10 to 15% Covid-19 patients may have only gastrointestinal symptoms, say AIIMS doctors

Around 10 to 15% Covid-19 patients have only gastrointestinal symptoms such as nausea, vomiting and diarrhoea rather than cough, breathlessness or sore throat, said All India Institute of Medical Sciences (AIIMS) doctors at the National Grand Round, a virtual platform for doctors to discuss trends and treatments for the disease.

Covid-19 patients may also suffer heart attack, stroke, clotting problems, kidney or liver dysfunction, the doctors said while discussing the impact of the illness on organs other than lungs.

“...10 to 15% of the Covid-19 patients may present with only gastrointestinal symptoms and no respiratory symptoms. It is, therefore, necessary to test those who have gastrointestinal symptoms for Covid-19 if they show any respiratory symptoms or if they have a history of contact with a positive patient,” said Dr Saurabh Kedia, assistant professor, department of gastroenterology, AIIMS.

The most common gastrointestinal symptoms of Covid-19 are diarrhoea (2 to 50%), appetite loss (30 to 40%), hepatitis (14 to 53%), digestive symptoms (3 to 23%), vomiting and nausea (1-12%), Dr Kedia said. Elevated liver enzymes were also a common finding, with half the Covid-19 patients having them, said Dr Shalimar, an additional professor at AIIMS.

Other than the gastrointestinal symptoms, Covid-19 can lead to clotting problems, heart and brain conditions, kidney injury, and dermatological symptoms, said Dr Neeraj Nischal, an associate professor of medicine at AIIMS.

Data presented by Nischal showed that among the 540 Covid-19 patients in a ward excluding those with dengue and blood cancer, 27% had low platelet count and 2.9% severely low platelet count. Dengue and blood cancers can both lead to low platelet count.

“Pulmonary embolism [the blockage of the blood vessel to the lung due to a blood clot] in Covid-19 patients is much higher as compared to those without Covid-19 – 20.6% as compared to 6.1%,” said Dr Nischal.