Long Covid symptoms can include ‘non-trivial’ gastrointestinal issues

People with long Covid can experience potentially serious gastrointestinal symptoms, such as constipation and diarrhoea, a study has concluded.

Other symptoms that stayed with people for up to a year after infection include bloating, chronic acid reflux and stomach pain.

The findings, described by the researchers as often “not trivial”, add to the array of symptoms already associated with the long-term and often debilitating fallout from being infected with Covid-19. These can include fatigue, breathlessness, brain fog, joint pain, and cardiac issues among others.

The US study, published in the journal Nature Communications, was based on the medical records of more than 11.6 million people, 154,000 of whom caught the virus between March 2020 and January 2021.

They were then compared with 5.6 million people who did not catch the disease in that period, and research from some 5.8 million people taken before the outbreak.

The researchers found that those who had the virus experienced more gastrointestinal symptoms a year later than those who did not catch it, and compared with the average pre-pandemic person.

Symptoms tended to be more likely to occur among those who had the virus more severely, including being admitted to hospital, but this wasn’t always the case.

Overall, gastrointestinal issues were 36% more likely in people who were infected. A lingering Covid-19 infection made people 54% more likely to develop signs of irritable bowel syndrome, and digestive symptoms such as constipation, bloating, diarrhoea. People were 35% more likely to have acid reflux disease

The symptoms could often be significant, too. As the researchers argued: “The constellation of findings suggests that people with SARS-CoV-2 infection are at increased risk of gastrointestinal disorders in the post-acute phase of Covid-19.

“The risks and burdens are not trivial – suggesting that post-acute Covid care strategies should include attention to gastrointestinal disease,” they added.

The findings suggested that gastrointestinal disease is “another facet” of the already multifaceted long Covid, the research team said.

“The risks were evident even in people whose acute disease did not necessitate hospitalization. This group represents the majority of people with Covid-19

“Although the absolute burdens (expressed per 1000 persons at 1-year) may appear small, because of the large number of people with SARS-CoV-2 infection, these rates may translate into large number of affected people.

“This will have ramifications not only for the personal health of affected individuals, but also on health systems which will have to address the care needs of people with post-acute Covid-19 gastrointestinal disorders,” they added.

One of the ongoing challenges both for people with long Covid and those supporting them, such as occupational health practitioners, is a lack of clarity about the long-term effects and progress of the condition.

For example, a study published earlier this year suggested people who experience long Covid following only a mild bout of Covid-19 are likely to see their symptoms resolve within a year.

But other studies have argued that long Covid patients can still have organ damage a year on from catching the virus.