVID-19 at home by staying hydrated, avoiding foods that upset your stomach, and getting as much rest as possible.

Can People Who Have The Covid

Typically, vaccinated people who test positive for COVID-19 are either asymptomatic or have very mild symptoms. It rarely results in hospitalization or death. Their symptoms are more like those of a common cold, such as cough, fever or headache, with the addition of significant loss of smell.

As of July 22, there were 65,000 breakthrough cases among the 160 million people who are fully vaccinated. That’s 0.04% of vaccinated people reporting breakthrough cases. No vaccine is 100% effective. With the COVID-19 vaccines averaging about 90% efficacy, health experts expect about 10% of those vaccinated could be infected.

Nationally, 97% of patients hospitalized with COVID-19 are unvaccinated, as of July 22.

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