Gastrointestinal symptoms at the acute COVID-19 phase are risk factors for developing gastrointestinal post-COVID symptoms: a multicenter study

Fernández‐de‐las‐Peñas, César; Martín-Guerrero, José D.; Navarro‐Pardo, Esperanza; Torres‐Macho, Juan; Canto-Diez, Ma Gabriela; Pellicer-Valero, Óscar J.

doi:10.1007/s11739-021-02850-5

Cited by 16 publications

(26 citation statements)

References 14 publications

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“…Although we did not perform an epidemiological screening based on ROME IV criteria process, the results of the mentioned study further support our data concluding that substantial portion of COVID-19 survivors develop long-term and bothersome gastrointestinal symptoms. Contrary to our results, multicentric study comparing the symptom prevalence at admission and 8 months after hospital discharge showed that it was almost similar (10% vs. 7%, respectively) [25]. This could be explained by considerable methodologic differences.…”

Section: Discussioncontrasting

confidence: 99%

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

Liptak

Ďuríček

Rosolanka

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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Introduction Post-coronavirus disease (post-COVID) symptoms arise mostly from impaired function of respiratory tract although in many patients, the dysfunction of gastrointestinal tract and liver among other organ systems may persist. Methods Primary data collection was based on a short gastrointestinal symptom questionnaire at the initial screening. A brief telephone survey within the patient and control group was performed 5-8 months after the initial screening. R ver. 4.0.5 and imbalanced RandomForest (RF) machine-learning algorithm were used for data explorations and analyses. Results A total of 590 patients were included in the study. The general presence of gastrointestinal symptoms 208.2 days (153-230 days) after the initial acute severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection was 19% in patients with moderate-to-serious course of the disease and 7.3% in patients with mild course compared with 3.0% in SARS-CoV-2 negative controls (P < 0.001). Diarrhea and abdominal pain are the most prevalent post-COVID gastrointestinal symptoms. RF machine-learning algorithm identified acute diarrhea and antibiotics administration as the strongest predictors for gastrointestinal sequelae with area under curve of 0.68. Variable importance for acute diarrhea is 0.066 and 0.058 for antibiotics administration. Conclusion The presence of gastrointestinal sequelae 7 months after the initial SARS-CoV-2 infection is significantly higher in patients with moderate-to-severe course of the acute COVID-19 compared with asymptomatic patients or those with mild course of the disease. The most prevalent post-COVID gastrointestinal symptoms are diarrhea and abdominal pain. The strongest predictors for persistence of these symptoms are antibiotics administration and acute diarrhea during the initial infection.

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Section: Discussioncontrasting

confidence: 99%

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

Liptak

Ďuríček

Rosolanka

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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“…Table 1 shows the details of the included studies with the study design, type of population, symptoms, duration, and the information provided. 13 – 62 Supplemental Table 2 shows the excluded studies with reasons of exclusion.…”

Section: Resultsmentioning

confidence: 99%

“…The overall frequency of GI symptoms was reported in 14 studies involving 296,487 patients. 13 , 14 , 27 , 28 , 39 , 40 , 42 , 45 , 48 , 49 , 51 , 55 , 59 , 60 The frequency of overall GI symptoms in patients with COVID-19 was 0.12 [95% confidence interval (CI), 0.06–0.22, I 2 = 99%] ( Figure 2 ). The frequency of GI symptoms in long COVID was reported in 12 studies (158,731 patients).…”

Section: Resultsmentioning

confidence: 99%

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Gastrointestinal manifestations of long COVID: A systematic review and meta-analysis

