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Background Many of the studies on COVID‐19 severity and its associated symptoms focus on hospitalized patients. The aim of this study was to investigate the relationship between acute GI symptoms and COVID‐19 severity in a clustering‐based approach and to determine the risks and epidemiological features of post‐COVID‐19 Disorders of Gut–Brain Interaction (DGBI) by including both hospitalized and ambulatory patients. Methods The study utilized a two‐phase Internet‐based survey on: (1) COVID‐19 patients’ demographics, comorbidities, symptoms, complications, and hospitalizations and (2) post‐COVID‐19 DGBI diagnosed according to Rome IV criteria in association with anxiety (GAD‐7) and depression (PHQ‐9). Statistical analyses included univariate and multivariate tests. Results Five distinct clusters of symptomatic subjects were identified based on the presence of GI symptoms, loss of smell, and chest pain, among 1114 participants who tested positive for SARS‐CoV‐2. GI symptoms were found to be independent risk factors for severe COVID‐19; however, they did not always coincide with other severity‐related factors such as age >65 years, diabetes mellitus, and Vitamin D deficiency. Of the 164 subjects with a positive test who participated in Phase‐2, 108 (66%) fulfilled the criteria for at least one DGBI. The majority ( n = 81; 75%) were new‐onset DGBI post‐COVID‐19. Overall, 86% of subjects with one or more post‐COVID‐19 DGBI had at least one GI symptom during the acute phase of COVID‐19, while 14% did not. Depression (65%), but not anxiety (48%), was significantly more common in those with post‐COVID‐19 DGBI. Conclusion GI symptoms are associated with a severe COVID‐19 among survivors. Long‐haulers may develop post‐COVID‐19 DGBI. Psychiatric disorders are common in post‐COVID‐19 DGBI.

Domperidone is an effective antiemetic used worldwide, but there have been reports of possible cardiotoxicity. Our goal was to explore the cardiac safety and clinical efficacy of long-term domperidone, titrated as high as 120 mg/day, in patients not responding or unable to tolerate other therapies for gastroparesis (GP).This retrospective cohort study was conducted at a single tertiary care academic center. We objectively assessed the safety and efficacy of domperidone through questionnaires, clinical follow-up and frequent ECGs as mandated by the Food and Drug Administration. We excluded patients with a history of dangerous arrhythmias, prolonged QTc, clinically significant electrolyte disturbances, gastrointestinal hemorrhage or obstruction, presence of a prolactinoma, pregnant or breastfeeding females, or allergy to domperidone. A total of 21 patients met the inclusion criteria for eligibility in this study (52.4% white, 42.9% Hispanic; mean age 50.1 years; 90.5% female). The mean duration of domperidone therapy was 52.3 (range 16–97) months with a mean highest dose of 80 mg/day (range 40–120 mg). Two patients (9.5%) taking 120 mg/day experienced asymptomatic meaningful QTc prolongation (>450 ms in males, >470 ms in females). One-third of patients had asymptomatic non-meaningful QTc prolongation. Palpitations or chest pain was reported in 19% of patients without ECG abnormalities or adverse cardiac events. The mean severity of vomiting and nausea was improved by 82% and 55%, respectively.Long-term treatment with high doses of domperidone (40–120 mg/day) improved GP symptoms in patients previously refractory to other medical therapies and with a satisfactory cardiovascular risk profile.