Post-infection functional gastrointestinal disorders following coronavirus disease-19: A Prospective follow-up cohort study

Abstract

Abstract Background:Acute gastrointestinal infections can lead to post-infectious irritable bowel syndrome (PI-IBS). Moreover, coronavirus disease (COVID-19) is related to long-term gastrointestinal sequelae. In this study, the frequency, disease spectrum, and risk factors for post-infection functional gastrointestinal disease (PI-FGID) in COVID-19 patients and healthy controls were prospectively examined. Methods: Validated Rome III and Rome IV questionnaires were used to assess the incidence of PI-FGID in 190 COVID-19 patients, and 160 healthy controls prospectively followed for 1, 3, and 6 months. Results:Six（3.2%）, 1（0.5%）, 3（1.6%）, 5（2.6%）, 6（3.2%）COVID-19 patients had diarrhea, abdominal pain, constipation, dyspepsia and their overlap at 1 month, respectively, while 4（2.1%）, 1（0.5%）, 4（2.1%）, 4（2.1%）, and 6（3.2%）COVID-19 patients had diarrhea, abdominal pain, constipation, dyspepsia and their overlap at three months, respectively. Furthermore, 2（1.3%）, 4（2.5%）, and 3（1.9%）healthy controls developed constipation, dyspepsia, and their overlap at one month, respectively (P=0.193), while 2（1.3%）, 4（2.5%), and 2（1.3%）healthy controls developed constipation, dyspepsia and their overlap at three months, respectively (P=0.286). FGIDs incidence was higher among COVID-19 patients（8.9%) than in healthy controls（3.1%) at 6-month follow-up (P=0.025). Moreover, 7 (3.7%), 5 (2.6%), 3 (1.6%), and 2 (1.1%) COVID-19 patients developed IBS, functional dyspepsia（FD）, functional diarrhea（FDr）, functional constipation（FC）at six months, respectively, while only 2 (1.3%) and 3 (1.9%) healthy controls developed IBS and FD at six months, respectively. Notably, gastrointestinal（GI）symptoms at onset were the independent risk factors for post-COVID-19 FGIDs at six months. Conclusions: COVID-19 increases new-onset PI-FGID at six months compared with healthy controls. GI symptom at the onset of COVID-19 is an independent risk factor for post-COVID-19 FGIDs.