COVID-19 News: Stanford Study Shows That SARS-CoV-2 Can Cause Individuals To Develop New Alcohol Sensitivity In Post COVID Phase!

COVID-19 News: In the ever-evolving landscape of COVID-19 research, a new and interesting study conducted at Stanford University School of Medicine has recently unveiled a novel aspect of post-acute sequelae of SARS-CoV-2 (PASC), more commonly known as long COVID. The study, presented as a compelling case series and is covered in this COVID-19 News report, brings to light a previously unexplored phenomenon - the development of new alcohol sensitivity in individuals who are recovering from acute COVID-19 infections.


SARS-CoV-2 Is Causing Many To Develop New Alcohol Sensitivity After Infections.

Understanding Post-Acute Sequelae of SARS-CoV-2
Post-acute sequelae of SARS-CoV-2 (PASC) refers to the persistent and varied symptoms experienced by individuals even after the acute phase of COVID-19 has subsided. These lingering symptoms can range from respiratory issues to neurological complications, leading to a spectrum of conditions collectively termed long COVID. While much attention has been given to these symptoms, this groundbreaking study focuses on an intriguing and often overlooked aspect – the emergence of alcohol sensitivity in post-COVID patients.
 
Alcohol Sensitivity - An Uncharted Territory
Alcohol sensitivity, characterized by adverse reactions to alcohol consumption, has long been recognized in various contexts. Genetic conditions, particularly prevalent in East Asian populations, can result in reduced capacities to metabolize ethanol, leading to symptoms such as facial flushing, nausea, and low blood pressure. Post-viral illnesses, such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), have also been associated with increased alcohol sensitivity. However, its association with post-COVID conditions has been notably absent from medical literature until now. This case series aims to bridge this gap by presenting findings from four patients who reported new-onset alcohol sensitivity during their recovery from COVID-19.
 
Case Series Presentation - Unraveling the Link
The study highlights four diverse cases, each with a history of confirmed COVID-19 infection and persistent post-COVID symptoms lasting beyond four weeks. These patients reported symptoms ranging from headaches and cognitive impairment to dysautonomia and shortness of breath. Intriguingly, all four individuals experienced new-onset alcohol sensitivity post-COVID, with varying degrees of adverse reactions, such as headaches, fatigue, and exacerbation of PASC symptoms.
 
-Patient 1, a 60-year-old male with no prior medical history, reported a mild to moderate acute COVID infection managed outpatient with supportive care. Before his initial COVID infection, he consumed alcohol twice a month with no issues. However, post-COVID, the same amount of alcohol now leads to persistent headaches.
 
-Patient 2, a 40-year-old female with a history of Ehlers-Danlos syndrome type III, asthma, anemia, hypotension, and migraines, reported feeling like she suffered from "alcohol poiso ning" after drinking even small amounts of alcohol post-COVID. Her tolerance has decreased significantly, resulting in severe hangovers and exacerbation of PASC symptoms.
 
-Patient 3, a 49-year-old female with a history of type 1 diabetes, celiac disease, and breast cancer, reported a bad reaction, similar to a "bad hangover," after consuming one glass of wine post-COVID. Notably, this patient also met the diagnostic criteria for ME/CFS.
 
-Patient 4, a 36-year-old female with a history of Raynaud’s syndrome, cryoglobulinemia, anxiety, Hashimoto’s thyroiditis, and sleep apnea, reported symptoms of flushing and headache after consuming similar amounts of alcohol post-COVID.
 
Exploring the Mechanisms
The study delves into potential mechanisms behind this newfound alcohol sensitivity in post-COVID patients. Drawing parallels with observations in ME/CFS patients, the researchers propose avenues for investigation, including orthostatic intolerance, autonomic dysfunction, neuroinflammation, and changes in the gut microbiome. These factors, individually or in combination, may contribute to the heightened sensitivity observed in these patients.
 
Orthostatic intolerance (OI), characterized by an individual's inability to tolerate an upright posture due to an abnormal response of the autonomic nervous system, is notably common in patients with ME/CFS. This condition, increasingly recognized in patients with long COVID or PASC, could be a key mechanism exacerbating symptoms in those recovering from viral infections. Alcohol, as a vasodilator and diuretic, may worsen blood pressure drop and dehydration, intensifying symptoms in individuals with OI.
 
