A Systematic Review of the Prevalence of Persistent Gastrointestinal Symptoms and Incidence of New Gastrointestinal Illness after Acute SARS-CoV-2 Infection

Abstract

It is known that SARS-CoV-2 infection can result in gastrointestinal symptoms. For some, these symptoms may persist beyond acute infection, in what is known as ‘post-COVID syndrome’. We conducted a systematic review to examine the prevalence of persistent gastrointestinal symptoms and the incidence of new gastrointestinal illnesses following acute SARS-CoV-2 infection. We searched the scientific literature using MedLine, SCOPUS, Europe PubMed Central and medRxiv from December 2019 to July 2023. Two reviewers independently identified 45 eligible articles, which followed participants for various gastrointestinal outcomes after acute SARS-CoV-2 infection. The study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools. The weighted pooled prevalence for persistent gastrointestinal symptoms of any nature and duration was 10.8% compared with 4.9% in healthy controls. For seven studies at low risk of methodological bias, the symptom prevalence ranged from 0.2% to 24.1%, with a median follow-up time of 18 weeks. We also identified a higher risk for future illnesses such as irritable bowel syndrome, dyspepsia, hepatic and biliary disease, liver disease and autoimmune-mediated illnesses such as inflammatory bowel disease and coeliac disease in historically SARS-CoV-2-exposed individuals. Our review has shown that, from a limited pool of mostly low-quality studies, previous SARS-CoV-2 exposure may be associated with ongoing gastrointestinal symptoms and the development of functional gastrointestinal illness. Furthermore, we show the need for high-quality research to better understand the SARS-CoV-2 association with gastrointestinal illness, particularly as population exposure to enteric infections returns to pre-COVID-19-restriction levels.

The incidence and predisposing factors for irritable bowel syndrome following COVID-19: a systematic review and meta-analysis

“…In a systematic review, Hawkings et al [44] provided an overview of the prevalence of persistent GI symptoms and the incidence of new GI illnesses following acute SARS-CoV-2 infection. The results revealed a higher risk for IBS in historically SARS-CoV-2-exposed individuals, but it is just descriptive research.…”

COVID-19, Possible Hepatic Pathways and Alcohol Abuse—What Do We Know up to 2023?

“…Nonetheless, the list of possible extrapulmonary symptoms and complications became longer and longer [4][5][6][7][8]. Finally, the spectrum of COVID-19related manifestations turned out to be associated with a broad range of systemic symptoms, e.g., neurological and dermatological syndromes, myocardial dysfunction, hyperglycemia, disorders of the gastrointestinal tract and acute kidney failure [9][10][11][12][13][14]. Concomitantly, a lot of observations also started to suggest an existing relationship between SARS-CoV-2 and chronic liver diseases (CLDs), indicating hepatic manifestations of the infection and the exacerbation of existing liver pathologies in the case of COVID-19 [15][16][17][18][19][20][21].…”