A study published this week found that surviving a bout of COVID-19 significantly increases the risk of developing long-term gastrointestinal symptoms and conditions ranging from constipation and diarrhea to chronic acid reflux, pancreatitis and inflammation of the bile ducts. can increase to at Nature Communications.
This study may confirm what many long-time COVID patients already know well. It is one of the largest and most comprehensive for assessing relative and absolute risk elevation.
The study was led by clinical epidemiologist Ziyad Al-Aly, VA Saint Louis Health Care System, St. Louis. Al-Aly, along with his colleagues, reviewed the medical records of more than 154,000 of his COVID-19-infected people between March 2020 and January 2021. The researchers compared the incidence of gastrointestinal disturbances in his COVID survivors one year after infection with those seen in two control groups. cohort. For one, from March 2020 to January 2021 he had no evidence of COVID-19 infection in a modern cohort of over 5.6 million people. The other, 5.8 million people followed in the year before the pandemic, served as a control for unreported COVID-19 cases in a contemporary cohort.
Researchers found increased relative and absolute risks in the form of excess disease burden per 1,000 population for a range of pre-specified gastrointestinal conditions and symptoms. Compared with controls, COVID-19 survivors had more constipation, diarrhea, abdominal pain, vomiting, and bloating during the first year after infection.
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Survivors also had a 35% higher risk of developing GERD (gastroesophageal reflux disease) than controls, with an overburden of 15.5 cases per 1,000 compared to controls. The risk of inflammation of the bile ducts (cholangitis) doubled, but was still rare, with only 0.22 cases of overburden. , with a 54% higher risk of irritable bowel syndrome and 0.44 cases of overburden. Overall, COVID survivors had a 37% higher risk of developing gastrointestinal conditions, with 17.37 overburdens.
The researchers didn’t look at potential health conditions that might be associated with these higher risks, but the more severe a patient’s COVID case, the greater the risk of long-term gastrointestinal problems. In other words, those who were in intensive care with COVID were at highest risk, followed by those who were hospitalized and those who were not. People remained at increased risk across the range of conditions evaluated compared to controls.
Like other forms of prolonged COVID, which can wreak havoc on many parts and systems of the body, it is unclear how viral infections lead to gastrointestinal problems a year after infection. Researchers hypothesized that persistent viruses could be present in some selected areas of the body. Several immunological studies suggest that people with long-term COVID may develop a persistent immune response to the SARS-CoV-2 antigens, a reactivation of the herpes virus (Epstein -bar, etc.), and suggests that you may experience a dangerous combination of chronic inflammation. But so far, researchers have not fully grasped this condition.
It’s also unclear who is at risk of developing long-term problems after COVID-19. Studies have shown that vaccination can reduce his risk of COVID over the long term, but it does not completely eliminate the risk, nor does it appear to eliminate previous infections. Also, an individual’s risk may change over time from the last vaccination/infection and, in some cases, different variants of SARS-CoV-2. In the current study, the time frame of tested COVID cases was largely before the vaccine was widely distributed, making it impossible for researchers to assess the impact of vaccination on risk.
“Overall, the evidence base reinforces the need to continue to emphasize primary prevention of SARS-CoV-2 infection (and prevention of reinfection) as a cornerstone of the public health response,” said Al-Aly and his colleagues. A colleague concluded. “Combined with the accumulating evidence on the magnitude and extent of long-lasting organ failure in COVID-19, the findings of this report are a useful tool for preventing and treating the acute sequelae of SARS-CoV-2 infection. It shows the urgent need to develop a strategy.”
