Gastrointestinal Complications of Long COVID

6 Gastrointestinal Complications of Long COVID

Learning Objectives

Describe proposed mechanisms underlying gastrointestinal manifestations of Long COVID, including viral persistence, microbiome alterations, autonomic dysfunction, and gut–brain axis signaling
Recognize common clinical presentations of gastrointestinal Long COVID and integrate these with systemic features such as dysautonomia and fatigue
Develop an evidence-informed approach to diagnosis and management of persistent gastrointestinal symptoms following COVID-19 infection

Faculty:

Linda Geng, MD, PhD – Clinical Associate Professor, Medicine (Primary Care and Population Health) at Stanford University School of Medicine

Students:

AAPM&R Guidelines: Cheng AL, Herman E, Abramoff B, et al. Multidisciplinary collaborative guidance on the assessment and treatment of patients with Long COVID: A compendium statement. PM&R. 2025; 17(6): 684-708. doi:10.1002/pmrj.13397
Geng LN, Erlandson KM, Hornig M, Letts R, Selvaggi C, Ashktorab H, Atieh O, Bartram L, Brim H, Brosnahan SB, Brown J, Castro M, Charney A, Chen P, Deeks SG, Erdmann N, et al.; RECOVER Consortium. 2024 Update of the RECOVER-Adult Long COVID Research Index. JAMA. 2025 Feb 25;333(8):694-700. doi: 10.1001/jama.2024.24184. PMID: 39693079; PMCID: PMC11862971.
Dos Santos Pinto A, Mwangi VI, Neves JCF, Maciel ABS, Neto AV, da Silva Valente J, de Melo GC, Monteiro WM, de Souza Sampaio V, da Costa AG, Almeida-Val FF. Clinical features and inflammatory signatures of patients with persistent gastrointestinal long COVID two years after severe SARS-CoV-2 infection. Sci Rep. 2026 Jan 29;16(1):6620. doi: 10.1038/s41598-026-37595-8. PMID: 41611926; PMCID: PMC12913777.
Kim DY, Youn J, Kang N, Cho SI, Ha IH. Potential application of brain-gut axis-based treatments in Long COVID and ME/CFS: a case-based systematic review. J Transl Med. 2026 Feb 10. doi: 10.1186/s12967-026-07807-w. Epub ahead of print. PMID: 41668172.