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Prolonged GI manifestations in COVID-19 and PASC are attributed to dysbiosis (microbiome imbalance), immune dysregulation and delayed viral clearance from the gut

These pathologies degrade ACE2, leading to increase activation of the ACE2 receptors, virus entry and persistence of inflammatory cytokine storm or oxidative stress (145)

Access to these amenities varies depending on situational medical recommendations and level of care

B12 alone is not enough to justify reflexive imaging, endoscopy, or invasive testing

Patients with a history of pancreatitis or severe gastrointestinal disease should be counselled about specific risks

276,277 Long-term adverse effects of KD include elevated cardiovascular risks with poor cholesterol profiles and nephrolithiasis, likely due to the metabolic effects of the KD, such as uric acidemia, hypocitraturia, hypercalciuria, aciduria, growth retardation, decreased bone mineral density, anemia, and neuropathy, 276,277 and are usually monitored during follow-up