Adult COVID-19 survivors are at higher risk for digestive diseases, including gastrointestinal (GI) dysfunction, peptic ulcers, gastroesophageal reflux disease (GERD), gallbladder disease, nonalcoholic liver disease, and pancreatic disease—even among patients with mild infections, according to a study published yesterday in BMC Medicine.

Southern Medical University researchers in China mined the UK Biobank database to compare rates of digestive diseases among COVID-19 survivors 30 or more days after infection (112,311), a contemporary comparison group (359,671), and a pre-COVID group (370,979) in the United Kingdom. Median follow-up was 8.4 months.

Participants were adults aged 37 to 73, and COVID-19 survivors were infected from January 2020 to October 2022. The contemporary group was made up of people who lived at the same time as recruitment of the COVID-19 group, and the historical group was made up of uninfected participants with data from January 2017 to October 2019.

GERD, GI disease risk persisted after 1 year

Relative to the contemporary group, elevated risk in COVID-19 survivors was 38% for GI dysfunction (hazard ratio [HR], 1.38), 23% for peptic ulcers, 41% for GERD, 21% for gallbladder disease, 35% for severe liver disease, 27% for nonalcoholic liver disease, and 36% for pancreatic disease.

The risk of GERD rose stepwise with COVID-19 severity, and the risk of GERD and GI dysfunction persisted 1 year after diagnosis (HRs, 1.64 and 1.35, respectively). Reinfected participants had a higher likelihood of having pancreatic disease (HR, 2.57).

This underscores the significance of ensuring that healthcare systems are equipped to provide appropriate care to this population of mild cases, as well as varying degrees of COVID-19 severity.

The study authors said that the reasons for the increased risks may be fecal-oral viral transmission, interactions between the SARS-CoV-2 spike protein and the expression of angiotensin-converting enzyme 2 (ACE2) receptors in the digestive tract, or virus-associated inflammation.

"This underscores the significance of ensuring that healthcare systems are equipped to provide appropriate care to this population of mild cases, as well as varying degrees of COVID-19 severity," they wrote.

Just months after the spread of avian flu was first confirmed in Antarctica's wild birds, the virus has now been detected for the first time in the region's mammals, which include elephant seals and fur seals on the island of South Georgia.

In a statement, the South Georgia and South Sandwich government said following the detection of the virus in wild birds in October, scientists spent 3 weeks aboard a British navy vessel visiting affected islands and collecting samples from dead mammals and birds. Sequencing has identified the H5N1 strain in samples from the two seal species, as well as birds, including brown skuas, kelp gulls, and Antarctic terns.

"The available genomic surveillance data continues to suggest no widespread mammalian adaptation of the virus. There remains no increased risk to human health—the risk of human infection with H5N1 remains very low," the government said.

Animal health groups have warned about the risk of virus spread to Antarctica's wildlife populations, with 48 bird species and 26 mammal species living in the region, often in dense colonies. The latest detections follow further southward spread of the virus, raising worries that the virus could jump to Oceania.

Countries report more outbreaks in poultry, wild birds

Elsewhere, European countries and Japan reported more highly pathogenic avian flu detections in wild birds and poultry, according to the latest notifications from the World Organization for Animal Health. In Europe, Germany reported an outbreak at a poultry farm in Bavaria state, and Denmark reported more detections in wild birds from six locations. And in Japan, animal health officials reported the H5N5 strain in a large-billed crow found dead in Hokkaido prefecture.

The University of Oxford today announced the launch of the first human trial for its candidate ChAdOx1-based Nipah virus vaccine, which was developed by scientists at the school's Pandemic Sciences Institute.

In a statement, Oxford said the phase 1 trial includes 51 adults ages 18 to 55 years old. Researchers will conduct the trial over the next 18 months, with the next phase expected to take place in a country affected by Nipah virus. The Coalition for Epidemic Preparedness Innovations (CEPI) has supported the development of Oxford's Nipah virus vaccine, along with three other candidates, including one from  Massachusetts-based Public Health Vaccines and others from Auro Vaccine and PATH and the University of Tokyo.

Also, an mRNA Nipah vaccine candidate from Moderna is in clinical trials.

Nipah virus, spread by fruit bats, can infect both humans and livestock and can spread person-to-person. People can also contract the virus from drinking palm sap or eating fruit contaminated with bat urine, droppings, or saliva. The disease has a high case-fatality rate, and currently there are no specific treatments or vaccine. CEPI and the World Health Organization have designated Nipah virus as a high-priority pathogen.

Following Argentina's report in December of a rare human Western equine encephalitis (WEE) case, its first in more than two decades, the number of infections has risen to 21, the Pan American Health Organization (PAHO) said yesterday in an update.

Also, as of January 9, health officials have reported 338 outbreaks in animals across Argentina, along with 36 animal outbreaks in Uruguay.

So far, 91 suspected cases have been reported, of which 21 were confirmed. Eleven were from Buenos Aires province, with illnesses also reported from Santa Fe (8), Entre Rios (1), and Santiago del Estero (1) provinces. One of the cases was fatal. All but two of the patients are male, and their ages range from 9 months to 75 years, with most of the cases in people ages 50 and older. The most common symptoms were sudden fever onset, headache, vomiting, and mental confusion.

All patients were hospitalized, and eight needed intensive care unit treatment. Eleven remain hospitalized, and nine have been discharged. Of seven patients with exposure histories, three were veterinarians, two were construction workers, and two had taken part in recreational activities.

Birds are the main hosts of the virus, which can pass the disease to humans and animals through infected mosquitoes. People who work or play outdoors in areas where the virus is endemic or is causing outbreaks in animals are at higher risk of infection.