Diarrhea Could Be a First Symptom of CCP Virus: Study

Transmission electron micrograph of CCP virus particles, isolated from a patient. Image captured and color-enhanced at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Md. NIAID

Some patients infected with the CCP (Chinese Communist Party) virus, commonly known as the novel coronavirus, could experience gastrointestinal symptoms including diarrhea as their first symptoms, a new study suggests.

The study (pdf), published March 30 in The American Journal of Gastroenterology, examined patients with “low severity disease” who displayed digestive symptoms, and found that some only later developed respiratory symptoms or fever—or not at all.

“In some cases, the digestive symptoms, particularly diarrhea, can be the initial presentation of COVID-19, and may only later or never present with respiratory symptoms or fever,” the researchers wrote.

“Although COVID-19 most commonly presents with respiratory symptoms, such as cough and shortness of breath, there is evidence that the illness can also present with non-respiratory symptoms, most notably digestive symptoms such as diarrhea, diminished appetite, and nausea.”

They noted that the findings are important as those infected but not presenting textbook symptoms of the virus may remain undiagnosed. They may also unknowingly transmit the virus to others, the researchers said.

Health experts say that CCP virus symptoms include a dry cough, shortness of breath, and fever and that it can lead to pneumonia, particularly in the elderly and in those who have preexisting conditions.

The authors said the emergence of gastrointestinal symptoms in those who may have come into contact with a CCP virus-positive patient “should at least prompt consideration of the illness.”

A failure to recognize these patients in the early stage may lead to unwittingly spreading the disease.

The study analyzed the symptoms of 206 patients with mild cases of CCP virus at Union Hospital, Tongji Medical College, in Wuhan, China. Of the 117 patients with gastrointestinal symptoms, about 67 (58 percent) experienced diarrhea, and 13 (19.4 percent) of these had diarrhea as their first symptom of the CCP virus.

The remaining patients developed diarrhea within the first 10 days after the onset of respiratory symptoms, the researchers noted, adding that on average, patients experienced the symptom for around five days.

“COVID-19 is not just a cough,” Dr. Brennan Spiegel, co-author of the paper, told TODAY. “Of course, we’re very focused on the lungs because that’s what can cause people to die. But this virus, if it gets into your saliva and you swallow it, can then enter the intestinal system.”

“I don’t want people to panic and think, ‘Oh my god, I had some loose stools, so I have COVID-19.’ Well, probably not,” he added. “I would say this: If you have new onset diarrhea—you’ve not had it before, and now all of a sudden you have new diarrhea—and you have a fever, that should be something that causes you to contact your doctor anyway, whether we’re in a pandemic or not.”