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Diarrhea is also a COVID-19 symptom

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The COVID-19 pandemic continues to wreak havoc across the globe. With numbers spiking without any specific reasons, it is all the more important to stay aware of any atypical or still unknown symptoms of the COVID-19 infection. Studies report that while patients typically present with fever and a respiratory illness, some patients also report gastrointestinal symptoms such as diarrhea, vomiting, and abdominal pain.Diarrhea has often been seen as a frequent presenting symptom in patients infected with SARS-CoV-2.2

The SARS-CoV-2 RNA has been detected in stool specimens of infected patients, and its viral receptor angiotensin converting enzyme 2 was found to be highly expressed in gastrointestinal epithelial cells. Put simply, this means that SARS-CoV-2 can actively infect and replicate in the gastrointestinal tract.1 

Data analysis shows an incidence rate of 2-50% cases with diarrhea, which may precede or trail respiratory symptoms. A pooled analysis2 revealed an overall percentage of diarrhea onset of 10.4%.

Emphasizing the link, a September 2020 study also stated there is increasing evidence that other systems are affected by SARS-CoV2; one of which is the gastrointestinal system with several organ-related symptoms and possible implications on prognosis and spread. According to this study, diarrhea is one of the main symptoms of gastrointestinal involvement in COVID-19.3

An in-depth analysis into the cause shows that SARS-CoV-2 of ACE-2-expressing epithelial cells of the small intestine, causes local intestinal damage. This cellular invasion may be the key factor for the much longer duration of SARS-CoV-2 positivity observed for feces compared to pharyngeal swabs. The associated diarrhea in these patients upsets the balance of intestinal flora, resulting in more-severe disease intensity and worse prognosis. Clinicians should be vigilant to this kind of COVID-19-associated diarrhea, and design more effective prevention and treatment options for patients with positive fecal nucleic acid tests and intestinal microflora disorders.4

Some patients with COVID-19 experience gastrointestinal symptoms, particularly diarrhea, as the first sign of illness, according to study published in the American Journal of Gastroenterology.5 Among this subset of patients — who have mild disease overall — respiratory symptoms show up only later in the illness, and some never develop respiratory symptoms at all. The findings are important because those without classic symptoms of COVID-19 — such as cough, shortness of breath and fever — may go undiagnosed and could potentially spread the illness to others, the researchers said. Doctors should thus recognize that sudden digestive symptoms in people with a possible COVID-19 contact “should at least prompt consideration of the illness. It can thus be concluded that the presence of diarrhea should generate suspicion of a possible COVID-19 and should be investigated to reach an early diagnosis.2

Source

1 Wong SH, Lui RS, Sung JJ. Covid-19 and the digestive system. J Gastroenterol Hepatol. 2020;35(5):744-48.
2 D’Amico F, Baumgart DC, Danese S, Peyrin-Biroulet. Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management. Clin Gastroenterol Hepatol. 2020;18(8): 1663–72.
3 Gaber Y. Diarrhoea and the COVID-19 pandemic. Arab J Gastroenterol. 2020;21(3):146-50.
4 Wang F, Zheng S, Zheng C, Sun X. Attaching clinical significance to COVID-19-associated diarrhea. Life Sci. 2020; 260:118312.
5 Pan L, Mu M, Yang P, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Am J Gastroenterol 2020;Article in Press.

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  1. dully

    May 3, 2021 at 4:31 pm

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Coronavirus

Dos and don’ts for vacay activities

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It is not a one size fits all when it comes to vacations or holidays because every family has a different demographic – some may have small kids who need to be taken to a washroom very often, some may have elderly who cannot sit too long during road trips. Therefore, every family should decide based on their own family size, needs and facilities. Traveling will inevitably lead to exposures to unvaccinated kids and adults. But the risk will be decided based on the extent of that exposure.

Masks reduce transmission and have been proven to be an effective tool with vaccination. Wearing a mask indoors and in public spaces further cuts down on risk considerably.

Before you travel:

  1. Get your RTPCR test done

While traveling:

  1. Wear a mask covering your nose and mouth at all times when you are in public places or around individuals that cannot maintain a safe distance of 6 feet away from you.
  2. Avoid crowds and stay at least 6 feet/2 meters from anyone who you do not know personally with their health history.
  3. Wash your hands often or use hand sanitizer (with at least 60% alcohol).

When you return from your vacation:

  1. If you see any signs of COVID, get tested and isolate yourself from other family members as well.
  2. Even if you test negative, stay home and self-quarantine for the full 7 days.
  3. If you don’t get tested, stay home and self-quarantine for 10 days after travel.
  4. Self-monitor for COVID-19 symptoms; isolate and get tested if you develop symptoms.

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It hasn’t affected kids till now – it won’t affect them ever

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Schools reopening across the globe has brought about a sense of panic in some parents and a sense of confidence in others because vaccination for children is yet to come and unvaccinated children are both at direct risk for COVID as well as at risk of transmitting the virus to others.

