Long-Term Impact of COVID-19 on Disorders of Gut–Brain Interaction: Incidence, Symptom Burden, and Psychological Comorbidities

 it is my pleasure to introduce our latest publications in the United European Gastroenterology Journal

Giovanni Marasco, Keren Hod, Luigi Colecchia, Cesare Cremon, Maria Raffaella Barbaro, Giulia Cacciari, Francesca Falangone, Anna Kagramanova, Dmitry Bordin, Vasile Drug, Egidia Miftode, Pietro Fusaroli, Salem Youssef Mohamed, Chiara Ricci, Massimo Bellini, M. Masudur Rahman, Luigi Melcarne, Javier Santos, Beatriz Lobo, Serhat Bor, Suna Yapali, Deniz Akyol, Ferdane Pirincci Sapmaz, Yonca Yilmaz Urun, Tugce Eskazan, Altay Celebi, Huseyin Kacmaz, Berat Ebik, Hatice Cilem Binicier, Mehmet Sait Bugdayci, Munkhtsetseg Banzragch Yağcı, Husnu Pullukcu, Berrin Yalınbas Kaya, Ali Tureyen, İbrahim Hatemi, Elif Sitre Koc, Goktug Sirin, Ali Riza Calıskan, Goksel Bengi, Esra Ergun Alıs, Snezana Lukic, Meri Trajkovska, Dan Dumitrascu, Antonello Pietrangelo, Elena Corradini, Magnus Simren, Jessica Sjolund, Navkiran Tornkvist, Uday C. Ghoshal, Olga Kolokolnikova, Antonio Colecchia, Jordi Serra, Giovanni Maconi, Roberto De Giorgio, Silvio Danese, Piero Portincasa, Antonio Di Sabatino, Marcello Maggio, Elena Philippou, Yeong Yeh Lee, Daniele Salvi, Alessandro Venturi, Claudio Borghi, Marco Zoli, Paolo Gionchetti, Pierluigi Viale, Vincenzo Stanghellini, Giovanni Barbara, for the GI-COVID19 study groups

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.