Is there a correlation between nausea and fever in adult patients with confirmed or suspected COVID‑19?

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Last updated: February 11, 2026 • View editorial policy

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Correlation Between Nausea and Fever in COVID-19

While nausea and fever commonly co-occur in COVID-19 patients, they typically present together as part of a constellation of symptoms rather than as isolated paired findings, with the majority of patients experiencing multiple concurrent respiratory and systemic symptoms. 1

Symptom Co-occurrence Patterns

The evidence demonstrates that gastrointestinal symptoms like nausea rarely occur in isolation in COVID-19:

  • Nausea/vomiting occurs in approximately 5-10% of COVID-19 patients, with reported ranges from 1.0% to 10.1% across cohort studies, and up to 10.2% in a meta-analysis of 4,243 patients. 1

  • Fever is among the most common presenting symptoms alongside dyspnea, cough, and chest pain in COVID-19 patients. 1

  • The critical finding is that patients with nausea or vomiting predominantly present with accompanying typical COVID-19 symptoms (fever, cough, shortness of breath) rather than gastrointestinal symptoms alone. 1

  • In hospitalized children specifically, fever and nausea/vomiting are listed together among the most common signs and symptoms, suggesting frequent co-presentation in this population. 1

Clinical Significance of the Relationship

When nausea occurs, it functions as part of the broader systemic inflammatory response rather than as a direct correlate of fever:

  • Patients with any gastrointestinal symptoms (including nausea, vomiting, abdominal pain, and diarrhea) were more likely to have illness duration of 1 week or longer (33%) compared to patients without GI symptoms (22%). 1

  • In some cases, nausea and other GI symptoms preceded the development of typical COVID-19 respiratory symptoms by a few days, suggesting they may be early manifestations of systemic infection. 1

  • The prevalence of nausea as the only presenting symptom in the absence of other COVID-related symptoms (including fever) was very low among hospitalized patients. 1

Practical Clinical Approach

For outpatients presenting with new-onset nausea, you must:

  • Obtain detailed history of high-risk contact exposure and systematically assess for fever, cough, shortness of breath, chills, muscle pain, headache, sore throat, and new loss of taste or smell. 1

  • Monitor for development of fever and other COVID-19 symptoms over the subsequent days, as GI symptoms may precede respiratory manifestations. 1

  • Consider COVID-19 testing in high-prevalence settings when nausea presents with fever or other systemic symptoms. 1

For hospitalized patients with suspected or confirmed COVID-19:

  • Obtain thorough history of all GI symptoms (nausea, vomiting, abdominal pain, diarrhea) including onset, characteristics, duration, and severity in relation to fever and respiratory symptoms. 1

  • Evaluate for treatment-related GI adverse effects from COVID-19 medications, as drugs like lopinavir/ritonavir can cause nausea, vomiting, and diarrhea in 4-28% of patients. 2

Important Caveats

The reported prevalence rates may not reflect true population-level correlation because most studies focused on hospitalized patients with more severe disease, potentially overestimating or underestimating the actual relationship between nausea and fever in milder cases. 1

Drug-induced symptoms can confound the clinical picture, as multiple COVID-19 treatments cause both fever and nausea as side effects, making it difficult to distinguish disease manifestations from medication effects. 2

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

2
Guideline

COVID-19 and Drug-Induced Liver Injury

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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