Why Experts Say Nausea and Throwing Up May Be Unpredictable Signs of Omicron COVID-19 Infections

• Unexplained bouts of nausea and vomiting may be a sign that your body is reacting to a COVID-19 infection caused by Omicron spread.

• Seasonal colds aren't usually linked to vomiting, experts explain, but the lack of concurrent symptoms may suggest other gastrointestinal issues or health issues over COVID-19.

• It is possible that a COVID-19 infection may primarily cause nausea or vomiting alone, especially for those experiencing a breakthrough infection.

• Experts say it's crucial to get tested if you begin to experience other known symptoms, like fever or body aches, alongside throwing up.

If there's one thing that experts know about the Omicron variant of SARS-CoV-2, it's that this strain may commonly lead to under-the-radar COVID-19 symptoms that don't always involve shortness of breath or loss of smell and taste.

Data collected in December and January by leading infectious disease specialists across the globe indicate that Omicron infections are trending towards upper respiratory tract symptoms. While it may be more common to experience a cold-like sore throat during an Omicron infection, experts stress that all known COVID-19 symptoms are a possibility for those impacted by Omicron — including one specific symptom that may be initially misguiding during the winter season.

More healthcare professionals are noticing an influx of COVID-19 patients reporting feeling nauseous and queasy or have uncontrollably vomiting as a primary symptom. While nausea and throwing up don't immediately equate to a COVID-19 infection, these symptoms may present themselves first before other gastrointestinal issues like diarrhea, as noted by providers at Tufts Medical Center. And the issue is that no two COVID-19 cases are the same; the timing and severity of gastrointestinal symptoms like these may lead you to believe that you're suffering from a simple case of food poisoning.

Shruti Gohil, M.D., an associate medical director of epidemiology and infection prevention at University of California Irvine Health, says that chronic nausea and vomiting are not primary symptoms for common colds or most flu cases — you should consider those secondary potential root issues compared to food poisoning, or a COVID-19 infection. When paired with the following symptoms, nausea should prompt you to take next steps in getting your symptoms diagnosed.

What are more symptoms of a COVID-19 infection?

If you're uncertain whether tummy issues are related to a potential COVID-19 sickness, you're not the only one — research on the role of gastrointestinal symptoms on COVID spread during the pandemic has been surprising for most. A 2021 scholarly review published in the Journal of Microbiology, Immunology and Infection found that nausea and vomiting were more commonly associated with initial symptoms than other side effects. The review's authors suggest that nausea, vomiting and issues like diarrhea may be triggered in a COVID-19 infection due to our body's inflammatory response to the virus infection.

Dr. Gohil adds that it's possible that an Omicron-fueled COVID-19 infection may kick off with gastrointestinal symptoms before moving into one or more symptoms. Here's the list of conditions you should be aware of, according to federal officials at the Centers for Disease Control and Prevention:

• Fever and body chills

• Shortness of breath or difficulty breathing

• Headache

• Congestion or runny nose

• Sore throat

• Cough

• Fatigue, or muscle and body aches

• Nausea

• Diarrhea

"You should get tested for COVID-19 if you develop any of the 11 known COVID symptoms," says Dr. Gohil, adding that it's likelier that you're infected if you experience multiple symptoms simultaneously. "But there are many causes of nausea and vomiting, so you should talk to your doctor to see if you need other testing as well."

Are nausea and vomiting a sign of Omicron infections?

While not usually associated with seasonal colds, nausea can be traced back to a myriad of other conditions — everything from food poisoning to irritable bowel syndrome, dehydration to ulcers; even mental issues like stress. Dr. Gohil explains if nausea is the only symptom you're experiencing, a call or a visit to your primary healthcare provider could be the only way to determine what exactly is causing you to be sick. "This list of potential issues is long, but your doctor can work through it fairly easily after talking [about] your history and examining you if necessary."

If you've been recently exposed to someone who has confirmed COVID-19 infection, don't brush off nausea as something else just yet. SARS-CoV-2 can enter the digestive system directly in some cases, meaning it's possible for those who have become infected to experience gastrointestinal symptoms alone, according to Tufts' experts. Cell surface receptors within a GI tract are 100 times "more plentiful" than those in our lungs, and are very susceptible to infectious SARS-CoV-2 virus particles.

Keep a close eye on your nausea and try to rule out more obvious reasons for chronic vomiting, Dr. Gohil advises. If you experience these symptoms for extended periods and can't determine why — or if they shift into other respiratory issues — the best solution is to seek out a COVID-19 test.

The bottom line:

Authors behind the same 2021 COVID-19 review argue that both healthcare professionals and the public should be more cognizant of nausea during the pandemic. "Recognizing characteristics of nausea and vomiting can raise suspicion of COVID-19, leading to early testing and diagnosis of the disease, and help people fight the virus in the long run," they wrote at the time.

Omicron is most likely to affect your upper respiratory tract, triggering things like sore throats, headaches, congestion and fever. But vomiting can be a telltale sign that you may be infected if it's sudden and unexplainable — and should prompt you to get tested or call your doctor, especially if it's accompanied by any other respiratory issue.

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