Docs report jaundice-like issues in nCoV patients

Published OnNovember 26, 2020

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Docs report jaundice-like issues in nCoV patients

Pune: For two whole days, Navin (name changed) reported a stomach discomfort accompanied by an urge to vomit.
By the third day, he started experiencing loose motion. His liver function test showed jaundice-like liver inflammation. All tests for water-borne or food-borne illnesses were negative. His Covid test, however, wasn’t.

Gastroenterologists said they have seen quite a few Covid-induced jaundice-like (hepatitis) cases, where earliest symptoms are nausea and loose motion — not fever. However, of some relief is the fact that the virus has been causing only mild liver dysfunctions. Patients presenting these symptoms, doctors said, are recovering within 10 to 20 days.

“I have seen nearly 12 patients with Covid-induced jaundice-like presentation over the last few days,” said city-based gastroenterologist Vinay Thorat. “Fever is conspicuously absent in them. Their main complaints are nausea, abdominal pain and loose motion.”

He added, “There is no permanent injury to the liver in Covid-linked hepatitis. So, there is no need to panic. Patients recover fast.”

In cases of regular jaundice, patients report high-grade fever, vomiting and appetite loss. Their liver function tests show liver enzymes (ALT and AST) counts of over 1,000. “But in Covid-linked jaundice, patients don’t have fever, yellowish eyes or very yellow urine — commonly seen in regular jaundice. Their liver function tests show liver enzymes (AST and ALT) count not more than three to five times the normal of 40,” said paediatric gastroenterologist, Vishnu Biradar.

Biradar said he has also seen children developing liver inflammation even after full Covid recovery. “I have seen three kids with post-Covid jaundice or liver inflammation. Usually, they have right-upper abdominal pain and vomiting. These symptoms last for about two to three weeks,” he said.

In fact, several Covid patients in Pune — instead of fever or flu-like symptoms — have shown only gastrointestinal (GI) symptoms such as diarrhoea, vomiting and belly pain.

“Absence of fever has been a hallmark of atypical Covid presentations with patients showing only GI symptoms. Lately, I have been seeing quite a few of these baffling cases,” Ruby Hall Clinic’s physician Abhijit Lodha said.

Doctors said patients with irregular symptoms can be a challenge.
Courtesy: TOI

 

“GPs mainly, who are first point of care for many, will have to determine if these symptoms are flare-ups of underlying disease or in fact, Covid-19,” Lodha said.