The combination of cancer and COVID-19 is highly likely to produce gastrointestinal distress, according to the results of a recent study published in the Journal of Clinical Gastroenterology.

Gastrointestinal distress, an umbrella term for digestive issues such as nausea, vomiting, diarrhea, anorexia (a pronounced lack of appetite) and abdominal pain, is a known symptom of COVID-19 and can “present independently” of respiratory impairment, per Cancer Therapy Advisor.

Certain cancers and cancer treatments can also cause severe gastrointestinal distress, including the nausea and vomiting that can accompany chemotherapy.

However, the prevalence of these symptoms in people who have both COVID-19 and cancer was not known prior to the publication of the study.

Unfortunately, it is very high.

Conducted by researchers affiliated with Harvard Medical School and Brigham and Women’s Hospital, the study identified 36 people with both cancer and COVID-19 (out of 395 people with COVID-19) who had received treatment for one or both diseases in Massachusetts between January and April 2020. COVID-19 infection was confirmed via polymerase chain reaction (PCR) testing, which is among the most accurate diagnostic methods.

The majority of the participants (23, or 63%) reported that they had at least one new gastrointestinal symptom, of which four, or 17%, reported that their symptoms were severe. The most common symptoms were nausea (12, or 52%), anorexia (12, or 52%), diarrhea (9, or 39%), vomiting (8, or 35%) and abdominal pain (6, or 26%).

Acute gastrointestinal distress was associated with an elevation in levels of liver transaminases, enzymes that serve as biomarkers of liver function. The elevation was present in 83% of participants with gastrointestinal symptoms and only 54% of participants without gastrointestinal symptoms.

However, acute gastrointestinal distress was not associated with an increase in disease severity or mortality risk. Over 40% of participants (15, or 42%) received intensive care, and nearly a quarter (8, or 22%) of the participants died.

To learn more about how chemotherapy or immunotherapy could affect the severity of COVID-19 symptoms, read “COVID-19 and Cancer Treatment.” And for a firsthand account of what it’s like to undergo lifesaving medical treatment during a pandemic, read “Fearing the Deadly Combo of COVID-19 and Cancer.” For more on how to handle gastrointestinal side effects from cancer treatment, see “Don’t Let Cancer Treatment Stop You From Eating Well.”