Recent observational studies have identified compositional changes within the gut microbiota associated with PASC. Speculatively, alterations in the gut microbiome of PASC patients may affect alcohol absorption. Moreover, alcohol consumption can alter the gut microbiome, increasing permeability and causing inflammation at the liver and elsewhere in the body, potentially leading to neuroinflammation. Future investigations may explore if the altered microbiome in PASC patients, coupled with further alterations from alcohol, triggers exacerbation of immune-modulated responses through inflammatory markers.
 
Prostaglandins and Neuroinflammation - Potential Culprits
The study further explores the role of prostaglandins (PGs) in acute alcohol sensitivity, drawing connections to conditions like Hodgkin’s lymphoma. Elevated prostaglandin E2 levels observed in SARS-CoV-2 infections may provide a potential link to alcohol intolerance in post-COVID patients. Furthermore, neuroinflammation, a recognized factor in ME/CFS pathogenesis, could compromise the blood-brain barrier, potentially increasing sensitivities to alcohol and other substances.
 
The mechanism behind alcohol sensitivity may be related to that seen in Hodgkin’s lymphoma or with medications, such as metronidazole. Some suggest that prostaglandins (PGs) may have a role in acute or short-term alcohol sensitivity or adverse reaction based on the effectiveness of PG inhibitors on hangover and flushing reactions.
 
One case study reporting on a patient with Hodgkin's lymphoma noted that the patient’s pain induced by alcohol consumption improved with ibuprofen. As ibuprofen inhibits the enzyme that produces prostaglandins, the authors suggest that lymph node vasodilation and prostaglandin production may lead to the observed, alcohol-related symptoms. It has been shown that SARS-CoV-2 infections are correlated with elevated prostaglandin E2 levels in the blood serum, with higher levels being associated with more severe infection. If this prostaglandin elevation persists in some patients with PASC, then it may contribute to alcohol intolerance among these patients similar to pathways proposed in alcohol reactions seen in patients with Hodgkin’s lymphoma.
 
Diversity in Responses and Future Implications
The study acknowledges the variability in alcohol sensitivity responses among the cases presented, emphasizing the need for larger cohort studies to establish prevalence, manifestations, and durability of this association. The researchers call for objective measures, such as blood alcohol levels, to quantitatively assess the degree of alcohol reaction relative to ingested amounts.
 
Recommendations and Management
While a definitive causal link between PASC and alcohol sensitivity awaits further exploration, the study suggests that clinicians assessing PASC patients should inquire about alcohol consumption and tolerance. This information can serve as a valuable tool for identifying potential triggers for worsening symptoms and guiding lifestyle management strategies.
 
The Connection Between Alcohol Types and Physiological Effects
Current recommendations for the management of alcohol sensitivity include abstinence, avoidance, or the use of antihistamines to see if the severity of the reaction may be reduced. Patients may be advised to avoid the type of drink or ingredient that may be triggering symptoms. The connection between differences in alcohol type and physiological effect is unclear, including whether it is the ethanol content itself or other compounds that are contained within various types of drinks, such as histamines and sulfites. More investigation is needed to understand the differences in response depending on the type of alcoholic beverage consumed, such as beer, hard liquor, or wine.
 
Conclusion - Opening Doors to Further Research
In conclusion, the Stanford study on new alcohol sensitivity in post-COVID patients marks a significant stride in understanding the diverse manifestations of long COVID. The findings not only provide insights into the pathobiology of post-viral conditions but also underscore the need for comprehensive research to unravel the intricacies of alcohol sensitivity in the context of COVID-19 recovery.

As the scientific community continues to grapple with the complexities of the virus, this study opens doors to further investigation and offers hope for improved clinical care for those navigating the long and winding road of post-COVID recovery. The call for larger cohort studies, quantitative measures, and exploration of biological mechanisms highlights the importance of this research in shaping our understanding of the long-term effects of COVID-19 and offering potential interventions for those experiencing persistent symptoms.
 
The study findings were published in the peer reviewed journal: Cureus.
https://www.cureus.com/articles/152512-new-alcohol-sensitivity-in-patients-with-post-acute-sequelae-of-sars-cov-2-pasc-a-case-series#!/
 
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