Long Covid patients more likely to have gastrointestinal issues, study finds

The study, which looked at patients infected early in the pandemic, found they were significantly more likely than people without contracted Covid to suffer from persistent reflux, constipation and other problems.

Stomach pain, constipation, diarrhoea, vomiting, bloating – these are common symptoms reported by people with a long history of Covid.

Now a large new study reports that Covid patients were significantly more likely to have gastrointestinal problems one year after infection than people not infected.

The study, published Tuesday in the journal Nature Communications, compared the medical records of 154,068 Covid patients in the Veterans Health Administration system with about 5.6 million patients of the same age and other characteristics who had not contracted the coronavirus. Patients with Covid were 36% more likely to have long-term gastrointestinal problems than they had before their infection, with 9,605 of them having problems affecting the digestive system, intestines, pancreas or liver.

The most common diagnoses were acid-related disorders, such as gastroesophageal reflux disease (known as GERD) and GERD. peptic ulcer, which have been identified in more than 2,600 patients.

"There appears to be some dysregulation that indicates a major imbalance in acid production," said study lead author Dr Ziyad. Al-Aly, chief of research and development at the V.A. St. Louis Health Care System and clinical epidemiologist at Washington University in St. Louis.

Severe inflammatory diseases - such as acute pancreatitis and cholangitis, which is an inflammation of the bile duct system - affected a much smaller percentage of patients, but were still more common in those who had Covid than in those who did not.

"With all of these disorders there is an increased odds ratio meaning that people who had Covid and survived for 30 days or more were at greater risk of each of these categories,” said Dr Saurabh Mehandru, Professor of Gastroenterology at Icahn Sc hool of Medicine at Mount Sinai in New York which did not participate in the study.

Patients with long-term Covid also had a higher risk of symptoms gastrointestinal complaints, the most common being constipation, abdominal pain and diarrhea

ImageACE2 , the receptor for SARS-CoV-2 (the virus that causes Covid-19), is shown in green, with intestinal epithelial cells in red and cell nuclei in blue. As shown, ACE2 covers a large area of ​​the small intestine epithelium. like others drawing on the veterans database, involves a largely white, male patient population with an average age of about 61. Yet the same patterns were seen among the study's 37,000 post-Covid black patients and nearly 17,000 post-Covid female patients, Dr. Al-Aly said.

Patients were infected during the early waves of the pandemic, testing positive for coronavirus between March 1, 2020 and January 15, 2021, the overwhelming majority before vaccines became available. Dr Al-Aly and Dr Mehandru noted that the experience might be different for those infected more recently. New virus variants could have different effects, they said, and some research suggests vaccines can reduce the risk of various long-lasting Covid symptoms.

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