• Posted March 8, 2023

COVID Raises Odds for Long-Term Gastro Problems

Add gastrointestinal problems to the long list of lingering conditions that can follow COVID-19.

New research has found that people who have had COVID-19 are at an increased risk of gastrointestinal disorders within a year of their infection -- including liver problems, acute pancreatitis, irritable bowel syndrome, acid reflux and ulcers in the lining of the stomach or upper intestine.

They may also have an increased likelihood of constipation, diarrhea, abdominal pain, bloating and vomiting, according to researchers from the Washington University School of Medicine in St. Louis, Mo., and the Veterans Affairs St. Louis Health Care system.

"Gastrointestinal problems were among the first that were reported by the patient community,"senior study author Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University, said in a school news release. "It is increasingly clear that the [gastrointestinal] tract serves as a reservoir for the virus."

This is the latest result of Al-Aly's ongoing research into lingering effects of COVID-19 on the brain, heart, kidneys and other organs. Altogether, about 80 adverse health outcomes have been associated with long COVID.

"At this point in our research, the findings on the [gastrointestinal] tract and long COVID did not surprise us,"Al-Aly said. "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."

For this study, the researchers analyzed about 14 million medical records in a database maintained by the U.S. Department of Veterans Affairs.

From that, they created a controlled data set of more than 154,000 people who had tested positive for COVID-19 between March 1, 2020, and Jan. 15, 2021, and lived past the first 30 days.

The investigators then used statistical modeling to compare gastrointestinal outcomes in the COVID-19 survivors with two groups of people who had not had the virus.

Gastrointestinal disorders were 36% more likely in people with COVID-19 than in those who had not had the virus.

"A lot of people draw comparisons between COVID-19 and the flu,"Al-Aly said. "We compared health outcomes in those hospitalized with the flu versus those hospitalized with COVID, and we still saw an increased risk of [gastrointestinal] disorders among people hospitalized with COVID-19. Even this far into the pandemic, COVID-19 remains more serious than the flu."

Those who had past COVID-19 infections had a 62% increased risk of ulcers in the stomach lining or small intestine; a 35% higher risk for acid reflux; and a 46% increased risk for acute pancreatitis.

In addition, they were 54% more likely to have irritable bowel syndrome and 47% more likely to have inflamed stomach lining.

These patients were also 54% more likely to have digestive symptoms such as constipation, diarrhea, bloating, vomiting and abdominal pain.

"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.

The researchers estimate that COVID-19 infections have contributed to more than 6 million new cases of gastrointestinal disorders in the United States and 42 million worldwide.

While the study was mostly made up of older white men, the data also included more than 1.1 million women and adults of all ages and races.

Newer data show that vaccination, which was not available to most during the study period, offers some protection against long COVID.

"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 [gastrointestinal] tract,"Al-Aly said.

The study findings were published online March 7 in Nature Communications.

More information

The U.S. Centers for Disease Control and Prevention has more on long COVID.

SOURCE: Washington University in St. Louis, news release, March 6, 2023