Diarrhea in coronavirus in humans
The third wave of the pandemic caused by a new coronavirus infection has captured many countries, including Russia. And there are increasing reports that patients have diarrhea as one of their first symptoms.

According to researchers who are constantly updated, COVID-19 is a viral infection that affects not only the respiratory tract, but also many other systems and organs. The immune system rebels, blood vessels suffer, and the digestive tract is often affected. The virus has a tendency to mutate, and its new strains become more aggressive, which means that new forms of infection appear.

The intestinal form of COVID-19 is no less dangerous for patients than its “classic” course. Frequent diarrhea, vomiting threaten with dehydration, which aggravates the already serious condition of the patient. Therefore, any manifestations of the gastrointestinal tract require close attention.1.

What day does diarrhea appear with coronavirus

The incubation period from the moment the virus enters the body to the appearance of the first manifestations is about 3-5 days. At this time, no manifestations of the disease are noted. Signs of digestive disorders may appear first, 2 to 3 days before respiratory manifestations, and if the infection proceeded in a mild form and mainly with intestinal symptoms, it is possible to form an extremely unstable immunity with a high probability of re-infection (if you do not get vaccinated and do not strengthen immunity by vaccinations). In many ways, clinical manifestations can be similar to rotavirus, norovirus, or bacterial gastroenteritis.

Among patients with chronic digestive disorders, manifestations of the intestinal form of COVID-19 may be more severe.2.

Causes of diarrhea with coronavirus

The development of diarrhea in coronavirus can be of primary and secondary origin. In the primary variant, the pathology develops as a result of the direct effect of the virus on the digestive system. If the virus is transmitted by the fecal-oral route (it enters the mouth from dirty hands), it penetrates the stomach and intestinal lumen, attaches to epithelial cells, which also contain ACE2 receptors, like the lungs, and provokes inflammatory reactions.3.

The secondary form of intestinal manifestations in COVID-19 refers to complications and adverse reactions in complex treatment. Thus, almost 80% of patients in the treatment of infection receive massive antibiotic therapy to prevent secondary bacterial complications. The drugs have an extremely negative effect on the microbial flora of the intestine, which leads to antibiotic-associated diarrhea. In addition, diarrhea is possible as an adverse reaction to intoxication, taking other medications, changes in nutrition in the treatment of the disease, as a result of exacerbation of chronic pathologies.

Symptoms of diarrhea with coronavirus

According to various sources, from 10 to 80% of patients report the development of diarrhea in one or another period of the course of COVID-194. Often diarrhea up to 3 – 5 or more times occurs as one of the first manifestations, and respiratory signs of the disease – cough, shortness of breath, sore throat, fever, occur 3 – 4 days later. The most likely manifestations of the intestinal form of coronavirus infection include:

  • a sharp decrease in appetite or its complete absence;
  • diarrhea up to 4 – 5 times a day, stools are liquefied, with an admixture of mucus;
  • nausea, sometimes vomiting;
  • cutting pains in the abdomen or cramping attacks.

Also, against the background of digestive symptoms, dizziness, headache, severe weakness, fever, severe sweating, muscle pain are possible. The duration of symptoms varies from 3-4 to 10 days, and if respiratory manifestations are attached, the infection is more severe.

In addition to the inflammatory response of the intestines and digestive disorders, due to which the absorption of nutrients, vitamins and minerals suffers, a large amount of fluid is lost during diarrhea and vomiting. This threatens the formation of dehydration (severe dehydration), which can complicate the course of the disease.

The elderly, patients with chronic pathologies and overweight people suffer the most from dehydration and complications. Their dehydration is life-threatening.
Ivan KonovalovCandidate of Medical Sciences, infectious disease specialist

Diagnosis of diarrhea in coronavirus

The diagnosis is confirmed similarly to the respiratory form. The basis is the detection of the virus by PCR (smears are taken). In addition, typical complaints are evaluated, and an ELISA test is carried out for antibodies.

There is evidence that the virus can also be isolated from feces, but in practice these tests have not yet been carried out.5.

Treatment of diarrhea with coronavirus

Treatment of the infection is carried out in accordance with the Temporary recommendations of the Ministry of Health6. To combat viruses, interferons are prescribed, antibiotics should be used only with proven bacterial contamination.

