COVID-19 gut symptoms may be sign of more severe illness

When Ging and Chuck Gilliam of Loganville, Georgia, both contracted the novel coronavirus in late March, they recognized the symptoms they had heard about on the news: the fever, cough, and shortness of breath.

But the retired builder and nurse experienced some odd symptoms, too, struggling with stomach pain and nausea.

Both landed in the ICU at Piedmont Walton Hospital for weeks.

Chuck Gilliam, who is 85, got very sick first and was hospitalized on March 27, 2020.

"I was fighting the devil, all the way from the entrance gate to the exit," he says.  "I wouldn't wish that on anybody. I lost 53 pounds in five weeks."

When he first got sick, Gilliam says, he was coughing, and struggling to breathe. But, he also felt nauseous.

"I felt at times I was going to vomit," Gilliam remembers.

Ging Gilliam, hospitalized a week after her husband, had some of the same strange symptoms.

She, too, had a cough.

“And, I noticed, after a couple of days, my stomach starts hurting, and I can't eat," she says.

The Gilliams both ended in separate ICU rooms at the hospital where Ging Gilliam had been a nurse supervisor for decades.

They were so sick, the Gilliams were placed into medically-induced comas and put on mechanical ventilators.

 "I was gone," Ging Gilliam remembers. "That medical coma makes you feel like you're already gone."

Although this novel coronavirus is a respiratory disease, researchers estimate about a third to a half of COVID-19 patients develop intestinal symptoms.

Andrew Gewirtz, a professor at Georgia State University’s Institute for Biomedical Sciences, says those early gut symptoms appear to be a warning sign a patient may be at risk of developing more severe disease.

 "So, those people who early on have diarrhea and nausea, those are the ones who are ending up in the hospital with acute kidney failure, living dysfunction, even cardiac abnormalities," he says.

Gewirtz has been studying data from COVID-19 patients at the Medical College of Georgia in Augusta, about 30% of whom report gut symptoms.

 "What we’re thinking is that the intestine is seeding the virus everywhere," Gewirtz says.  "So, the virus can replicate very well in the intestine.   And, also, it will end up in the kidney and cardiac tissue."

Gewirtz says our gut is a "microbiome" made up of trillions of bacteria, both "good" and "bad."

He says how well patients like the Gilliams do may come down to, at least in part, how healthy the balance of bacteria is in their intestinal tract.

"This seems to be one of the big factors that determines how well the virus will replicate in the intestine," he says. "Certain bacteria will promote the replication, other bacteria will inhibit it."

They are early in their research, Gewirtz says, but he hopes to one day develop ways to improve the balance of bacteria in the gut, to help people battle the virus.

The Gilliams are working to regain their strength.

In May, they celebrated their 42nd wedding anniversary, back at home, together.