Some Covid-19 patients show only gastrointestinal symptoms: Doctors

Some Covid-19 patients may only show gastrointestinal symptoms, such as nausea, vomiting and diarrhoea, an examination of findings, published in the Abdominal Radiology journal, from 36 studies done across the world from July has shown.

The Bengaluru-based gastroenterologists say most common presentation is extreme fatigue, diarrhoea, loss of appetite and gastric symptoms.

At Meenakshi Institute of Gastroenterology and Fortis Hospital, doctors have seen three to four cases out of 20 patients with this presentation. They have seen a few cases of jaundice and pancreas as well.

Dr Praveen Kumar A C, a medical gastroenterologist at St Martha’s Hospital and a Professor at Rajarajeshwari Medical College, Kengeri, told DH that every second day, he sees such patients and that they’re quite common.

“Initially, when the pandemic started, we were not aware. We’re lucky to not have picked up infection despite this. We’ve had patients with weakness and loss of appetite, but no other respiratory symptoms like cold, cough or fever. Some had just hiccups or
vomiting.

A subset of patients had loose motions and abdominal pain but no respiratory symptoms. As we started treating more patients, we were surprised to see that 60% to 70% of patients tested positive for Covid. Any patient who requires endoscopy is being asked to get an RT PCR test,” Dr Kumar said.

Dr S Ravindra, director of gastroenterology and hepatology, Fortis Hospital, said, “Most common presentation we’re seeing is extreme tiredness, weakness, gastric-like features and diarrhea. Some come with jaundice and pancreatitis (inflamed pancreas) also. When we check them, most of them turn out to be Covid positive. We should also get a chest CT done to check for Covid characteristics. Whenever we order a CT abdomen, pelvis we ask radiologists to also screen the chest.”

Dr C Vikram Belliapa, a surgical gastroenterologist, Vikram Hospital, said, “While a majority of Covid patients show respiratory symptoms, a minority can show symptoms of other (body) systems. A small percentage of these can show only gastrointestinal presentation.

This is known to happen from our observational experience. Covid has various manifestations that affect almost all systems of the body - dermatological, psychiatric, etc. The fine difference to understand here is whether Covid patients will present with only gastro symptoms or along with gastro symptoms.”

Dr N S Nagesh, surgical gastroenterologist, PMSSY Hospital, said, “Sometimes it is possible for Covid patients to present with loose stools and diarrhea. The virus affects the lungs but for some patients, it is the gut. It is a sequela of the viral infection.”