COVID-19 could cause severe diarrhea, says CECC expert

Central Epidemic Command Center (CECC) advisor Chang Shan-chwen/ Photo courtesy of the CECC

By Chen Wei-ting, Hsu Chih-wei and Elizabeth Hsu

TAIPEI, Taiwan – (CNA) An expert with Taiwan’s Central Epidemic Command Center (CECC) has confirmed recent studies saying that the new coronavirus could cause diarrhea, but he stressed that those who have diarrhea are not necessarily infected with the disease.

Taiwan saw an increase in the number of confirmed cases with diarrhea over the past week, leading health authorities to include the symptom in the definition of COVID-19 infection in addition to fever, coughing and the loss of the senses of taste and smell.

At the CECC’s daily press briefing Monday, CECC advisor Chang Shan-chwen said that after observing the conditions of COVID-19 patients who had diarrhea, he found some patients suffered up to eight runs a day while others just had loose bowels.

“Diarrhea is a common physiological phenomenon,” Chang said, noting that diarrhea could be caused by norovirus or food poisoning. The CECC has recently been worried about people with severe diarrhea, especially those returning from overseas trips or who had recent contact with COVID-19 patients, Chang said.

But those who have no contact or recent overseas travel history have no reason to worry they have the coronavirus if they have a brief bout with diarrhea, he said.

According to CECC data, 19 of the 322 cases confirmed before March 31 had diarrhea symptoms or about 6 percent. Of the 26 cases confirmed between April 1 – 3, however, five, or 19 percent, experienced diarrhea.

The global medical community has increasingly recognized digestive symptoms as possible markers of COVID-19 in recent weeks.

The American Journal of Gastroenterology, for example, published a study on March 18 based on the experience of patients in Wuhan showing that digestive symptoms, including diarrhea, were common in coronavirus patients.

After Taiwan’s latest findings, people with unexplained diarrhea in addition to overseas travel or contact history will be required to seek medical attention and testing, the CECC said.

Chang also noted Monday that the viral load in COVID-19 patients was found to reach its highest level within seven days after the onset of the disease, citing foreign research finding that five days after the onset, the virus reproduces massively in the esophagus and is the most infectious.

“When patients began to develop symptoms, we normally detect high viral loads. As symptoms ease, the viral load will also decline,” he said.

He also said those carrying the virus but who show no symptoms can still pass the virus on to others via close contact.

On Monday, Taiwan confirmed ten new COVID-19 cases, bringing the total to 373 since the pandemic began late last year, according to the CECC’s latest update.

Fifty-seven of Taiwan’s COVID-19 patients have been released from quarantine, while five have died. The others are still being quarantined and observed in hospitals, the CECC said.


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