Long Covid does not spare the intestines. Five months after Sars-CoV-2 infection, several patients may still present with gastrointestinal disorders which, however, do not appear serious and tend to subside in the long term. Among the most common aftermaths diarrhea and asthenia, an ‘extraintestinal’ symptom, but related to the effects of the virus on the system. This is what emerges from a study conducted by the Milan Polyclinic on 164 patients, published in ‘Neurogastroenterology and Motility’ and selected as an oral communication for ‘Digestive Disease Week’, the largest US gastroenterological congress, reports a note.
Authors of the work Maurizio Vecchi, full professor and director of the Postgraduate School of Digestive System Diseases of the State University of Milan, and Guido Basilisco of the Gastroenterology and Endoscopy Operational Unit of the Polyclinic. “The study – the experts highlight – on the one hand reassures patients suffering from Covid-19 in the sense that the long-term gastrointestinal effects are of mild severity, on the other hand it underlines the possibility that both intestinal and extraintestinal manifestations may persist even for months of distance”.
Already some evidence in the literature – the note recalls – revealed since 2020 how the coronavirus Sars-CoV-2 could also affect the gastrointestinal system, with at least 30% of patients with diarrhea or gastroenterological symptoms in the acute phase of the disease. Less known was the trend over time of these symptoms, an important aspect given that often, after bacterial or viral infections, some of these disorders tend to become chronic even for years, sometimes accompanied by extraintestinal symptoms (back pain, head, weakness) not explained by a specific organic alteration, defined as ‘somatoforms’. This trend characterizes some functional syndromes such as irritable colon or so-called ‘post-infectious’ dyspepsia.
“We analyzed after a time interval of 5 months the patients admitted to our hospital for acute Covid-19 infection – explains Basilico – to understand if the gastrointestinal symptoms that characterize functional gastrointestinal diseases such as irritable bowel, and somatoform symptoms such as fatigue / asthenia, may be present months after infection. We studied 164 patients 5 months after acute Covid infection. The results were compared with those of healthy and Covid-19 negative subjects “.
“The data – summarizes the specialist – show that gastroenterological symptoms are present at a distance from the infection, albeit in a very mild form; the most frequent symptom is diarrhea. Among the extraintestinal symptoms much more frequent is asthenia, which reaches values of 40% among those affected by Covid-19. These results suggest, in line with the most recent literature, that both the symptoms that characterize functional gastrointestinal diseases and the somatoform symptoms may have a common biological origin “.
“Our research has studied a topic of considerable interest, namely the long-term follow-up of patients with an acute Covid-19 infection who in 30-40% of cases had gastrointestinal problems, especially diarrhea – comments Vecchi – Others studies had also shown cases of pancreatitis, clinically not always evident, but detectable by the alteration of the enzymes characteristic of the pancreas. Finally, another strong evidence of the relationship between virus and digestive system is the fact that in acute infection there is a significant fecal elimination of Sars-CoV-2, probably subsequent to the initial phase, during which the virus is localized in the upper airways, before it reaches the other organs and gastrointestinal tissues “.