Patients with COVID-19 experience GI symptoms more frequently than noninfected controls
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Key takeaways:
- Patients with COVID-19 had lower rates of constipation and hard stools but higher rates of IBS 12 months after infection.
- Researchers expect an increase in diagnoses related to gut-brain disorders.
Hospitalized patients with COVID-19 had a “modest increased risk” for long-term gastrointestinal symptoms and irritable bowel syndrome compared with control patients, according to research published in Gut.
“The data we collected show that those who have contracted COVID-19 experience gastrointestinal symptoms more frequently than those who have not been affected by it,” Giovanni Barbara, MD, study coordinator and professor of medical and surgical sciences at the University of Bologna in Italy, said in a related press release. “Given the vast spread of COVID-19 globally, we should therefore expect an increase in diagnoses related to gut-brain interaction disorders.”
In a prospective study, researchers analyzed data from 883 hospitalized patients to investigate the prevalence of GI symptoms and post-COVID-19 disorders of gut-brain interaction (DGBI). They enrolled 269 patients with SARS-CoV-2 infection (mean age, 49.9 years; 59.9% men) and 269 controls (mean age, 50.9 years; 62.1% men), who were assessed for GI symptoms, anxiety and depression at admission and 1, 6 and 12 months after hospitalization. Secondary study endpoints included assessment of post-infection DGBI predictive factors.
According to results, patients with COVID-19 more frequently reported GI symptoms at enrollment compared with controls (59.3% vs. 39.7%), including nausea (28.8% vs. 12.6%), diarrhea (37.3% vs. 9.4%), loose stools (27.2% vs. 7.9%) and urgency (15.9% vs. 4.9%). However, they reported a lower rate of hard stools (7.7% vs. 12.7%).
At the 12-month assessment, patients with COVID-19 reported lower rates of constipation (9.6% vs. 16%) and hard stools (10.9% vs. 17.7%) but higher rates of IBS (3.2% vs. 0.5%). In addition, they had higher rates of “abnormal” depression (3.4% vs. 2.7%) and anxiety (4.5% vs. 1.1%), according to the Hospital Anxiety and Depression Scale.
A post-hoc multivariate analysis showed that a history of allergies (OR = 10.024; 95% CI, 1.766-56.891), chronic proton pump inhibitor use (OR = 4.816; 95% CI, 1.447-16.025) and dyspnea (OR = 4.157; 95% CI, 1.336-12.934) were predictive factors for IBS.
“We know that the SARS-CoV-2 virus can also infect the gastrointestinal tract, and this confirms the possibility that COVID-19 can lead to the development of irritable bowel syndrome,” Giovanni Marasco, MD, PhD, an assistant professor at the university and first author of the study, said in the release. “Traces of the coronavirus were indeed found in the small intestine even 6 months after infection: This leads us to believe that the prolonged state of inflammation and activation of the immune system may lead to the development of the gastrointestinal symptoms that were observed.”
Reference:
- COVID-19 is associated with an increased risk to develop gastrointestinal disorders. https://www.newswise.com/coronavirus/covid-19-is-associated-with-an-increased-risk-to-develop-gastrointestinal-disorders/?article_id=788991. Published March 20, 2023. Accessed March 29, 2023.
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