Long-term gastrointestinal sequelae following COVID-19: A prospective follow-up cohort study

Background and aims: Coronavirus disease 2019 (COVID-19) is associated with long-term gastrointestinal sequelae; however, prospective longitudinal data are sparse. The authors prospectively studied the frequency, spectrum, and risk factors of post-infection functional gastrointestinal disorders/disorders of gut-brain interaction (PI-FGID/DGBI) after COVID-19.
Methods: 320 cases with COVID-19 and 2 control groups, group A, 320 healthy spouses/family controls, and group B, 280 healthy COVID serology-negative controls, were prospectively followed up at 1, 3, and 6 months by using validated Rome IV criteria to evaluate the frequency of PI-FGID/DGBI.
Results: Of 320 cases, at 1 month 36 (11.3%) developed FGID symptoms. Persistent symptoms were noted in 27 (8.4%) at 3 months and in 21 (6.6%) at 6 months. At 3 months, 8 (2.5%) had irritable bowel syndrome (IBS), 7 (2.2%) had functional diarrhea, 6 (1.9%) had functional dyspepsia, 3 (0.9%) had functional constipation, 2 (0.6%) had functional dyspepsia-IBS overlap, and 1 (0.3%) had functional abdominal bloating/distention. Among symptomatic individuals at 3 months, 8 (29.6%) were positive for isolated carbohydrate malabsorption, 1 (3.7%) was positive for post-infection malabsorption syndrome, and 1 (3.7%) was positive for intestinal methanogen overgrowth. None of the healthy controls developed FGID up to 6 months of follow-up (p < 0.01). Predictive factors at 3 and 6 months were severity of infection (p < 0.01) and presence of gastrointestinal symptoms at the time of infection (p < 0.01).

Conclusions: COVID-19 led to significantly higher number of new onset post-infection functional gastrointestinal disorders/disorders of gut-brain interaction compared with healthy controls at 3 and 6 months of follow-up. If further investigated, some patients can be diagnosed with underlying malabsorption.

Prof. Dr. V. Ahuja or Prof. Dr. S. Kedia, Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India,
E-Mail: vineet.aiims@gmail.com

or

E-Mail: dr.saurabhkedia@gmail.com

DOI: DOI: 10.1016/j.cgh.2022.10.015

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