SARS-CoV-2 impacts brain-gut axis long-term
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SARS-CoV-2 may have a lasting impact on the brain-gut axis, according to a presentation at Digestive Disease Week.
“It is known that bacterial, protozoa and viral infections of the GI tract represent a risk factor for the development of functional GI disorders like irritable bowel syndrome and functional dyspepsia, as well as chronic fatigue and other extra-intestinal symptoms like somatoform disorders,” Daniele Noviello, MD, University of Milan, said. “In February 2020, a SARS-CoV-2 outbreak occurred in Italy with extreme severity in Milan; this provided us a unique opportunity to assess the long-term impact of SARS-CoV-2, a previously unknown viral infection, on the burden of both GI and extra-intestinal symptoms.”
To assess the frequency and relative risk of long-term GI and somatoform symptoms after SARS-CoV-2 infection, 164 patients with confirmed SARS-CoV-2 infection (mean age 44 years, 40% women) and 183 patients with negative SARS-CoV-2 results (mean age 40 years, 61% women) completed an online questionnaire 5-months post-infection. Researchers evaluated the presence and severity of symptoms using the Structured Assessment of GI Symptoms (SAGIS), Rome IV criteria for IBS, SCL 12 for somatoform disorders and Hospital Anxiety and Depression Scale; patients with a previous diagnosis of IBS, IBD or celiac disease were not included.
According to study results, chronic fatigue (adjusted Relative Risk [ARR] = 2.24; 95% CI, 1.48-3.37; 31.7% vs. 13.7%), somatization (aRR = 3.62; 95% CI, 1.01-6.23; 24.4% vs. 14.2%) and loose stool (aRR = 1.88; 95% CI, 0.99-3.54; 17.8% vs. 9.3%) symptoms persisted at a higher frequency in patients vs. controls. Patients further reported a greater severity of abdominal pain/discomfort and diarrhea/incontinence after their infection resolved.
“Mild gastroenterological symptoms 5 months after SARS-CoV-2 infection increases the risk of chronic fatigue and somatoform disorders. Sequelae could be more severe in patients with diarrhea during the acute infection,” Noviello concluded. “They [persisted symptoms] should be investigated in the follow-up in SARS-CoV-2 patients.”
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Noviello D, et al. Abstract 782 Presented at: Digestive Disease Week; May 21-23, 2021 (virtual meeting).
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