tetano
Editor, Senior Moderator
United European Gastroenterol J
. 2025 Mar 21.
doi: 10.1002/ueg2.70005. Online ahead of print. Long-Term Impact of COVID-19 on Disorders of Gut-Brain Interaction: Incidence, Symptom Burden, and Psychological Comorbidities
Giovanni Marasco[SUP] 1 2 [/SUP], Keren Hod[SUP] 3 4 [/SUP], Luigi Colecchia[SUP] 1 [/SUP], Cesare Cremon[SUP] 1 2 [/SUP], Maria Raffaella Barbaro[SUP] 1 [/SUP], Giulia Cacciari[SUP] 1 2 [/SUP], Francesca Falangone[SUP] 5 [/SUP], Anna Kagramanova[SUP] 6 7 [/SUP], Dmitry Bordin[SUP] 6 8 9 [/SUP], Vasile Drug[SUP] 10 [/SUP], Egidia Miftode[SUP] 11 [/SUP], Pietro Fusaroli[SUP] 12 [/SUP], Salem Youssef Mohamed[SUP] 13 [/SUP], Chiara Ricci[SUP] 14 [/SUP], Massimo Bellini[SUP] 15 [/SUP], M Masudur Rahman[SUP] 16 [/SUP], Luigi Melcarne[SUP] 17 [/SUP], Javier Santos[SUP] 18 19 20 [/SUP], Beatriz Lobo[SUP] 21 [/SUP], Serhat Bor[SUP] 21 [/SUP], Suna Yapali[SUP] 22 [/SUP], Deniz Akyol[SUP] 23 [/SUP], Ferdane Pirincci Sapmaz[SUP] 24 [/SUP], Yonca Yilmaz Urun[SUP] 25 [/SUP], Tugce Eskazan[SUP] 26 [/SUP], Altay Celebi[SUP] 27 [/SUP], Huseyin Kacmaz[SUP] 28 [/SUP], Berat Ebik[SUP] 29 [/SUP], Hatice Cilem Binicier[SUP] 30 [/SUP], Mehmet Sait Bugdayci[SUP] 31 [/SUP], Munkhtsetseg Banzragch Yağcı[SUP] 32 [/SUP], Husnu Pullukcu[SUP] 23 [/SUP], Berrin Yalınbas Kaya[SUP] 25 [/SUP], Ali Tureyen[SUP] 25 [/SUP], İbrahim Hatemi[SUP] 26 [/SUP], Elif Sitre Koc[SUP] 22 [/SUP], Goktug Sirin[SUP] 27 [/SUP], Ali Riza Calıskan[SUP] 28 [/SUP], Goksel Bengi[SUP] 30 [/SUP], Esra Ergun Alıs[SUP] 33 [/SUP], Snezana Lukic[SUP] 34 [/SUP], Meri Trajkovska[SUP] 35 [/SUP], Dan Dumitrascu[SUP] 36 [/SUP], Antonello Pietrangelo[SUP] 37 [/SUP], Elena Corradini[SUP] 37 [/SUP], Magnus Simren[SUP] 38 [/SUP], Jessica Sjolund[SUP] 38 [/SUP], Navkiran Tornkvist[SUP] 38 [/SUP], Uday C Ghoshal[SUP] 39 [/SUP], Olga Kolokolnikova[SUP] 40 [/SUP], Antonio Colecchia[SUP] 41 [/SUP], Jordi Serra[SUP] 42 [/SUP], Giovanni Maconi[SUP] 43 [/SUP], Roberto De Giorgio[SUP] 44 [/SUP], Silvio Danese[SUP] 45 [/SUP], Piero Portincasa[SUP] 46 [/SUP], Antonio Di Sabatino[SUP] 47 [/SUP], Marcello Maggio[SUP] 48 [/SUP], Elena Philippou[SUP] 49 [/SUP], Yeong Yeh Lee[SUP] 50 [/SUP], Daniele Salvi[SUP] 2 [/SUP], Alessandro Venturi[SUP] 2 [/SUP], Claudio Borghi[SUP] 1 2 [/SUP], Marco Zoli[SUP] 1 2 [/SUP], Paolo Gionchetti[SUP] 1 2 [/SUP], Pierluigi Viale[SUP] 1 2 [/SUP], Vincenzo Stanghellini[SUP] 1 2 [/SUP], Giovanni Barbara[SUP] 1 2 [/SUP]; GI‐COVID19 study groups
Affiliations
Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has highlighted the potential exacerbation of gastrointestinal symptoms in patients with disorders of gut-brain interaction (DGBIs). However, the distinct symptom trajectories and psychological burden in patients with post-COVID-19 DGBIs compared with patients with pre-existing irritable bowel syndrome (IBS)/functional dyspepsia (FD) and non-DGBI controls remain poorly understood.
