Factors Associated With Chronic De Novo Post-Coronavirus Disease Gastrointestinal Disorders in a Metropolitan US County

Abstract

The first coronavirus disease 2019 (COVID-19) pandemic surge harshly impacted the medically underserved populations of the urbanized northeastern United States. SARS-CoV-2 virions infect the gastrointestinal (GI) tract, and GI symptoms are common during acute infection.¹ Post-COVID syndromes increasingly are recognized as important public health considerations.² Postinfectious disorders of gut-brain interaction (DGBIs; formerly known as functional gastrointestinal disorders) can occur after enteric illness; the COVID-19 pandemic is anticipated to provoke DGBI development³ within a rapidly evolving post-COVID framework of illness. Here, we evaluate factors associated with DGBI-like post-COVID gastrointestinal disorders (PCGIDs) in our hospital's surrounding communities comprised predominantly of racial/ethnic minorities and those of reduced socioeconomic status.

Figure 1

Factors associated with de novo functional dyspepsia (FD)- and irritable bowel syndrome (IBS)-like symptoms after coronavirus disease 2019 (COVID-19) infection and correlation between psychological distress and gastrointestinal symptom severity. (A) Logistic regression comparing those with de novo gastrointestinal (GI) symptoms after infection and those without symptoms showed a significant association between chronic gastrointestinal symptoms and female sex as well as a history of depression and anxiety. Correlation was noted both between psychological distress (by the Kessler Psychological Distress Scale [K10]) and the (B) Patient Assessment of Gastrointestinal Disorders–Symptom Severity (PAGI-SYM) gastrointestinal index in patients meeting criteria for functional dyspepsia and the (C) Irritable Bowel Syndrome–Symptom Severity Score (IBS-SSS) index in patients meeting criteria for IBS.

Supplementary Figure 1

Progression of patients screened for gastrointestinal (GI) symptoms during coronavirus disease 2019 (COVID-19) infection and logistic regression of patient characteristics. A total of 200 patients without any dyspeptic or bowel symptoms before their COVID-19 infection comprised the analyzed cohort. Seventy-nine patients (39.5%) developed new chronic dyspeptic and bowel symptoms after their COVID-19 infection, meeting criteria for functional dyspepsia (FD)-like or irritable bowel syndrome (IBS)-like post-COVID GI disorders, while 121 did not meet the criteria for these conditions.