New-onset gastrointestinal disorders in COVID-19 patients 3.5 years post-infection in the inner-city population in the Bronx

Abstract

This study examined the incidence, characteristics, and risk factors of new gastrointestinal disorders (GID) associated with SARS-CoV-2 infection up to 3.5 years post-infection. This retrospective study included 35,102 COVID-19 patients and 682,594 contemporary non-COVID-19 patients without past medical history of GID (controls) from the Montefiore Health System in the Bronx (3/1/2020 to 7/31/2023). Comparisons were made with unmatched and propensity-matched (1:2) controls. The primary outcome was new GID which included peptic ulcer, inflammatory bowel disease, irritable bowel syndrome, diverticulosis, diverticulitis, and biliary disease. Multivariate Cox proportional hazards model analysis was performed with adjustment for covariates. There were 2,228 (6.34%) COVID-19 positive patients who developed new GID compared to 38,928 (5.70%) controls. COVID-19 patients had an elevated risk of developing new GID (adjusted HR = 1.18 (95% CI 1.12-1.25) compared to propensity-matched controls, after adjusting for confounders that included smoking, obesity, diabetes, hypertension. These findings underscore the need for additional research and follow-up of at-risk individuals for developing GID post infection.

Keywords: SARS-CoV-2; health disparity; long covid; post-acute sequelae of COVID-19 (PASC).

Fig. 1

Flowchart of cohort selection. After determining which patients were positive for COVID-19 versus COVID-19 negative, patients were excluded based on prior gastrointestinal history. Additionally, COVID-19 negative patients were identified after the index date determined in our study as March 2020.

Fig. 2

Cumulative incidence curve of new onset of gastrointestinal conditions stratified by patients with COVID-19 to non-COVID-19 patients (matched cohort). Cohort data were matched by age, sex and ethnicity.