COVID and Liver/Gut Symptoms
As we get farther from the start of the COVID-19 pandemic we continue to get more information coming out on how COVID affects our bodies in the short and long term. One of the most common symptoms we have seen come up are changes in digestion and liver function. Specifically a rise in liver enzymes with 1 month of infection. Clinically we have noticed that liver enzymes may take up to 3-6 months post COVID-19 infection to rise to their highest. After this time, if there are no other subsequent illnesses, they should drop back down to normal. But why is this happening? Newer research is giving us some insights.
COVID-19 and the Liver
Elevated liver enzymes can be found in up to 58% of those with COVID-19 infections. Both liver enzymes (AST and ALT) can be elevated, but the most common enzyme elevated is ALT. Approximately 95% of people that have elevated liver enzymes do not have abnormal markers before infection. And many do not present with other complicating conditions prior to infection.
But what is happening with the liver? A recent study shows that COVID-19 virus will enter liver cells specifically after infection and interact with certain receptors. The ACE2 receptor specifically involves the vascular system. Interaction with this receptor and the cells in the liver an gastrointestinal tract can cause damage to the cells and vascular leakage.
So far as we know, this involvement of the liver is transient and will resolve on it’s own, but can take up to months. Some patients we have seen take upwards of a year to resolve. Liver elevations can be scary though. If you have any elevation in liver enzymes, make sure to monitor them on a regular basis and make sure they do not rise too high. If you have any symptoms of yellowing of the eyes or skin, or brown urine, you need to contact your doctor right away.
COVID-19 and the Gut
Gastrointestinal symptoms (GI) are also one of the most common symptoms that arise after COVID-19 infection. Up to 53% of those infected with COVID describe having one of the following symptoms: loss of appetite, nausea, vomiting, diarrhea and abdominal pain.
COVID-19 has also been shown to react directly with the intestinal microbiome. This can lead to diarrhea, or abdominal upset. If antibiotics are used, it can also complicate this outcome. For those with IBS (Crohn’s/Colitis) there does not appear to be any increased risk of complications.
There are not any specific treatments at this time for infection in the gut. But if you did have COVID-19 and start having more GI symptoms, then it should be monitored closely. Work on the microbiome can be done and you can look for changes in the bacteria with comprehensive stool testing. Additionally, if there are any other problems with digestion, they should be analyzed and addressed.
Takeaways
If you have had COVID-19, it is a good idea to get some basic work up done within a month of getting an infection. Basic blood work to check in on liver enzymes is easy and can be ordered by any doctor. Additionally – if you have any abdominal upset, or yellowing of the nails, eyes or skin, you should contact your doctor right away.
Our physicians also work extensively with treating symptoms stimulated by COVID-19 including many autoimmune diseases. If you have any questions about what our clinic can do for you, call our office today.
