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COVID Impacts

Detailed information and resources on the long-term health consequences of COVID-19 infection and the broad social impacts of the COVID-19 pandemic

Gastrointestinal Complications of COVID

People who have had COVID-19 are at increased risk of developing gastrointestinal (GI) disorders within a year after infection compared with people who haven’t been infected, according to an analysis of federal health data by researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system.

Such conditions include liver problems, acute pancreatitis, irritable bowel syndrome, acid reflux, and ulcers in the lining of the stomach or upper intestine. The post-COVID-19 GI tract also is associated with an increased likelihood of constipation, diarrhea, abdominal pain, bloating and vomiting.


Mechanisms

The receptor for SARS-CoV-2, the angiotensin-converting enzyme 2 (ACE2) receptor, and the cellular serine protease required for viral entry, transmembrane protease serine 2 (TMPRSS2), are co-expressed in the cells of multiple GI organs, including cholangiocytes, colonocytes, esophageal keratinocytes, ileal absorbing enterocytes, and pancreatic β-cells. 

SARS-CoV-2 mRNA was detected in the stool of 54% of COVID-19 patients, and the previously reported point estimate for the prevalence of GI symptoms among patients with COVID-19 was 20%. Collectively, these suggest that direct viral injury is likely the major cause of COVID-19-related GI symptoms 

Irritable Bowel Syndrome