our recent publication:
Keren Hod, Giovanni Marasco, 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, on behalf of GI-COVID19 study group … See fewer authors
First published: 15 May 2025
https://doi.org/10.1111/nmo.70079
Funding: This work was partly supported by Fondazione del Monte di Bologna e Ravenna, Fondazione Cassa di Risparmio in Bologna.
Keren Hod and Giovanni Marasco contributed equally and share co-first authorship.
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ABSTRACT
Background
Exposure to COVID-19 has been shown previously to be associated with a higher risk for irritable bowel syndrome (IBS). This study aimed to better explain this relationship using mediation analysis.
Methods
This post hoc analysis of a multicenter cohort study includes 623 patients with and without COVID-19 infection. All participants completed the ROME IV criteria, gastrointestinal symptom rating scale (GSRS), and hospital anxiety and depression scale (HADS) over 1 year. Mediation analysis utilized the PROCESS macro and Baron and Kenny's method for parametric and nonparametric mediating variables, respectively.
Key Results
The impact of COVID-19 on the development of post-COVID-19 IBS is completely mediated by dyspnea at baseline (adjusted OR = 3.561, p = 0.012), severity of acid regurgitation at 1 month [indirect effect, log-odds metric = 0.090, 95% CI (0.006–0.180)], hunger pains at 1 [indirect effect, log-odds metric = 0.094, 95% CI (0.024–0.178)], and 6 months [indirect effect, log-odds metric = 0.074, 95% CI (0.003–0.150)], depression at 6 [indirect effect, log-odds metric = 0.106, 95% CI (0.009–0.225)] and 12 months [indirect effect, log-odds metric = 0.146, 95% CI (0.016–0.311)] as well as borborygmus [indirect effect, log-odds metric = 0.095, 95% CI (0.009–0.203)], abdominal distention [indirect effect, log-odds metric = 0.162, 95% CI (0.047–0.303)], and increased flatus [indirect effect, log-odds metric = 0.110, 95% CI (0.005–0.234)] at 12 months.
Conclusions and Inferences
Our findings provide evidence for psychological and clinical mediators between COVID-19 and post-COVID-19 IBS, which may be promising targets for interventions tailored for treating or preventing depression. The presence of specific GI symptoms at COVID-19 onset and their persistence should increase awareness of a potential new onset of IBS diagnosis.
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