Hangover symptoms suck — there’s no debate there. And despite being fully responsible for our own alcohol intake, after a night of heavy social drinking, many of us look for someone or something else to blame for the aftermath. According to new study, you may be able to point a finger at long COVID.
Long COVID continues to be an offshoot of the pandemic that experts are trying to unpack. Also known as post-COVID or post-acute sequelae of SARS-CoV-2 infection (PASC), long COVID is typically marked by a range of lingering symptoms lasting months after an initial diagnosis or infection. Some people have complained of debilitating symptoms years later.
As of late, people are complaining of harsher hangovers as a result of long COVID. In a peer-reviewed study out of Stanford University, it was suggested that SARS-CoV-2 may actually lead to increased alcohol sensitivity.
“The patients highlighted in this report, despite varying demographics and health backgrounds, share a new-onset sensitivity to alcohol post-COVID-19 infection, triggering unprecedented symptoms at similar or lower alcohol consumption levels,” the study reports. “Responses to alcohol varied among patients. Some experienced individual symptoms like headaches or a delayed emergence of symptoms resembling a typical ‘hangover,’ while others experienced a general worsening of their PASC symptoms.”
That said, the study only included four individuals, three women and one man within in the 36-60 age range. So we tapped two trusted infectious disease specialists to weigh in.
Can Long COVID Actually Lead to Increased Alcohol Sensitivity?
Probably not, our experts say. “I am always cautious about drawing too many conclusions from case reports, especially when the sample size (in this instance) is only four people,” says Andrea C. Love, PhD, an immunologist and microbiologist, founder of ImmunoLogic, and advisory board member for POPSUGAR’s Condition Center. On top of that, the data being summarized are from personal accounts; there is no biological or clinical data involved, Dr. Love points out.
“I don’t think anything close to definitive can be established by a case series of just four patients self-reporting their own sensitivity to alcohol,” adds infectious-disease expert Amesh Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security. Even the study authors admit that “a definitive causal link between PASC and alcohol sensitivity cannot be established based on a limited case series,” Dr. Adalja emphasizes.
“Additionally, because there are no defined clinical or biomarker criteria to diagnose PASC, it makes attributing symptoms, especially self-reported symptoms, to viral infection itself challenging,” Dr. Love tells PS. Psychological factors can also impact patient recall of symptoms, making it harder to draw reliable conclusions.
Why Might Alcohol Sensitivity Increase After Infection?
Again, there is no proven connection between alcohol sensitivity and long COVID. But there are a few reasons why someone may have decreased alcohol tolerance after a viral infection, says Dr. Love. The liver, for example, which is responsible for metabolizing alcohol, may have damage of inflammation as a result of infection. “While this is not common in the context of COVID-19, if individuals already have medical conditions that compromise liver function, it could be exacerbated due to viral infection,” she explains.
“Similar with gastrointestinal function, if a viral infection or the subsequent immune response impacted absorption of alcohol, this could impact how alcohol is processed. Similar to liver injury, this is not considered common pathology with SARS-CoV-2,” Dr. Love adds. Residual inflammatory response after infection, dehydration, and certain medications can also impact how alcohol is metabolized.
But none of these factors were measured in the Stanford study. There are tons of additional biomarkers needed for conclusive results, both experts agree. “Some people have reported these types of reactions to alcohol, but it is going to take some time to untangle whether or not this is a true signal and what the physiology may be,” Dr. Adalja says. You’d have to do studies that control for alcohol level, type of alcohol, volume of alcohol, other medications a patient might be on, and more, he tells PS. Dr. Love also says factors like how much sleep participants received, their level of hydration, and physical activity — all of which can increase someone’s sensitivity to consuming alcohol — would need to be accounted for.
Ultimately, according to Dr. Adalja, “The entire article is just anecdote with speculation about what mechanisms could be involved and there is not a physiological link given. It would be arbitrary to postulate any kind of physiological mechanism because there can be many factors at play.”
What Should You Do If You Think Your Hangovers Are Associated With Long COVID?
For starters, never try to self-diagnose or use people on the internet to diagnose, Dr. Love advises. “If you think you have legitimate medical issues associated with PASC (or any medical condition), you should always seek trained and accredited healthcare providers for further evaluation and treatment,” she tells PS. And separately, if you have adverse effects from consuming alcohol, consider limiting or reducing your consumption while simultaneously trying to evaluate a causal relationship, Dr. Love adds.