Objectives: To examine the long-term gastrointestinal symptom progression and psychological comorbidities in patients with post-COVID-19 DGBI, patients with pre-existing IBS/FD and non-DGBI controls.
Methods: This post hoc analysis of a prospective multicenter cohort study reviewed patient charts for demographic data and medical history. Participants completed the Gastrointestinal Symptom Rating Scale at four time points: baseline, 1, 6, and 12 months, and the Hospital Anxiety and Depression Scale at 6 and 12 months. The cohort was divided into three groups: (1) post-COVID-19 DGBIs (2) non-DGBI, and (3) pre-existing IBS/FD, with the post-COVID-19 DGBIs group compared to the latter two control groups.
Results: Among 599 eligible patients, 27 (4.5%) were identified as post-COVID-19 DGBI. This group experienced worsening abdominal pain, hunger pain, heartburn, and acid regurgitation, unlike symptom improvement or stability in non-DGBI controls (p < 0.001 for all symptoms, except hunger pain, p = 0.001). While patients with pre-existing IBS/FD improved in most gastrointestinal symptoms but worsened in constipation and incomplete evacuation, patients with post-COVID-19 DGBI exhibited consistent symptom deterioration across multiple gastrointestinal domains. Anxiety and depression remained unchanged in patients with post-COVID-19 DGBI, contrasting with significant reductions in controls (non-DGBI: p = 0.003 and p = 0.057; pre-existing IBS/FD: p = 0.019 and p = 0.007, respectively).
Conclusions: COVID-19 infection is associated with the development of newly diagnosed DGBIs and distinct symptom trajectories when compared with patients with pre-existing IBS/FD. Patients with post-COVID-19 DGBI experience progressive gastrointestinal symptom deterioration and persistent psychological distress, underscoring the need for tailored management strategies for this unique subgroup.
Keywords: COVID‐19; anxiety; depression; disorders of gut‐brain interaction; functional dyspepsia; gastrointestinal symptoms; irritable bowel syndrome; post‐infection gastrointestinal disorders.
. 2025 Mar 21.
doi: 10.1002/ueg2.70005. Online ahead of print. Long-Term Impact of COVID-19 on Disorders of Gut-Brain Interaction: Incidence, Symptom Burden, and Psychological Comorbidities
Giovanni Marasco[SUP] 1 2 [/SUP], Keren Hod[SUP] 3 4 [/SUP], Luigi Colecchia[SUP] 1 [/SUP], Cesare Cremon[SUP] 1 2 [/SUP], Maria Raffaella Barbaro[SUP] 1 [/SUP], Giulia Cacciari[SUP] 1 2 [/SUP], Francesca Falangone[SUP] 5 [/SUP], Anna Kagramanova[SUP] 6 7 [/SUP], Dmitry Bordin[SUP] 6 8 9 [/SUP], Vasile Drug[SUP] 10 [/SUP], Egidia Miftode[SUP] 11 [/SUP], Pietro Fusaroli[SUP] 12 [/SUP], Salem Youssef Mohamed[SUP] 13 [/SUP], Chiara Ricci[SUP] 14 [/SUP], Massimo Bellini[SUP] 15 [/SUP], M Masudur Rahman[SUP] 16 [/SUP], Luigi Melcarne[SUP] 17 [/SUP], Javier Santos[SUP] 18 19 20 [/SUP], Beatriz Lobo[SUP] 21 [/SUP], Serhat Bor[SUP] 21 [/SUP], Suna Yapali[SUP] 22 [/SUP], Deniz Akyol[SUP] 23 [/SUP], Ferdane Pirincci Sapmaz[SUP] 24 [/SUP], Yonca Yilmaz Urun[SUP] 25 [/SUP], Tugce Eskazan[SUP] 26 [/SUP], Altay Celebi[SUP] 27 [/SUP], Huseyin Kacmaz[SUP] 28 [/SUP], Berat Ebik[SUP] 29 [/SUP], Hatice Cilem Binicier[SUP] 30 [/SUP], Mehmet Sait Bugdayci[SUP] 31 [/SUP], Munkhtsetseg Banzragch Yağcı[SUP] 32 [/SUP], Husnu Pullukcu[SUP] 23 [/SUP], Berrin Yalınbas Kaya[SUP] 25 [/SUP], Ali Tureyen[SUP] 25 [/SUP], İbrahim Hatemi[SUP] 26 [/SUP], Elif Sitre Koc[SUP] 22 [/SUP], Goktug Sirin[SUP] 27 [/SUP], Ali Riza Calıskan[SUP] 28 [/SUP], Goksel Bengi[SUP] 30 [/SUP], Esra