- Two case studies have described unusual cases of COVID-19 in which hiccups appear to be the only major symptom.
- It is possible that hiccups are a rare symptom of COVID-19, but there has not been enough research to say for sure, according to medical experts.
- Visit the Business Insider website for more stories.
Doctors at Cook County Health’s Emergency Medicine Department reported in April an unusual case of COVID-19: A patient whose main symptom appeared to be hiccups.
The 62-year-old man had arrived at the ER after hiccuping four days straight, with no idea why. He had also lost 25 pounds in four months.
Thinking the man would have a tumor between his lungs, the doctors gave him an X-ray for chest. Instead, the scans showed “ground glass,” a common characteristic in the lungs of COVID-19 patients, making them appear cloudy on a scan. They test the man on COVID-19; he was positive.
A similar story unfolded in another case study published in June, which has not been peer reviewed. A 64-year-old man came to the reporting room with persistent hiccups and wheezing. His doctors performed a chest X-ray, saw patterns of green glass, and then tested the patient for COVID-19. He was also positive.
The question that both of these case studies investigate is – are persistent hiccups a symptom of COVID-19? – does not have a solid answer yet. Other than these two examples, the association between hiccups and the new coronavirus has not been much studied.
“My overall task is, it’s bad to say,” Aparajita Singh, a gastroenterologist at the University of California San Francisco, told Business Insider, adding, “I can see why many people would be interested in asking this question. research and try to find an association, because hiccups are very, very common. ”
Still, she said, the existing evidence so far is “very low quality.”
The coronavirus can irritate the digestive system
According to the Healthline Health Information website, “Is hiccups a sign of COVID-19?” was a trending topic last week.
Singh said it is plausible that hiccups may be a sign of COVID-19 for some patients, based on what we know about how the virus and the digestive system interact.
Research has shown that the virus can lead to gastrointestinal problems: One study found that of 204 patients with COVID-19, 103 reported some type of gastrointestinal symptom. The most common were diarrhea and loss of appetite. Six of these patients had no respiratory symptoms – only gastrointestinal. A CDC study similarly found that about half of patients had gastrointestinal symptoms, including diarrhea and vomiting.
When the coronavirus irritates the gastrointestinal tract, it can also affect the phrenic nerve, which controls the membrane. An irritated frenetic nerve can cause involuntary contractions of the diaphragm – also called hiccups.
“Every time, the GI tract is affected. It’s biologically plausible that you could end up with the hiccup,” Lisa Maragakis, senior director of infection prevention at the Johns Hopkins Health System, told Business Insider.
Researchers do not yet know if hiccups and COVID-19 are related
To determine if there really is a link between infection and hiccups, scientists would need more than a few case studies – ideally double-blind threads. Singh noted that in the two cases described, other factors could play a role: The man in the Cook County case study, for example, had low sodium levels, which can also cause hiccups.
To date, none of the larger analyzes have included gastrointestinal symptoms of COVID-19 hiccups. However, Singh said the two case studies piqued her interest.
“I would look more at this symptom, at the literature,” she said. “But I would not add this directly to my list of symptoms.”
Maragakis said they encourage people who have persistent, unusual symptoms such as persistent hiccups, to be “wrong on the side of caution and testing.”
But she added that there is a fine line between being cautious and being unnecessarily afraid.
“Once you try to be vigilant about all the symptoms, we each have things we wonder about every day,” she said.
