Why Does COVID-19 Cause Diarrhea for Some Sufferers?

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus was formerly believed to be the Source of respiratory illnesses, with the fragile cells of the respiratory system serving as a vehicle for infection to move among people through the respiratory tract. People were urged to go for Rapid COVID Test and look for three common symptoms: fever, a new, persistent cough, and shortness of breath.

After successful evidence of monoclonal antibody treatment, there is evidence that the virus can cause non-respiratory symptoms has increased as the epidemic continues. Currently, COVID-19 is indicated by eleven signs, including two gastrointestinal symptoms, according to the Centers for Disease Control and Prevention (CDC), as more individuals presented with symptoms including nausea, loss of appetite, and diarrhea, interest in the effects of COVID-19 on the gastrointestinal tract started to grow. Early case reports showed the virus in stool samples, suggesting a different fecal-oral transmission route.

Gastrointestinal Symptoms and the Biological Basis of SARS-CoV-2

Angiotensin-converting enzyme two is widely acknowledged as a route by which the COVID-19-causing virus might enter and infect host cells (ACE-2). On the surface of many different cell types, ACE-2 is an enzyme that helps to reduce inflammation. 

Diarrhea Frequency in COVID-19

The effects of diarrhea as a COVID-19 symptom are considerable for overall public health. For locations with inadequate sanitation, the possibility of spreading the virus via the fecal-oral route poses significant difficulties. The virus may make current disinfection techniques, such as chlorination ineffective.

Although rates varied significantly between studies, a comprehensive evaluation of gastrointestinal symptoms in COVID-19 revealed an overall incidence of diarrhea between 5 and 10%. The prevalence rates in more extensive cohort studies range from 20 to 30 percent.

Possible Underreporting of Diarrhea

Studies examining the incidence of diarrhea symptoms after SARS-CoV-2 infections have found lower rates than those seen with other coronaviruses. Some reports indicate that up to 50% of SARS patients and 75% of MERS patients have diarrhea. However, experts think that the magnitude of diarrhea caused by COVID-19 may be understated by the statistics that are now available. A particular definition of diarrhea has only been used in a small number of research so far, neither in terms of the frequency of evacuations per day nor the consistency of stools.

Studies that outline the symptoms of COVID-19 tend to concentrate on the sickest individuals with the greatest danger of fatality, life-threatening disease, or long-term damage. The effect of the infection on the gastrointestinal system has been overshadowed by the virus’s effects on the respiratory or circulatory systems. COVID-19 testing programs and public health awareness campaigns have mostly emphasized identifying respiratory symptoms.

Consequences for Prognosis of Diarrhea in COVID-19

There is still room for clarity about the relationships between diarrhea and clinical outcomes in COVID-19, as well as diarrhea and symptom severity. Studies have occasionally revealed that people with severe COVID-19 illness experience more significant diarrhea.

There is conflicting evidence on when respiratory symptoms first appear and whether gastrointestinal issues follow. In one American research, individuals only had diarrhea after experiencing the characteristic COVID-19 symptoms of cough, fever, and shortness of breath.

More recent research separated COVID-19 patients into three subgroups: those who only experienced respiratory symptoms, those who experienced both respiratory and gastrointestinal symptoms, and a final, smaller category who experienced gastrointestinal symptoms solely. The time between the beginning of symptoms and viral clearance was more significant in patients who underwent stomach symptoms, suggesting a potentially more enormous viral load. This might point to a subset of people who may be unknowingly transmitting the virus.

How to Distinguish this Condition from Others

Passing loose, watery feces three or more times per day, or more frequently than is typical for an individual, is the primary sign of diarrhea. A person with this illness may also experience one or more of the following symptoms, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 

  • an impulse to use the restroom
  • abdominal discomfort; cramps; inability to regulate bowel motions; nausea;

People who have certain diseases and have diarrhea could also:

  • spitting up blood
  • feeling faint and queasy; vomiting

Diarrhea comes in three different forms:

  • Acute diarrhea is frequent, lasts one to two days, and resolves independently. 
  • Although symptoms of chronic diarrhea usually linger for at least four weeks, they may persist or come and go.

Different factors than those that cause acute diarrhea cause chronic diarrhea. Since episodes of severe diarrhea typically recover on their own within four days, it may not always be necessary for doctors to identify the cause. Acute diarrhea is frequently brought on by diseases, traveler’s diarrhea, or some adverse drug effects.


Healthcare professionals should be aware that, in the absence of conventional respiratory symptoms, newly-appearing diarrhea may signify COVID-19 infection. Patients should be advised to have a Rapid COVID test, isolate themselves, and seek medical assistance if they have recently come into touch with an infected person. The oral-fecal transmission pathway should be considered while developing preventative measures to stop the virus from spreading.

Ahsan Ali

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