Gastrointestinal involvement in post-acute Coronavirus disease (COVID)-19 syndrome

Curr Opin Infect Dis. 2023 Oct 1;36(5):366-370. doi: 10.1097/QCO.0000000000000959. Epub 2023 Aug 22.

Abstract

Purpose of review: Ten percentage of patients with coronavirus disease (COVID)-19 report having gastrointestinal (GI) symptoms as severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) not only infects the pulmonary but also the GI tract. GI infections including that due to viral infection is known to cause postinfection disorders of gut-brain interaction (DGBI); hence, we wish to review the long-term GI consequences following COVID-19, particularly post-COVID-19 DGBI.

Recent findings: At least 12 cohort studies, four of which also included controls documented the occurrence of post-COVID-19 DGBI, particularly IBS following COVID-19. The risk factors for post-COVID-19 DGBI included female gender, symptomatic COVID-19, particularly GI symptoms, the severity of COVID-19, the occurrence of anosmia and ageusia, use of antibiotics and hospitalization during the acute illness, persistent GI symptoms beyond 1 month after recovery, presence of mental health factors, The putative mechanisms for post-COVID-19 DGBI include altered gut motility, visceral hypersensitivity, gut microbiota dysbiosis, GI inflammation, and immune activation, changes in intestinal permeability, and alterations in the enteroendocrine system and serotonin metabolism.

Summary: Long-term sequelae of SARS-CoV2 infection may persist even after recovery from COVID-19. Patients with COVID-19 are more likely to develop post-COVID-19 IBS than healthy controls. Post-COVID-19 IBS may pose a substantial healthcare burden to society.

Publication types

  • Review

MeSH terms

  • COVID-19* / complications
  • Female
  • Humans
  • Irritable Bowel Syndrome*
  • RNA, Viral
  • SARS-CoV-2

Substances

  • RNA, Viral