Long COVID-19 patients more likely to have gastroenteritis

NWEW YORK >> Stomach pain, constipation, diarrhea, vomiting, bloating — these are symptoms frequently reported by people with long COVID-19 .

Now a large new study reports that COVID-19 patients were significantly more likely to experience gastrointestinal problems a year after infection than people who were not infected.

The study, published Tuesday in the journal Nature Communications, compared medical records of 154,068 COVID-19 patients in the Veterans Health Administration system with about 5.6 million patients of similar age and other characteristics who had not contracted the coronavirus. COVID-19 patients were 36% more likely to have long-term gastrointestinal problems that they did not have before their infection, with 9,605 of them experiencing issues affecting the digestive system, intestines, pancreas or liver.

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

“There seems to be some dysregulation that points to a major imbalance in acid production,” said the senior author of the study, Dr. Ziyad Al-aly, chief of research and development at the VA St. Louis Health Care System and a clinical public health researcher at Washington University in St. Louis.

Serious inflammatory illnesses — like acute pancreatitis and cholangitis, which is inflammation of the bile duct system — affected a much smaller percentage of patients, but they were nonetheless more common among those who had COVID-19 than those who did not.

“With all of these disorders, there is an increased odds ratio, meaning that the people who had COVID and survived for 30 days or longer were more at risk of each of these categories,” said Dr. Saurabh Mehandru, a professor of gastroenterology at the Icahn School of Medicine at Mount Sinai in New York who was not involved in the study.

Long COVID-19 patients were also at higher risk of gastrointestinal symptoms, the most common being constipation, abdominal pain and diarrhea. The study, like others drawing on the database of veterans, involves a patient population that is largely white and male with an average age of about 61. Still, the same patterns were seen among the study’s 37,000 POST-COVID-19 Black patients and nearly 17,000 POST-COVID-19 female patients, Al-aly said.

The patients became infected during the pandemic’s early waves, testing positive for the coronavirus between March 1, 2020, and Jan. 15, 2021, the overwhelming majority before vaccines were available. Al-aly and Mehandru noted that the experience might be different for people infected more recently. Newer virus variants might have different effects, they said, and some research suggests that vaccines can reduce the risk of various long COVID-19 symptoms.