Choudhury

Tariq

Jena

et al. 2022

Therap Adv Gastroenterol

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Background: Prolonged symptoms after COVID-19 are an important concern due to the large numbers affected by the pandemic. Objectives: To ascertain the frequency of gastrointestinal (GI) manifestations as part of long GI COVID. Design: A systematic review and meta-analysis of studies reporting GI manifestations in long COVID was performed. Data Sources and Methods: Electronic databases (Medline, Scopus, Embase, Cochrane Central Register of Controlled Trials, and Web of Science) were searched till 21 December 2021 to identify studies reporting frequency of GI symptoms in long COVID. We included studies reporting overall GI manifestations or individual GI symptoms as part of long COVID. We excluded pediatric studies and those not providing relevant information. We calculated the pooled frequency of various symptoms in all patients with COVID-19 and also in those with long COVID using the inverse variance approach. All analysis was done using R version 4.1.1 using packages ‘meta’ and ‘metafor’. Results: A total of 50 studies were included. The frequencies of GI symptoms were 0.12 [95% confidence interval (CI), 0.06–0.22, I2 = 99%] and 0.22 (95% CI, 0.10–0.41, I2 = 97%) in patients with COVID-19 and those with long COVID, respectively. The frequencies of abdominal pain, nausea/vomiting, loss of appetite, and loss of taste were 0.14 (95% CI, 0.04–0.38, I2 = 96%), 0.06 (95% CI, 0.03–0.11, I2 = 98%), 0.20 (95% CI, 0.08–0.43, I2 = 98%), and 0.17 (95% CI, 0.10–0.27, I2 = 95%), respectively, after COVID-19. The frequencies of diarrhea, dyspepsia, and irritable bowel syndrome were 0.10 (95% CI, 0.04–0.23, I2 = 98%), 0.20 (95% CI, 0.06–0.50, I2 = 97%), and 0.17 (95% CI, 0.06–0.37, I2 = 96%), respectively. Conclusion: GI symptoms in patients were seen in 12% after COVID-19 and 22% as part of long COVID. Loss of appetite, dyspepsia, irritable bowel syndrome, loss of taste, and abdominal pain were the five most common GI symptoms of long COVID. Significant heterogeneity and small number of studies for some of the analyses are limitations of the systematic review.

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“…Participants provided their informed consent before collecting any data. It should be noted that the same sample of participants included in the LONG-COVID-EXP-CM study has been used in three letters to the editor [29][30][31], but current data are completely new and not previously published.…”

Section: Participantsmentioning

confidence: 99%

Female Sex Is a Risk Factor Associated with Long-Term Post-COVID Related-Symptoms but Not with COVID-19 Symptoms: The LONG-COVID-EXP-CM Multicenter Study

Fernández‐de‐las‐Peñas

Martín-Guerrero

Pellicer-Valero

et al. 2022

JCM

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215

121

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This multicenter cohort study investigated the differences between coronavirus disease 2019 (COVID-19) related symptoms and post-COVID symptoms between male and female COVID-19 survivors. Clinical and hospitalization data were collected from hospital medical records in a sample of individuals recovered from COVID-19 at five public hospitals in Spain. A predefined list of post-COVID symptoms was systematically assessed, but patients were free to report any symptom. Anxiety/depressive levels and sleep quality were also assessed. Adjusted multivariate logistic regressions were used to identify the association of sex with post-COVID related-symptoms. A total of 1969 individuals (age: 61, SD: 16 years, 46.4% women) were assessed 8.4 months after discharge. No overall significant sex differences in COVID-19 onset symptoms at hospital admission were found. Post-COVID symptoms were present in up to 60% of hospitalized COVID-19 survivors eight months after the infection. The number of post-COVID symptoms was 2.25 for females and 1.5 for males. After adjusting by all variables, female sex was associated with ≥3 post-COVID symptoms (adj OR 2.54, 95%CI 1.671–3.865, p < 0.001), the presence of post-COVID fatigue (adj OR 1.514, 95%CI 1.040–2.205), dyspnea (rest: adj OR 1.428, 95%CI 1.081–1.886, exertion: adj OR 1.409, 95%CI 1.109–1.791), pain (adj OR 1.349, 95%CI 1.059–1.720), hair loss (adj OR 4.529, 95%CI 2.784–7.368), ocular problems (adj OR 1.981, 95%CI 1.185–3.312), depressive levels (adj OR 1.606, 95%CI 1.002–2.572) and worse sleep quality (adj OR 1.634, 95%CI 1.097–2.434). Female sex was a risk factor for the development of some long-term post-COVID symptoms including mood disorders. Healthcare systems should consider sex differences in the management of long haulers.

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Gastrointestinal symptoms at the acute COVID-19 phase are risk factors for developing gastrointestinal post-COVID symptoms: a multicenter study

Cited by 16 publications

References 14 publications

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

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

Gastrointestinal manifestations of long COVID: A systematic review and meta-analysis

Female Sex Is a Risk Factor Associated with Long-Term Post-COVID Related-Symptoms but Not with COVID-19 Symptoms: The LONG-COVID-EXP-CM Multicenter Study

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