Researchers assessed health data from the U.S. Department of Veterans Affairs, which included information from about 14 million individuals, and determined that people who have had COVID-19 are at increased chance of developing a gastrointestinal issue in the year after their infection. These issues might include acid reflux, acute pancreatitis, irritable bowel syndrome, liver dysfunction, or ulcers in the stomach or upper intestine. After COVID-19, there is also an increase in the risk of gastrointestinal distress, such as abdominal pain, bloating, constipation, diarrhea, and vomiting. The findings have been reported in Nature Communications.
Senior study author Ziyad Al-Aly, MD, a clinical epidemiologist at Washington University School of Medicine in St. Louis, noted that some of the first symptoms patients reported were gastrointestinal problems. "It is increasingly clear that the GI tract serves as a reservoir for the virus."
Previous work by Al-Aly and colleagues has shown that COVID-19 can have a lasting impact on various organs including the heart, brain, and kidneys, and that there are around 80 adverse health impacts that are linked to COVID-19. They were not surprised to find that the GI tract was also affected in a chronic way.
"The virus can be destructive, even among those considered healthy or who have had mild infections. We're seeing COVID-19's ability to attack any organ system in the body, sometimes with serious long-term consequences, including death," Al-Aly noted.
The gastrointestinal system includes the stomach and gut, as well as the mouth, throat, esophagus, rectum, and organs that generate enzymes that aid in digestion, such as the pancreas and liver. SARS-CoV-2 infections, which cause COVID-19, are estimated to have influenced the development of 42 million new cases of gastrointestinal (GI) disorders around the world.
"This is no small number," said Al-Aly "It is crucial to include GI health as an integral part of post-acute COVID care."
In this study, the researchers focused on 154,068 COVID-19 patients who were diagnosed between March 202 and January 2021, and survived for 30 days or more after their diagnoses. These patients were included whether or not they had been hospitalized for their infection, and were compared to over 5.6 million people who had not been infected with COVID-19 during the period, and another group of over 5.8 million people from between March 2018 and December 2019, prior to the emergence of SARS-CoV-2.
This showed that people who had gotten COVID-19 were 36 percent more likely to have a gastrointestinal disorder than people who had not gotten the virus.
Al-Aly noted that this finding demonstrates that the flu and COVID-19 are not comparable, even though some people compare the two. "Even this far into the pandemic, COVID-19 remains more serious than the flu."
The research data was primarily from older white men, although Al-Aly noted that people who had gotten gastrointestinal disorders after COVID-19 spanned all races, ages, and sexes. This study also did not include many vaccinated people because of the time frame, and a lot of the data was obtained before the emergence of some variants.
"While the vaccines may help to reduce the risks of long COVID, they do not offer complete protection against long-term symptoms of COVID-19 that can affect the heart, lungs, brain and now, we know, the GI tract," Al-Aly said.
According to this study, COVID-19 increased the risk of ulcers in the stomach or small intestine by 62 percent, while there was a 35 percent increase in the risk of acid reflux disease, and a 46 percent increase in acute pancreatitis risk. Irritable bowel incidence increased by 54 percent, and there were increases in the risk of digestive issues.
"Taken with all the evidence that has accumulated thus far, the findings in this report call for the urgent need to double down and accelerate our effort to develop strategies to prevent and treat the long-term health effects after COVID-19 infection," Al-Aly said.
Sources: Washington University School of Medicine in St. Louis, Nature Communications
