with Omicron, duration, which drug?

Santé Publique France reports a return of digestive disorders such as nausea, vomiting and diarrhea in cases positive for the new Omicron BA.4 and BA.5 variants compared to the first Omicron cases (BA1 and BA2). What to do ? How long do they last?

They are rarer but nevertheless present. Gastrointestinal disorders (nausea, vomitingdiarrhoea, etc. can be signs of contamination with the coronavirus responsible for Covid-19. “Typically, the first intestinal symptom is nausea, as is found in common gastroenteritis that can be caused by many viruses. Other patients vomit, some others suffer from diarrhoea”Alessandro Diana explained to us in 2020. “From the start of the epidemic, we realized that 15 to 20% of patients presented with gastrointestinal symptoms, continues our expert. According to a study by researchers at the University of Alberta in Canada, almost 18% of infected people have gastrointestinal symptoms. According to this same study published in the journal Abdominal Radiology, 16% of patients would only present this type of disorder. “What surprises us is the variability of symptoms from patient to patient. Some patients have no digestive symptom while others have only these symptoms. It’s a broad-spectrum disease.” poses our expert. In June 2022, Public Health France confirmed that the digestive disorders such as nausea, vomiting and diarrhea are higher in them positive cases for the new Omicron BA.4 and BA.5 variants compared to the first Omicron cases (BA1 and BA2).

Age and symptoms of BA.4 and BA.5 infection cases compared to previously investigated BA.1 infection cases.
Age and symptoms of BA.4 and BA.5 infection cases compared to previously investigated BA.1 infection cases. © Public Health France

How long do gastrointestinal symptoms last?

According to Alessandro Diana, these symptoms are found especially during the “viral phase of the diseasei.e. the first 5 or 7 days, when the patient excretes the most virus”..

What medicine can you take for diarrhea?

Gastrointestinal symptoms related to SARS-CoV-2 should be treated like a ‘classic’ gastroenteritis. The patient should drink small amounts regularly in order not to become dehydrated and may favor drinks containing sugar and salt in order to compensate for the losses linked to diarrhea and vomiting. He will also have to choose your diet well. Against fever, vomiting and diarrhoea, medication may be taken on medical advice (paracetamol, Spasfon®…) but it requires medical advice as a precaution beforehand.

Children more exposed to gastrointestinal disorders?

According to a pre-publication posted online in August 2020 on the Medrxiv medical platform, children had more gastrointestinal symptoms than adults. According to the first results of this study, still in progress, carried out by researchers at Queen’s University Belfast on 1000 infected children, the gastrointestinal symptoms would be more important in them than the cough or the loss of taste. “Following the first wave of the pandemic in the UK, we learned that half of the children infected with SARS-CoV-2 taking part in this study are asymptomatic. cough or change in their sense of smell or taste, but have gastrointestinal disorders much more frequently”, explained Tom Waterfield, researcher at Queen’s University of Belfast and responsible for the study. Do we know why children have more of these types of symptoms? “The age or the presence of an autoimmune disease are criteria but we have not yet established precise profiles. What are the risk factors? We don’t know” comments Alessandro Diana. Very young children do not present any greater risk of presenting gastrointestinal disorders. However, with the baby, it is necessary to be particularly vigilant and monitor him carefully if he suffers from diarrhea and/or vomiting. Indeed, the infant becomes dehydrated quickly and can lose weight quickly.

Covid-19 or gastroenteritis?

Alessandro Diana recalls the very recent case of a 9 month old baby. “The child had diarrhea and had vomited at the start of the illness. His father had felt mild symptoms of Covid-19, but did not get tested. The test revealed that he was positive, the infant also. The difficulty will be to distinguish between gastroenteritis and Covid-19.” More progressive in the case of Covid-19, the symptoms between gastroenteritis and Covid-19 are however very similar. In the end, only the PCR test (more reliable) will allow us to say whether it is Covid or not.

Diarrhea, nausea, vomiting: when to get tested?

“We know that Covid-19 can cause gastrointestinal symptoms, exclusively or accompanied by other symptoms. So, You should get tested even if you have no other symptoms. more characteristic of the disease. This virus is versatile. The public is more aware of anosmia than of isolated diarrhoea. But yes, Covid-19 may only cause gastrointestinal symptoms!”, asserts the specialist. Thus, these specific symptoms should, in the same way as a dry cough and headaches, push the patient to be tested. In the childthe context of the disease must be taken into account. “The chain of transmission is much more active from adult to child. If a child is sick, it is necessary to find out whether an adult or an adolescent could have contracted the virus in his entourage”, says Alessandro Diana.

What prevention?

“Barrier gestures have proven their worth in this disease. It is important to respect them. You also have to think about thoroughly disinfect the surface of the toilet, the virus is also known to be found in bodily secretions. What matters most is knowing when you are positive. This pushes us to raise the cursor on protective measures, he adds.

Thanks to Doctor Alessandro Diana, pediatrician and infectiologist at the University Hospitals of Geneva. Statements collected in 2020.

Sources:

• Study, Abdominal imaging findings in patients with SARS-CoV-2 infection: a scoping review, journal Abdominal Radiology, September 2020

• UK-wide study shows children with gastrointestinal symptoms should be included in COVID-19 testing, Queen’s University Belfast, August 2020

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