diarrhea

Why do some patients get gastrointestinal symptoms such as diarrhea?

Daily thoughts & numbers on the COVID-19 pandemic from a M.D. working in the front lines at the Emergency Department in a hospital in Stockholm, Sweden.

Clin Gastroenterol Hepatol 2020-04-08 article by D’Amico et al, ‘Diarrhea during COVID-19 infection: pathogenesis, epidemiology, prevention and management‘: *

RESULTS:

Clinical studies show an incidence rate of diarrhea ranging from 2% to 50% of cases. It may precede or trail respiratory symptoms. A pooled analysis revealed an overall percentage of diarrhea onset of 10.4%. SARS-CoV uses the the angiotensin-converting enzyme 2 (ACE2) and the serine protease TMPRSS2 for S protein priming. ACE2 and TMPRSS2 are not only expressed in lung, but also in the small intestinal epithelia. ACE2 is expressed furthermore in the upper esophagus, liver, and colon. SARS-CoV-2 binding affinity to ACE2 is significantly higher (10-20 times) compared with SARS-CoV. Several reports indicate viral RNA shedding in stool detectable longer time period than in nasopharyngeal swabs. Current treatment is supportive, but several options appear promising and are the subject of investigation.

So, in other words, we have ACE2 receptors in our guts too, therefor diarrhea in some patients.

Looks like this:

diarr Image from: D’Amico et al, 2020, Clin Gastroenterol Hepatol. *

COVID-19 Numbers Sweden 2020-04-12 *

899 deaths nationally
- 528 of them in Stockholm
10 483 confirmed cases nationally
DEATHS [SWE]

New confirmed deaths daily in Sweden.
(Number of COVID-19 cases over time in Sweden, updates during mornings at 14:00 so todays numbers are not yet complete until the next day).
ICU [SWE]

New Covid-19 patients Being Treated at the ICU in Sweden.
(Number of COVID-19 cases over time in Sweden, updates during mornings at 14:00 so todays numbers are not yet complete until the next day).
NEW CONFIRMED CASES [SWE]

New confirmed cases daily in Sweden.
(Number of COVID-19 cases over time in Sweden, updates during mornings at 14:00 so todays numbers are not yet complete until the next day).
TOTAL CONFIRMED CASES [SWE]

New confirmed cases accumulated over time in Sweden.
(Number of COVID-19 cases over time in Sweden, updates during mornings at 14:00 so todays numbers are not yet complete until the next day).
Intensive care Sweden: *
- 830 COVID-19 confirmed patients treated in the ICU in total so far
- 10,5 days from symptoms to ICU
- 23,6 % women
  
  Total number of recorded of COVID-19 patients needing ICU care each week. From Week 10 it seems to more than triple each week for the first 4 weeks. From week ten: 5 → 24 → 129 → 424 → 754 → (1038 this week up until now, however since it’s only sunday this weeks numbers are yet incomplete)