According to the World Health Organisation (WHO), data suggests that children under the age of 18 years represent about 8.5% of reported cases, with relatively few deaths compared to other age groups and usually mild disease. However, cases of critical illness have been reported. As with adults, pre-existing medical conditions have been suggested as a risk factor for severe disease and intensive care admission in children. Further studies are underway to assess the risk of infection in children and to better understand transmission in this age group.

Although research has shown that children develop severe disease from COVID-19 far less commonly than adults, and therefore, the risk of death due to severity of COVID-19 is also much lower in children. However, they are not immune. There are reports of children dying due to COVID-19.  But even when children do not get seriously ill with COVID-19 or show symptoms, they can still transmit the virus to other children and adults. The rate of child-to-adult transmission of SARS-CoV-2 is roughly half the rate of adult-to-child transmission. So even when the risk is low for children, transmission to other unvaccinated kids and adults is still a serious concern.

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Coronavirus

Vaccination can help us tide over the third wave

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The  second wave is declining, although up to 30-40,000 daily new cases continue to be recorded. India is far from being a COVID-19 free nation. Moreover, the looming third wave and alerts released by different State heads to be prepared for a third wave or to make adequate arrangements for the third wave in terms of oxygen cylinders, beds, critical care wards, etc. has kept us all on our toes and inside homes for fear of expediting the arrival of the third wave.

Eminent virologist and retired professor (CMC Vellore), Dr. T Jacob John, in a recent media interview said if the Government can do justice to the vaccination, in terms of making it available in abundance and everywhere, even the unlikely probability of a third wave can be mitigated, adding that in other words, the third wave can be and must be prevented with vaccination. Dr. John also believes that the two strong waves of COVID-19 pandemic in India would have created high herd-immunity, which is why even a moderate level of vaccination will surely avert the third wave.

We should continue to follow physical distancing protocols and avoid crowding indoors or outdoors as much as possible.

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Coronavirus

Complete vaccinated individuals three times less likely to get COVID-19

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In what comes as more evidence to back completing the (two-dose or one-dose) mandated course for vaccinations for COVID-19, a recent update published by the Imperial College London has shown that people who have received both doses of their coronavirus vaccine are three times less likely to get infected with COVID-19. These results from the 13th round of the Imperial-led REACT-1 study, a major coronavirus monitoring programme, are based on swab tests taken by almost 100,000 people in England between 24 June and 12 July. 

According to their website, REACT (REal-time Assessment of Community Transmission) is a series of studies that are using home testing to improve the understanding of how the COVID-19 pandemic is progressing across England. This major research programme was commissioned by the Department of Health and Social Care (DHSC) and is being carried out by Imperial College London in partnership with Ipsos MORI and Imperial College Healthcare NHS Trust.

The analysis by Imperial College London and Ipsos MORI, which had almost 100,000 volunteers taking part in the study in England between June 24 and July 12, suggests that double vaccinated people are also less likely to pass on the virus to others. Results have also indicated that people who were fully vaccinated were less likely to be carriers of infection to pass the virus on to others, because they have a lower viral load on average and therefore shed less virus. 

In his statement to the Press post release of study results, the UK Vaccines Minister Mr. Nadhim Zahawi also stated, “these results show the positive impact of the vaccination program with those who are double jabbed three times less likely than unvaccinated people to get the virus and less likely to pass on this awful disease to those around them”.

It is important to note that no vaccine has 100% efficacy but benefits outweigh the risks and therefore vaccination is an important step towards curbing the pandemic. Vaccination however, must also be complemented by COVID appropriate behavior.

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Coronavirus

Breastfeeding post vaccination can kill your baby

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There isn’t any research to support this claim, and based on how vaccines work, there is no reason to believe that the vaccine could harm mom or baby. In fact studies support the fact that the vaccines are not excreted into the breast milk, but antibodies produced by mothers in response to the COVID-19 vaccine do — providing hope that breastfed babies might have some level of protection.

A report published in the journal Nature states that COVID-19 vaccines do not carry a risk of igniting an active infection and that they are extremely unlikely to cross into breast milk. The report further elaborates how the fragile messenger RNA used in the Pfizer–BioNTech and Moderna vaccines, is designed to break down so quickly that it should never leave the cells where it was injected. Therefore, it cannot get into the bloodstream and then the breast. In fact, experts believe none of the current vaccines will be excreted into breast milk.

The World Health Organisation (WHO) Strategic Advisory Group of Experts on Immunization (SAGE) Guidance also recommends that mothers continue to breastfeed after vaccination. The Centre for Disease Control (CDC) and the UK Joint Committee on Vaccination and Immunisation issued statements shortly after the first vaccines were authorized in both countries recommending COVID-19 vaccination for breastfeeding women.

Australia’s Department of Health has indicated that breastfeeding women can get an approved COVID-19 vaccine and don’t need to stop breastfeeding before or after. 

Therefore, in conclusion, no safety concerns have been identified in lactating women who have been vaccinated. Women can continue to breastfeed pre and post COVID-19 vaccination.

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