Gastrointestinal issues linger long after COVID-19 recovery

Gut-brain interaction disorders and persistent gastrointestinal (GI) symptoms prevail 12–18 months following COVID-19 hospitalization, and these prolonged GI issues are associated with the severity of the symptoms during hospitalization and the psychological toll of the illness experience, according to a study.

For the study, researchers conducted a follow-up survey of 530 individuals who were previously hospitalized with COVID-19 across North America. The survey was administered between 12 and 18 months following discharge from the hospital to determine the presence of persistent GI symptoms and their severity, as well as the development of disorders of gut-brain interaction (DGBIs).

The survey tools used included the Rome IV Diagnostic Questionnaire for Disorders of Gut-Brain Interaction, a rating scale of 24 COVID-related symptoms, the Gastrointestinal Symptoms Rating Scale (GSRS), and the Impact of Events-Revised (IES-R) trauma symptom questionnaire (a measure of post-traumatic stress associated with the illness experience).

Of the individuals who were invited to participate in the survey, 116 responded (mean age 55.2 years, 52.6 percent women), and 73 of them (60.3 percent) met the criteria for one or more Rome IV DGBI at follow-up, higher than the prevalence in the US general population (p<0.0001).

Around 42 percent of the patients who had COVID-related GI symptoms during the index hospitalization (eg, abdominal pain, nausea, vomiting, or diarrhoea) retained at least one of these symptoms at follow up. Meanwhile, 89.8 percent of respondents overall retained any (GI or non-GI) COVID-related symptom.

The number of self-reported moderate or severe GI symptoms experienced during the index COVID-19 infection was associated with the development of DGBI and severity of GI symptoms at follow-up.

Around 41 percent of respondents had post-traumatic stress disorder (IES-R score >33) resulting from the COVID-19 illness experience. These individuals had notably higher DGBI prevalence and greater GI symptom severity.

Regression analysis showed that higher psychological trauma score (IES-R) had the strongest association with GI symptom severity at follow-up.