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People who have had COVID-19 have an overall 36% higher risk of developing gastrointestinal (GI) problems within a year of infection than those who haven’t, according to a large new study. is indicated by
Researchers estimate that SARS-CoV-2 infection has so far caused more than 6 million new gastrointestinal disorders in the United States and 42 million worldwide.
According to researchers led by Evan Shue, a data analyst at the Center for Clinical Epidemiology, a research and development service of the VA St. Louis Health Care System, the more common diagnosis among COVID-infected patients is from stomach upset to acute It’s gotten to pancreatitis. in Missouri.
Signs and symptoms of gastrointestinal problems, such as constipation and diarrhea, were also more common among patients infected with the virus, the study found.
“Overall, our results indicate that persons infected with SARS-CoV-2 are at increased risk of gastrointestinal distress after the acute phase of COVID-19,” the researchers wrote. “Post-COVID care requires attention to gastrointestinal health and disease.”
Result is publish online of Nature Communications.
disease risk rises
Researchers identified 154,068 people with confirmed COVID-19 between March 1, 2020 and January 15, 2021, using data from the U.S. Department of Veterans Affairs’ National Health Database. Statistical modeling was used to compare those patients with 5.6 million patients with similar characteristics. A control group that had not been infected during the same period and a historical control group of 5.9 million patients from March 1, 2018 to December 31, 2019, before the virus began to spread worldwide.
This study included hospitalized and non-hospitalized COVID patients. Although the majority of the study population was male, the study included approximately 1.2 million female patients.
The increased risk of gastrointestinal diagnosis and excess disease burden after 1 year in post-COVID patients compared with controls, respectively, was:
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102% for cholangitis. 0.22 per 1000 people
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62% in peptic ulcer disease. 1.57 per 1000 people
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54% of irritable bowel syndrome (IBS). 0.44 per 1000 people
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47% for acute gastritis. 0.47 per 1000 people
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46% for acute pancreatitis. 0.6 per 1000 people
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36% for functional dyspepsia. 0.63 per 1000 people
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35% for gastroesophageal reflux disease. 15.5 per 1000 people
Also, patients who had been infected with the virus had a higher risk of gastrointestinal symptoms than those without COVID. Researchers found that their risk was 60% higher for constipation, 58% for diarrhea, 52% for vomiting, 46% for bloating, and 44% for abdominal pain.
The risk of developing GI symptoms increased with the severity of COVID-19, and was highest among those in intensive care because of the virus, researchers note.
Subgroup analyzes revealed multiple risks of gastrointestinal outcomes in all subgroups based on age, race, sex, obesity, smoking, cardiovascular disease, chronic kidney disease, diabetes, hyperlipidemia, and hypertension The authors write that it was found that
Increased burden of disease
The rising number of gastrointestinal patients with previous SARS-CoV-2 infection is changing the burden on the healthcare system, says senior author Ziyad Al-Clin, a clinical epidemiologist at Washington University in St. Louis, Missouri. Aly, MD said. Medscape Medical News.
The change could be noticeable in primary care, and gastrointestinal concerns should be seen as triggers for questions about previous SARS-CoV-2 infections, Al-Aly said.
Patients may encounter long wait times at gastroenterology clinics or may give up trying to make an appointment if the wait time becomes too long, he said. If he doesn’t get it, he may go to the emergency department, he added.
Simon C. Matthews, M.D., Ph.D., assistant professor of gastroenterology at Johns Hopkins Medicine in Baltimore, Maryland, said: Medscape Medical News He has seen wait times increase since COVID hit.
“We know the pandemic has impacted the ability and willingness of patients to seek gastrointestinal care. Patients who are only now reconnected to care are experiencing long backlogs. As a result, our clinics are busier than ever, with longer wait times, and unfortunately appointments are longer than we’d like,” said Matthews, who was not involved in the investigation. says.
Abdominal pain, bloating, diarrhea and constipation continue to be among the most common symptoms Mathews sees in the clinic, he said.
Kyle Starrer, M.D., General Brigham Gastroenterologist in Massachusetts, said: Medscape Medical News It is important to distinguish symptoms from definitive diagnosis, which is delayed.
“Are patients attributing their symptoms to COVID, or is COVID itself creating an inflammatory backdrop, causing neurological changes that make these symptoms more common? There is little suspicion of both’Motility Laboratory at Mass General in Boston.
His clinic sees patients with the gastrointestinal signs and symptoms described in the article, but “some diagnoses like peptic ulcer and pancreatitis are less common,” he said. “I suspect they may be related to some of the consequences of being in critical condition in general rather than specific to COVID. I am more skeptical about
Unknown duration of symptoms
Given the relatively short amount of time researchers need to study the virus, it’s difficult to tell patients how long gastrointestinal symptoms will last after Covid-19, he said, not being involved in the study. Mr Staller said.
The symptoms he sees in patients after COVID mimic those of post-infection IBS, and according to the literature, the symptoms can last for months or years, Staller said. . “But they should improve over time,” he added.
Senior author Al-Aly agreed that the duration of post-COVID gastrointestinal symptoms is unknown.
“What I can say is that even people who have been infected with SARS-CoV-2 since March 2020 are returning due to gastrointestinal problems.
Unlike other long-lasting symptoms of COVID, such as brain fog, gastroenterologists are fortunately aware of how to treat the gastrointestinal disturbances that result from SARS-CoV-2 infection, and the long-lasting effects of the virus on the brain. Al-Aly, who has studied the effects of , kidneys, heart and other organs.
All health care providers should “consider COVID as a risk factor for all these diseases” and ask patients about SARS-CoV-2 infection when taking their medical history, he said.
The authors, Staller, and Mathews do not report any relevant financial relationships.
common nut. Published online on March 7, 2023. full text
Marcia Frellick is a freelance journalist based in Chicago. She previously contributed to Chicago She’s Tribune, Science She’s News, Nurse.com and was editor at Chicago She’s the Sun Times, Cincinnati She’s the Enquirer, and St. She’s the Cloud (Minnesota) Times. . Follow her on her Twitter. @mfrellick.
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