Post COVID-19 irritable bowel syndrome

Marasco G 1 , Cremon C 1 , Barbaro MR 1 , Cacciari G 1 , Falangone F 2 , Kagramanova A 3 Show all authors , Bordin D 3 , Drug V 4 , Miftode E 5 , Fusaroli P 6 , Mohamed SY 7 , Ricci C 8 , Bellini M 9 , Rahman MM 10 , Melcarne L 11 , Santos J 12 , Lobo B 12 , Bor S 13 , Yapali S 14 , Akyol D 15 , Sapmaz FP 16 , Urun YY 17 , Eskazan T 18 , Celebi A 19 , Kacmaz H 20 , Ebik B 21 , Binicier HC 22 , Bugdayci MS 23 , Yağcı MB 24 , Pullukcu H 15 , Kaya BY 17 , Tureyen A 17 , Hatemi İ 18 , Koc ES 14 , Sirin G 19 , Calıskan AR 20 , Bengi G 22 , Alıs EE 25 , Lukic S 26 , Trajkovska M 27 , Hod K 28 , Dumitrascu D 29 , Pietrangelo A 30 , Corradini E 30 , Simren M 31 , Sjölund J 31 , Tornkvist N 31 , Ghoshal UC 32 , Kolokolnikova O 33 , Colecchia A 34 , Serra J 35 , Maconi G 36 , De Giorgio R 37 , Danese S 38 , Portincasa P 39 , Di Sabatino A 40 , Maggio M 41 , Philippou E 42 , Lee YY 43 , Salvi D 44 , Venturi A 1 , Borghi C 1 , Zoli M 44 , Gionchetti P 1 , Viale P 1 , Stanghellini V 1 , Barbara G 45 , GI-COVID19 study group

Affiliations 

  • 1 Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy
  • 2 Medical-Surgical Department of Clinical Sciences and Translational Medicine, University Sapienza Rome, Rome, Italy
  • 3 Loginov Moscow Clinical Scientific Center, Moscow, Russian Federation
  • 4 Gastroenterology, Grigore T Popa University of Medicine and Pharmacy Faculty of Medicine, Iasi, Romania
  • 5 Department of Infectious Diseases, 'Grigore T Popa' University of Medicine and Pharmacy, Iasi, Romania
  • 6 Gastroenterology Unit, University of Bologna, Imola, Italy
  • 7 Internal Medicine Department, Zagazig University, Zagazig, Egypt
  • 8 Gastroenterology Unit, University of Brescia, Brescia, Italy
  • 9 Department of New Technologies and Translational Research in Medicine and Surgery, University of Pisa, Pisa, Italy
  • 10 Department of Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh
  • 11 Gastroenterology Department, Hospital Universitario Parc Tauli, Sabadell, Cataluña, Spain
  • 12 Digestive System Research Unit, Hospital General Vall D'Hebron, Barcelona, Spain
  • 13 Ege University School of Medicine, Izmir, Turkey
  • 14 Division of Gastroenterology, Acibadem University, Altunizade Acibadem Hospital, Istanbul, Turkey
  • 15 Department of Infectious Diseases, Ege University, Izmir, Turkey
  • 16 Division of Gastroenterology, University of Health Sciences, Keciören Education and Research Hospital, Keciören, Turkey
  • 17 Division of Gastroenterology, Eskisehir City Hospital, Eskisehir, Turkey
  • 18 Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Division of Gastroenterology, Turkey
  • 19 Division of Gastroenterology, Kocaeli University, Kocaeli, Turkey
  • 20 Division of Gastroenterology, Adiyaman Education and Research Hospital, Adiyaman, Turkey
  • 21 Division of Gastroenterology, University of Health Sciences, Diyabakır Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey
  • 22 Division of Gastroenterology, Dokuz Eylül University, Izmir, Turkey
  • 23 Division of Gastroenterology, İstanbul Aydın University Florya Liv Hospital, Istanbul, Turkey
  • 24 Division of Gastroenterology, Darıca Farabi Education and Research Hospital, Kocaeli, Turkey
  • 25 Department of Infectious Diseases, İstanbul Aydın University Florya Liv Hospital, Istanbul, Turkey
  • 26 Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Beograd, Beograd, Serbia
  • 27 Clinic of Gastroenterohepatology, Skopje, Macedonia (the former Yugoslav Republic of)
  • 28 Research Division, Assuta Medical Center, Tel Aviv, Tel Aviv, Israel
  • 29 2nd Medical Department of Internal Medicine, University of Medicine and Pharmacy, Cluj-Napoca, Romania
  • 30 Division of Internal Medicine, University of Modena and Reggio Emilia, Modena, Italy
  • 31 Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
  • 32 Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • 33 Medsi Clinical Hospital, Moscow, Russian Federation
  • 34 Division of Gastroenterology, University of Modena and Reggio Emilia, Modena, Italy
  • 35 CIBERehd, University Hospital Germans Trias i Pujol, Barcelona, Spain
  • 36 Gastroenterology, L.Sacco University Hospital, Milan, Italy
  • 37 Department of Translational Medicine, University of Ferrara, Ferrara, Italy
  • 38 Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milano, Italy
  • 39 Division of Internal Medicine "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
  • 40 First Department of Internal Medicine, Università degli Studi di Pavia Facoltà di Medicina e Chirurgia, PV, Lombardia, Italy
  • 41 Geriatric Clinic Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
  • 42 Department of Life and Health Sciences, Cyprus University of Nicosia, Nicosia, Cyprus
  • 43 School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
  • 44 Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
  • 45 Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy giovanni.barbara@unibo.it
Gut, 2022 Dec 09.
PMID: 36591612 DOI: 10.1136/gutjnl-2022-328483

Abstract

OBJECTIVES: The long-term consequences of COVID-19 infection on the gastrointestinal tract remain unclear. Here, we aimed to evaluate the prevalence of gastrointestinal symptoms and post-COVID-19 disorders of gut-brain interaction after hospitalisation for SARS-CoV-2 infection.

DESIGN: GI-COVID-19 is a prospective, multicentre, controlled study. Patients with and without COVID-19 diagnosis were evaluated on hospital admission and after 1, 6 and 12 months post hospitalisation. Gastrointestinal symptoms, anxiety and depression were assessed using validated questionnaires.

RESULTS: The study included 2183 hospitalised patients. The primary analysis included a total of 883 patients (614 patients with COVID-19 and 269 controls) due to the exclusion of patients with pre-existing gastrointestinal symptoms and/or surgery. At enrolment, gastrointestinal symptoms were more frequent among patients with COVID-19 than in the control group (59.3% vs 39.7%, p<0.001). At the 12-month follow-up, constipation and hard stools were significantly more prevalent in controls than in patients with COVID-19 (16% vs 9.6%, p=0.019 and 17.7% vs 10.9%, p=0.011, respectively). Compared with controls, patients with COVID-19 reported higher rates of irritable bowel syndrome (IBS) according to Rome IV criteria: 0.5% versus 3.2%, p=0.045. Factors significantly associated with IBS diagnosis included history of allergies, chronic intake of proton pump inhibitors and presence of dyspnoea. At the 6-month follow-up, the rate of patients with COVID-19 fulfilling the criteria for depression was higher than among controls.

CONCLUSION: Compared with controls, hospitalised patients with COVID-19 had fewer problems of constipation and hard stools at 12 months after acute infection. Patients with COVID-19 had significantly higher rates of IBS than controls.

TRIAL REGISTRATION NUMBER: NCT04691895.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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