Gastrointestinal symptoms and the severity of COVID‐19: Disorders of gut–brain interaction are an outcome

Abstract

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.

Gastrointestinal sequalae months after severe acute respiratory syndrome corona virus 2 infection: a prospective, observational study

“…To the best of our knowledge, we are not aware of any study performing machine-learning with RF algorithm approach to identify such predictor factors. The results of recently published study by Nakhli et al [26] using hierarchical clustering as another type of machine-learning support our finding that abdominal pain is one of the predictors for developing long-term post-COVID gastrointestinal sequalae.…”

COVID-19: gastrointestinal and hepatobiliary manifestations

“…[ 5 ] A recent paper that surveyed 2222 patients found that severe disease was more prevalent among patients who fell into symptom clusters that included GI symptoms. [ 8 ] A meta-analysis of 21 studies including 5285 patients found that abdominal pain was associated with a 2.8-fold increased risk of severe COVID-19, whereas the association between diarrhea and severe COVID-19 was regionally different. [ 9 ] Zheng and co-investigators found that the risk of clinical deterioration was higher among patients with GI symptoms than those without.…”

“…At six months follow-up, 5.3%, 2.1%, and 1.8% still had these symptoms, respectively. Another study [ 8 ] surveyed 108 subjects and found that 38 experienced functional dyspepsia and 26 experienced irritable bowel syndrome. Among subjects with at least one post-COVID-19 disorder of gut-brain interaction, 86% reported having had at least one GI symptom during their acute illness.…”

Trastornos de la interacción intestino-cerebro relacionados con COVID-19 y <i>Helicobacter pylori</i> en SII

“…de anotar que el modelo fisiopatológico subyacente y los criterios diagnósticos para los trastornos de la interacción intestino-cerebro (TIIC) post-COVID-19 habían sido publicados el año pasado precisamente por Schmulson, Ghoshal y Barbara 2 . Sin embargo, en esta revisión única hasta ahora de artículos originales registrados en PubMed los autores no solo revisan los cuatro artículos hasta ahora publicados de TIIC post-COVID-19 [3][4][5][6] que confirman lo esbozado por Schmulson, Ghoshal y Barbara, sino que además revisan temas el impacto de la COVID-19 en pacientes previamente diagnosticados con TIIC, la presencia de TIIC como factores de riesgo para la presencia de síntomas gastrointestinales (GI) durante la COVID-19, así como factores de riesgo para el desarrollo de TIIC post-COVID-19.…”

“…Las secuelas gastrointestinales de la COVID-19 también fueron muy frecuentes, con tasas del 44% a los tres meses hasta el 27% a los seis meses [11][12][13] . Y específicamente en cuanto a los TIIC post-COVID-19, los cuatro estudios publicados en extenso hasta ahora y que fueron revisados en el presente artículo reportan una frecuencia de TIIC post-COVID-19 del 9.2 al 49% [3][4][5][6] . Esta gran variabilidad depende de la metodología de los estudios principalmente, es decir, si fueron retrospectivos, por internet o por llamada telefónica de pacientes hospitalizados, o estudios prospectivos de pacientes diagnosticados con COVID-19.…”