The COVID-19 pandemic as a modifier of DGBI symptom severity: A systematic review and meta-analysis

Kulin D 1 , Shah A 1 , Fairlie T 1 , Wong RK 2 , Fang X 3 , Ghoshal UC 4 Show all authors , Kashyap PC 5 , Mulak A 6 , Lee YY 7 , Talley NJ 8 , Koloski N 1 , Jones MP 9 , Holtmann GJ 1

Affiliations 

  • 1 Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
  • 2 Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • 3 Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  • 4 Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, India
  • 5 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
  • 6 Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland
  • 7 School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
  • 8 School of Medicine and Public Health, and Hunter Medical Research Institute, The University of Newcastle, Newcastle, New South Wales, Australia
  • 9 Macquarie University, School of Psychological Sciences, Sydney, New South Wales, Australia
Neurogastroenterol Motil, 2024 Jul 26.
PMID: 39056447 DOI: 10.1111/nmo.14878

Abstract

BACKGROUND: This SRMA reviewed and assessed the changes in the severity of disorders of gut-brain interaction (DGBI) symptoms during the COVID-19 pandemic, and evaluated factors associated with symptom severity changes.

METHODS: Electronic databases were searched until February 2024, for articles reporting on changes in symptom severity in DGBI patients during the COVID-19 pandemic. The proportion of DGBI patients who reported a change in their symptom severity were pooled using a random-effects model, and subgroup analyses were conducted to assess the effect of socio-cultural modifiers on symptom severity in DGBI.

KEY RESULTS: Twelve studies including 3610 DGBI patients found that 31.4% (95% CI, 15.9-52.5) of DGBI patients experienced symptom deterioration, while 24.3% (95% CI, 10.2-47.5) experienced improvement. Countries with high gross domestic product (GDP) had a 43.5% (95% CI, 16.3-75.2) likelihood of symptom deterioration, compared to 9.2% (95% CI, 1.4-42.2) in lower GDP countries. Similarly, countries with low COVID fatality rates had a 60.1% (95% CI, 19.7-90.3) likelihood of symptom deterioration, compared to 18.3% (95% CI, 7.8-36.9) in higher fatality rate countries. Countries with lenient COVID policies had a 58.4% (95% CI, 14.1-92.3) likelihood of symptom deterioration, compared to 19% (95% CI, 8.2-38.1) in countries with stricter policies. Patients in high vaccine hesitancy countries had a 51.4% (95% CI, 19.5-82.2) likelihood of symptom deterioration, compared to 10.6% (95% CI, 2.7-33.4) in low vaccine hesitancy countries.

CONCLUSIONS & INFERENCES: This meta-analysis reveals that a significantly higher proportion of DGBI patients experienced deterioration of symptoms during the COVID-19 pandemic. Various sociocultural, economic and environmental factors potentially modify the effects of the COVID-19 pandemic on DGBI.

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

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