Nausea, Vomiting, and Diarrhea Common in Community-Acquired Acute Viral Respiratory Illness

Individuals with community-acquired acute viral respiratory illness may present with concurrent gastrointestinal (GI) symptoms, according to study results published in Digestive Diseases and Sciences.

Respiratory pathogens are known to develop in addition to GI symptoms, such as diarrhea, nausea, and vomiting. However, the incidence and severity of GI symptoms alongside respiratory infections had not been well examined. Researchers aimed to investigate the prevalence of GI symptoms in those with acute viral respiratory infections and to determine clinical outcomes based on severity.

For the analysis, the researchers collected mid-nasal swabs and self-reported questionnaires from a large-scale community surveillance study. Eligible participants (N=3,183) were aged over 13 years and had 2 or more common symptoms:

• nausea or vomiting
• fever
• headache
• sore throat
• rhinorrhea
• fatigue
• myalgia
• dyspnea
• diarrhea
• ear pain
• rash

Samples were collected and tested by RT-PCR for 26 common respiratory pathogens; nonviral pathogens were excluded from the analysis because of high rates of asymptomatic carriage. Those without respiratory tract symptoms, such as cough, runny nose, or sore throat were also excluded from the study.

In total, 29.4% of study participants reported GI symptoms. GI symptoms were more likely to be reported in adults than children (30.8% in individuals aged ≥ 18 years vs 26.2% in individuals aged < 18 years).

Nausea and vomiting were the most commonly reported GI symptom among both children and adults. GI symptom reporting was associated with a higher likelihood of total symptoms overall (mean 6.9 symptoms reported for encounters with GI symptom vs 4.1 no GI symptom, P <.001). Additionally, those with GI symptoms were more likely to visit a doctor and receive antibiotics for the illness (P <.001).

In unadjusted analysis, the most common pathogens associated with GI symptoms were enterovirus-D68, human metapneumovirus, and human parainfluenza.

Of note, of those who tested positive for influenza virus, vaccination was not associated with an increased risk for GI symptoms. Controlling for number of symptoms reported, age, and seasonal month, no risk reduction of GI symptoms was observed in those vaccinated.

Study limitations include a lack of stool specimen collection. Additionally, as antibiotic and symptom data were collected simultaneously, there may have been a temporal relationship of GI symptoms and antibiotic use.

“Patients presenting with GI and respiratory symptoms should have respiratory virus testing, even if the respiratory symptom is not the primary concern because presence of respiratory viruses may affect recommended isolation and treatment recommendations,” study authors noted.

This article originally appeared on Gastroenterology Advisor