10 to 15% of covid-19 patients only have sympomts like vomiting and diarrhoea, say AIIMS doctors

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

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

“Interestingly, 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 in the department of gastroenterology at 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 it, said Dr Shalimar, additional professor from the same department.

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, associate professor of medicine at the hospital.

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

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“Pulmonary embolism (blockage of 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. The clotting problems rarely lead to gangrene (death of tissue due to blood supply being cut off), but the doctors presented the case of an 8-year-old boy who was admitted to the hospital with gangrene in the legs and penis.