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. The alcohol sensitivity that is observed and reported from these patients generates interesting questions and hypotheses. It warrants further study as it may also reveal further insights into pathophysiology and provide guidance for lifestyle management in clinical care. Alcohol consumption can lead to different types of adverse reactions, ranging from mild to severe, from simple flushing to potentially life-threatening anaphylaxis. Those affected may experience symptoms, including facial flushing, nausea, and low blood pressure, even at low levels of consumption.

1. At the Minneapolis-based clinic, only a few long COVID patients have brought up concerns about alcohol intolerance.
2. A neurologist with long COVID in Louisiana also wrote about her experience with it in a March 2021 blog post, and a Reddit thread from last February revealed more people dealing with the same problem.
3. However, these cases reported here may reflect a larger population of individuals with PASC who suffer from new-onset alcohol sensitivity following COVID-19.
4. An NIH spokesperson said in an email that the topic was not asked about or analyzed in the agency’s own research, published in May 2023.
5. It’s a hallmark symptom of POTS (postural orthostatic tachycardia syndrome), which about 2% to 14% of people who test positive for COVID end up developing.

Alcohol reactions and sensitivity are not well characterized in the literature as it relates to post-viral illness. While there have been some anecdotal reports of new alcohol sensitivity in PASC patients in the media, there is a paucity of published data in the medical literature about this topic. During their medical consultation, the patients self-reported new changes in their symptoms or behaviors following the use of alcohol. A new onset of alcohol sensitivities should be assessed along with other post-COVID-19 symptoms and may provide novel avenues to explore the pathobiology of illness and potential interventions. This case series describes four PASC patients who developed new onset alcohol sensitivities after COVID-19 infection. 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.

Has Long COVID Made It Harder to Enjoy Wine? You’re Not Alone

"However, it is a relatively common phenomenon observed in patients with (chronic fatigue syndrome), a related condition to (long COVID), and has been anecdotally reported on social media among patients" with long COVID. While the COVID-19 pandemic is no longer in the crisis stage globally, many people—including some wine lovers—continue to feel its effects. Anecdotal evidence has indicated a potential link between COVID infection and increased alcohol sensitivity. That sensitivity can cause headaches, severe hangover-like symptoms and other effects, including intoxication at low levels of consumption.

New Alcohol Sensitivity in Patients With Post-acute Sequelae of SARS-CoV-2 (PASC): A Case Series

When it’s related to long COVID or another chronic condition, however, alcohol intolerance likely harms the body through a different chemical mechanism that doesn’t involve an inherited genetic mutation or allergy, Komaroff said. Long COVID, also known as post-COVID conditions, occurs when health problems last for weeks, months or even years after a coronavirus infection. It was recognized by the American With Disabilities Act in 2021 and roughly 30% of adults may experience at least one COVID symptom that lasts three months or more, according to research. When stress exceeds a certain limit, it might trigger brain inflammation, resulting in symptoms like those seen in ME/CFS, including alcohol intolerance. Ongoing research, including advanced brain scans, aims to further investigate these connections. However, due to the limited available data on post-COVID-19 alcohol intolerance, it’s unclear whether it’s a temporary or long-term symptom.

Stanford researchers clarified in their writings that they did not find a “definitive causal link” between long COVID and alcohol sensitivity, due to the limited size of their study. Many long COVID patients (along with ME/CFS patients) experience issues with their autonomic nervous system, which plays a critical role in how blood vessels constrict and dilate, but researchers don’t yet fully understand why. Rachakonda said it’s not unreasonable to request a blood test if you’re experiencing alcohol intolerance.

Here, we present a case series of patients reporting alcohol sensitivity following a SARS-CoV-2 infection that were evaluated at the Post-Acute COVID-19 Syndrome (PACS) Clinic at Stanford University. Patients had a history of confirmed COVID-19 infection and persistent post-COVID symptoms that lasted longer than four weeks. Patients 1, 2, and 4’s PASC symptoms persisted since their acute infection, while Patient 3’s PASC symptoms became noticeable two months after their initial COVID-19 infection. PASC symptoms and functional status were assessed during visits through clinical intake forms long covid alcohol intolerance and a comprehensive medical evaluation during their consultation. Alcohol use habits were elicited, and any changes in drinking behaviors or symptoms following alcohol consumption were noted. "Alcohol sensitivity following viral infections in general have not been well characterized in the medical literature," the study said.

While research on alcohol intolerance post-COVID-19 is limited, numerous anecdotal reports suggest that alcohol intolerance could be a symptom of long COVID for some individuals. Because drinking alcohol and being hungover can lead to digestive upset, headaches, mood changes, and difficulty thinking clearly — all symptoms of long COVID — it may worsen these symptoms. To manage increased alcohol sensitivity, Stanford researchers recommend abstinence and avoidance of alcohol, symptom-triggering ingredients and antihistamines. Since this is a case report of just four patients, no causality can be established between long COVID and alcohol sensitivity.

Why do some people have alcohol intolerance after COVID?

True alcohol allergy, a rare occurrence, is an immune response to alcohol compounds that leads to rashes, itchiness, swelling, severe stomach cramps, and potentially severe manifestations, such as anaphylaxis 3. In this case series report, we use the non-specific term "alcohol sensitivity" to describe a range of adverse reactions to alcohol, including symptoms such as fatigue, brain fog, and headaches. Alcohol reactions and sensitivity are not well characterized in the literature as it relates to post-viral illness. The patient used to consume several drinks per week and drink socially, but reported that she had not consumed alcohol for the last seven months due to decreased tolerance.

While not widely recognized as a symptom of long COVID due to limited research, alcohol intolerance has been reported by some individuals. Long COVID refers to persistent symptoms that occur more than three weeks after the initial COVID-19 infection. However, the 2021 study mentioned above suggests that people who drink alcohol often are more likely to develop acute respiratory distress syndrome (ARDS) during COVID-19 hospitalization. Some research suggests that alcohol intolerance is common for people with long COVID.

She also reported worsening anxiety and depression in addition to myalgias and arthralgias with numbness in her hands and feet. Prior to the patient's acute COVID infection, she drank socially without issue, but post-COVID infection, similar amounts of alcohol results in symptoms of flushing and headache. The patient had three doses of COVID-19 vaccine after her initial COVID infection. One, a 49-year-old woman, used to consume several drinks per week before getting COVID. Now, her tolerance has decreased so dramatically that she has not had any alcohol for seven months.

Their experiences varied widely, from mildly increased sensitivity to alcohol to severe intolerance. Other potential mechanisms include disruption of the gut microbiome, which has been reported in long COVID and can also be caused by alcohol. This disruption could affect alcohol absorption and trigger inflammation in the liver, brain and elsewhere. That inflammation, in turn, may be connected to aggravated symptoms and patient discomfort. The good news is that you can avoid alcohol intolerance by avoiding booze altogether.