Ergun Alıs[SUP] 33 [/SUP], Snezana Lukic[SUP] 34 [/SUP], Meri Trajkovska[SUP] 35 [/SUP], Dan Dumitrascu[SUP] 36 [/SUP], Antonello Pietrangelo[SUP] 37 [/SUP], Elena Corradini[SUP] 37 [/SUP], Magnus Simren[SUP] 38 [/SUP], Jessica Sjolund[SUP] 38 [/SUP], Navkiran Tornkvist[SUP] 38 [/SUP], Uday C Ghoshal[SUP] 39 [/SUP], Olga Kolokolnikova[SUP] 40 [/SUP], Antonio Colecchia[SUP] 41 [/SUP], Jordi Serra[SUP] 42 [/SUP], Giovanni Maconi[SUP] 43 [/SUP], Roberto De Giorgio[SUP] 44 [/SUP], Silvio Danese[SUP] 45 [/SUP], Piero Portincasa[SUP] 46 [/SUP], Antonio Di Sabatino[SUP] 47 [/SUP], Marcello Maggio[SUP] 48 [/SUP], Elena Philippou[SUP] 49 [/SUP], Yeong Yeh Lee[SUP] 50 [/SUP], Daniele Salvi[SUP] 2 [/SUP], Alessandro Venturi[SUP] 2 [/SUP], Claudio Borghi[SUP] 1 2 [/SUP], Marco Zoli[SUP] 1 2 [/SUP], Paolo Gionchetti[SUP] 1 2 [/SUP], Pierluigi Viale[SUP] 1 2 [/SUP], Vincenzo Stanghellini[SUP] 1 2 [/SUP], Giovanni Barbara[SUP] 1 2 [/SUP]; GI‐COVID19 study groups
Affiliations
- PMID: 40119532
- DOI: 10.1002/ueg2.70005
Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has highlighted the potential exacerbation of gastrointestinal symptoms in patients with disorders of gut-brain interaction (DGBIs). However, the distinct symptom trajectories and psychological burden in patients with post-COVID-19 DGBIs compared with patients with pre-existing irritable bowel syndrome (IBS)/functional dyspepsia (FD) and non-DGBI controls remain poorly understood.
Objectives: To examine the long-term gastrointestinal symptom progression and psychological comorbidities in patients with post-COVID-19 DGBI, patients with pre-existing IBS/FD and non-DGBI controls.
Methods: This post hoc analysis of a prospective multicenter cohort study reviewed patient charts for demographic data and medical history. Participants completed the Gastrointestinal Symptom Rating Scale at four time points: baseline, 1, 6, and 12 months, and the Hospital Anxiety and Depression Scale at 6 and 12 months. The cohort was divided into three groups: (1) post-COVID-19 DGBIs (2) non-DGBI, and (3) pre-existing IBS/FD, with the post-COVID-19 DGBIs group compared to the latter two control groups.
Results: Among 599 eligible patients, 27 (4.5%) were identified as post-COVID-19 DGBI. This group experienced worsening abdominal pain, hunger pain, heartburn, and acid regurgitation, unlike symptom improvement or stability in non-DGBI controls (p < 0.001 for all symptoms, except hunger pain, p = 0.001). While patients with pre-existing IBS/FD improved in most gastrointestinal symptoms but worsened in constipation and incomplete evacuation, patients with post-COVID-19 DGBI exhibited consistent symptom deterioration across multiple gastrointestinal domains. Anxiety and depression remained unchanged in patients with post-COVID-19 DGBI, contrasting with significant reductions in controls (non-DGBI: p = 0.003 and p = 0.057; pre-existing IBS/FD: p = 0.019 and p = 0.007, respectively).
Conclusions: COVID-19 infection is associated with the development of newly diagnosed DGBIs and distinct symptom trajectories when compared with patients with pre-existing IBS/FD. Patients with post-COVID-19 DGBI experience progressive gastrointestinal symptom deterioration and persistent psychological distress, underscoring the need for tailored management strategies for this unique subgroup.
Keywords: COVID‐19; anxiety; depression; disorders of gut‐brain interaction; functional dyspepsia; gastrointestinal symptoms; irritable bowel syndrome; post‐infection gastrointestinal disorders.