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What can the gut tell us about long-COVID?

Five different hypotheses that may explain ongoing symptoms.
Gastroenterology Journal Article
Gastroenterology Journal Article

Gastroenterology’s new commentary, Rear Window – What Can the Gut Tell Us About Long-COVID, written by Drs. Moritz Leppkes and Markus F. Neurath, highlights the incomplete understanding of pathophysiology of post-COVID-19 syndrome and the need for continued studies on the potential difference in gastrointestinal infection due to variants of the virus.

The authors share five different hypotheses that may explain ongoing symptoms in the post-acute phase:

  • Tissue damage that occurred during acute COVID-19 as a result of direct viral toxicity, vessel injury, microthrombosis or macrothrombosis, and ongoing or incomplete healing processes might cause persistent symptoms.

  • Incomplete viral clearance and persistent low-level viral replication or continued presence of viral antigens in specialized niches of the body might affect recovery.

  • Autoimmune attacks instigated by the immune response to SARS-CoV2 might cause ongoing damage to specific tissues.

  • Increased body awareness and the perceived association of diffuse symptoms to COVID might spike reporting of symptoms that usually would remain unnoted by health care providers.

  • Consequences of aggressive therapy — especially in the setting of postcritical illness — might contribute to prolonged or incomplete recovery.

Read the full commentary, Rear Window – What Can the Gut Tell Us About Long-COVID, in Gastroenterology this month.

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