To correct the water-salt balance, if there is fluid loss with diarrhea and vomiting, an enhanced drinking regime is used – sweet tea, mineral water without gas, special solutions from the pharmacy (Rehydron, Orasan, Citraglucosolan). Enterosorbent preparations can be used – Smecta, Polysorb, Enterosgel, Filtrum-STI, White coal.

With the development of diarrhea against the background of antibiotic therapy, drugs are recommended that restore the intestinal microflora – Baxet, Linex, Probifor, RioFlora, Acipol.

show more

Popular questions and answers

We discussed with gastroenterologist Valeria Trapeznikova the possibilities of treating diarrhea with coronavirus infection, clarified the features of the diet and tactics if diarrhea does not go away.

What should be the diet for diarrhea against the background of coronavirus?
In each case, there should be an individual approach, depending on the comorbidity. Nevertheless, there are general provisions: you need to drink more, exclude fresh vegetables, fruits and berries, spicy seasonings, smoking, pickles, sour-milk products, fatty foods, fast food from the diet. Products must be subjected to full heat treatment (stewing, baking in the oven, etc.)
How long can diarrhea last with coronavirus?
The duration of diarrhea can be from 3 to 7 – 10 days, depending on the severity of the disease.
Can diarrhea be accompanied by nausea?
With diarrhea, there may well be nausea and other symptoms from the gastrointestinal tract (vomiting, bloating, rumbling, flatulence, and others).
What to do if diarrhea does not go away?
Be sure to consult a doctor and do not self-medicate.
Can you get diarrhea after getting the coronavirus vaccine?
Yes, after vaccination there may be manifestations of functional disorders of the gastrointestinal tract. As a rule, these symptoms do not last long and go away on their own. But, if suddenly, there is no improvement and the state of health worsens, then it is necessary to consult a doctor.
Can you get diarrhea after getting the coronavirus vaccine?
Yes, after vaccination there may be manifestations of functional disorders of the gastrointestinal tract. As a rule, these symptoms do not last long and go away on their own. But, if suddenly, there is no improvement and the state of health worsens, then it is necessary to consult a doctor.
Why does diarrhea occur after suffering a coronavirus?
The receptors affected by the coronavirus are also present in the gastrointestinal tract. Also, drugs that are used in the treatment of covid can cause diarrhea. Well, we must not forget that many patients have chronic diseases of the gastrointestinal tract, which can worsen against the background of coronavirus disease or after recovery.
  1. Drapkina O. M., Maev I. V., Bakulin I. G., Nikonov E. L., Chulanov V. P., Belousova E. A., Veselov A. V., Saiganov S. A., Simanenkov V. I., Bakulina N. V., Avalueva E. B., Oganezova I. A., Skalinskaya M. I., Skazyvaeva E. V., Kashin S. V., Kuvaev R. O. Temporary guidelines: ” Diseases of the digestive system in the context of a pandemic of a new coronavirus infection (COVID-19). Preventive medicine. 2020;23(3):2120-2152. Path: https://doi.org/10.17116/profmed202023032120
  2. Pavlov A.I., Khovanov A.V., Bakirova V.E. On the issue of treatment of intoxication and diarrheal syndrome in coronavirus infection // Effective Pharmacotherapy. 2020. V. 16. No. 24. S. 92–98. DOI 10.33978/2307-3586-2020-16-24-92-98
  3. Gu J., Han B., Wang J. COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission // Gastroenterology. 2020. Vol. 158. № 6. P. 1518–1519.
  4. Xiao F., Tang M., Zheng X. et al. Evidence for gastrointestinal infection of SARS-CoV-2 // Gastroenterology. 2020. Vol. 158. № 6. P. 1831–1833.e3.
  5. Xu Y., Li X., Zhu B. et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding // Nat. Med. 2020. Vol. 26. № 4. P. 502–505.
  6. Nikitenkova K.O., Fedorova Yu.N. Obtaining high-quality planting material for flowers of the bulbous (bulbosus) and lily (liliaceae) families // Proceedings of the Velikoluksky State Agricultural Academy, 2013. Path: https://cyberleninka.ru/article/n/poluchenie-kachestvennogo-posadochnogo-materiala-tsvetov-semeystv -lukovichnye-bulbosus-i-lileynye-lili-ceae

Leave a Reply