Functional bowel disorders after COVID-19

Abstract

Background:

To assess gut-brain interaction disorders and gastrointestinal symptoms after COVID-19 hospitalisation.

Material and Methods:

This prospective study was done on Medical wards and ICUs of Jinnah Hospital Lahore, Mayo Hospital Lahore, DHQ Hospital Gujranwalla, and Hijaz Hospital Lahore from April 1, 2020–December 31, 2021.We enrolled 1284 patients (both COVID-19 and non-COVID-19) who met the inclusion criteria and followed them for 1, 6, and 12 months after hospital discharge. Validated questionnaires measured depression, anxiety, and gastrointestinal symptoms. 881 patients were included in the primary analysis after excluding those with preexisting GI symptoms or surgery. (270 controls, 611 COVID-19).

Results:

Out of 805 (62.7%) of the remaining 1035 had COVID-19, and 162 (94 COVID-19 and 68 control) were excluded due to history of existing gastrointestinal symptoms or surgery in the past. 873 subjects without pre-existing confounders were assessed and followed up for primary and secondary aim analysis. 746 patients completed 6-month and 603 patients completed 12-month follow-up evaluations. In primary aim analysis, mean age was 48.9 ±20.1 years for control group and 52.9±14.2 for COVID patients (p=0.47). 62.1% of control and 58.7% of COVID cases were male (p=0.54). BMI in control group was 24.8±7.5 and in COVID cases it was 23.9±7.6 (p=0.6). COVID-19 patients had more gastrointestinal symptoms at enrollment (65.5% vs 38.5%, p<0.0015). Controls (15.5%) have more constipation than COVID-19 patients (9.1%) at 12 months ( p=0.029 ). ROME IV-defined IBS was higher in COVID-19 patients (4.0% vs. 0.3%, p=0.035). IBS was linked to allergies, dyspnoea, and proton pump inhibitors.At 6 months, the rate of depression among COVID-19 patients was higher than that of controls.

Conclusion:

At 12 months, patients hospitalised with COVID-19 had less number of hard stools and constipation than controls. COVID-19 patients had significantly more IBS than controls.