Colon to Rectum
Post-COVID-19 irritable bowel syndrome
Objectives: The long-term consequences of COVID-19 infection on the gastrointestinal tract remain unclear. Here, the authors aimed to evaluate the prevalence of gastrointestinal symptoms and post-COVID-19 disorders of gut-brain interaction after hospitalization for SARS-CoV-2 infection.
Design: GI-COVID-19 is a prospective, multicenter, controlled study. Patients with and without COVID-19 diagnosis were evaluated on hospital admission and after 1, 6 and 12 months post hospitalization. Gastrointestinal symptoms, anxiety and depression were assessed using validated questionnaires.
Results: The study included 2183 hospitalized 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 dyspnea. 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, hospitalized 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 irritable bowel syndrome than controls.