Objectives The long-term consequences of COVID-19 infection on the gastrointestinal tract remain unclear. Here, we aimed to evaluate the prevalence of gastrointestinal symptoms and post-COVID-19 disorders of gut–brain interaction after hospitalisation for SARS-CoV-2 infection.
Design GI-COVID-19 is a prospective, multicentre, controlled study. Patients with and without COVID-19 diagnosis were evaluated on hospital admission and after 1, 6 and 12 months post hospitalisation. Gastrointestinal symptoms, anxiety and depression were assessed using validated questionnaires.
Results The study included 2183 hospitalised 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 dyspnoea. 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, hospitalised 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 IBS than controls.
Trial registration number NCT04691895.
- irritable bowel syndrome
Data availability statement
Data are available upon reasonable request. Data are available on reasonable request. All figures have associated raw data. The additional data that support the findings of this study are available from the corresponding author by request.
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Collaborators Alessio Piacentini, Mariam Shengelia, Valeriy Vechorko, Carla Cardamone, Claudia Agabiti Rosei, Andrea Pancetti, Francesco Rettura, Marc Pedrosa, Adoración Nieto, Claudia Barber, Alejandro Henao, Caterina Campoli, Dragana Mijac, Milos Korac, Uros Karic, Aleksandar Markovic, Ana Najdeski, Dafina Nikolova, Marija Dimzova, Orly Lior, Nadav Shinhar, Ori Perelmutter, Yehuda Ringel, Cristina Marica Sabo, Ana Chis, Gregorio Bonucchi, Giacomo Pietro Ismaele Caio, Caterina Ghirardi, Beatrice Marziani, Barbara Rizzello, Ariadna Aguilar, Domenica Maria Di Paolo, Leonilde Bonfrate, Giovanni Marconi, Michele Di Stefano, Sara Tagliaferri, Juan Enrique Naves, Andrea Galli, Gabriele Dragoni, Laurentiu Nedelcu, Milena Stevanovic, Ance Volkanovska Nikolovska, Antonio Capogreco, Alessio Aghemo, Paula Antonia Mauloni, Sara Del Vecchio, Luca Rotondo, Federica Capuani, Davide Montanari, Francesco Palombo, Clara Paone, Giada Mastel, Claudia Fontana, Lara Bellacosa, Rosanna F. Cogliandro.
Contributors GB, GMarasco, CC, and VS designed the study; all authors collected data for the study; GMarasco carried out statistical analysis; GMarasco, GB, and CC validated and interpretated data; GB, GMarasco, CC, and VS drafted the manuscript; and all authors critically revised, approved, and agree on all aspects of the final version of the manuscript. GB is the guarantor of the article.
Funding GB’s contribution to this research was partly supported by funding from Fondazione Cassa di Risparmio in Bologna, the Italian Ministry of Education, University and Research; and Fondazione del Monte di Bologna e Ravenna and European Grant H2020, DISCOvERIE, SC1-BHC-01-2019
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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