Gut. 2022 Dec 9;gutjnl-2022-328483. doi: 10.1136/gutjnl-2022-328483. Online ahead of print.

Giovanni Marasco ^1 2, Cesare Cremon ^1 2, Maria Raffaella Barbaro ¹, Giulia Cacciari ^1 2, Francesca Falangone ³, Anna Kagramanova ⁴, Dmitry Bordin ^4 5 6, Vasile Drug ⁷, Egidia Miftode ⁸, Pietro Fusaroli ⁹, Salem Youssef Mohamed ¹⁰, Chiara Ricci ¹¹, Massimo Bellini ¹², Mohammed Masudur Rahman ¹³, Luigi Melcarne ¹⁴, Javier Santos ¹⁵, Beatriz Lobo ¹⁵, Serhat Bor ¹⁶, Suna Yapali ¹⁷, Deniz Akyol ¹⁸, Ferdane Pirincci Sapmaz ¹⁹, Yonca Yilmaz Urun ²⁰, Tugce Eskazan ²¹, Altay Celebi ²², Huseyin Kacmaz ²³, Berat Ebik ²⁴, Hatice Cilem Binicier ²⁵, Mehmet Sait Bugdayci ²⁶, Munkhtsetseg Banzragch Yagci ²⁷, Husnu Pullukcu ¹⁸, Berrin Yalinbas Kaya ²⁰, Ali Tureyen ²⁰, Ibrahim Hatemi ²¹, Elif Sitre Koc ¹⁷, Goktug Sirin ²², Ali Riza Caliskan ²³, Goksel Bengi ²⁵, Esra Ergun Alis ²⁸, Snezana Lukic ²⁹, Meri Trajkovska ³⁰, Keren Hod ³¹, Dan Dumitrascu ³², Antonello Pietrangelo ³³, Elena Corradini ³³, Magnus Simren ³⁴, Jessica Sjölund ³⁴, Navkiran Tornkvist ³⁴, Uday C Ghoshal ³⁵, Olga Kolokolnikova ³⁶, Antonio Colecchia ³⁷, Jordi Serra ³⁸, Giovanni Maconi ³⁹, Roberto De Giorgio ⁴⁰, Silvio Danese ⁴¹, Piero Portincasa ⁴², Antonio Di Sabatino ⁴³, Marcello Maggio ⁴⁴, Elena Philippou ⁴⁵, Yeong Yeh Lee ⁴⁶, Daniele Salvi ², Alessandro Venturi ¹, Claudio Borghi ^1 2, Marco Zoli ², Paolo Gionchetti ^1 2, Pierluigi Viale ^1 2, Vincenzo Stanghellini ^1 2, Giovanni Barbara ^47 2; GI-COVID19 study group

Collaborators

GI-COVID19 study group: 

Alessio Piacentini, Mariam Shengelia, Valeriy Vechorko, Carla Cardamone, Claudia Agabiti Rosei, Andrea Pancetti, Francesco Rettura, Marc Pedrosa, Adoración Nieto, Claudia Barber, Alejandro Henao, Caterina Campoli, Dragana Mijac, Milos Korac, Uros Karic, Aleksandar Markovic, Ana Najdeski, Dafina Nikolova, Marija Dimzova, Orly Lior, Nadav Shinhar, Ori Perelmutter, Yehuda Ringel, Cristina Marica Sabo, Ana Chis, Gregorio Bonucchi, Giacomo Pietro Ismaele Caio, Caterina Ghirardi, Beatrice Marziani, Barbara Rizzello, Ariadna Aguilar, Domenica Maria Di Paolo, Leonilde Bonfrate,  

Author information

¹Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy.

²Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

³Medical-Surgical Department of Clinical Sciences and Translational Medicine, University Sapienza Rome, Rome, Italy.

⁴Loginov Moscow Clinical Scientific Center, Moscow, Russian Federation.

⁵Tver State Medical University, Tver, Russian Federation.

⁶Medicine and Dentistry, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.

⁷Gastroenterology, Grigore T Popa University of Medicine and Pharmacy Faculty of Medicine, Iasi, Romania.

⁸Department of Infectious Diseases, 'Grigore T Popa' University of Medicine and Pharmacy, Iasi, Romania.

⁹Gastroenterology Unit, University of Bologna, Imola, Italy.

¹⁰Internal Medicine Department, Zagazig University, Zagazig, Egypt.

¹¹Gastroenterology Unit, University of Brescia, Brescia, Italy.

¹²Department of New Technologies and Translational Research in Medicine and Surgery, University of Pisa, Pisa, Italy.

¹³Department of Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh.

¹⁴Gastroenterology Department, Hospital Universitario Parc Tauli, Sabadell, Cataluña, Spain.

¹⁵Digestive System Research Unit, Hospital General Vall D'Hebron, Barcelona, Spain.

¹⁶Ege University School of Medicine, Izmir, Turkey.

¹⁷Division of Gastroenterology, Acibadem University, Altunizade Acibadem Hospital, Istanbul, Turkey.

¹⁸Department of Infectious Diseases, Ege University, Izmir, Turkey.

¹⁹Division of Gastroenterology, University of Health Sciences, Keciören Education and Research Hospital, Keciören, Turkey.

²⁰Division of Gastroenterology, Eskisehir City Hospital, Eskisehir, Turkey.

²¹Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Division of Gastroenterology, Turkey.

²²Division of Gastroenterology, Kocaeli University, Kocaeli, Turkey.

²³Division of Gastroenterology, Adiyaman Education and Research Hospital, Adiyaman, Turkey.

²⁴Division of Gastroenterology, University of Health Sciences, Diyabakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.

²⁵Division of Gastroenterology, Dokuz Eylül University, Izmir, Turkey.

²⁶Division of Gastroenterology, Istanbul Aydin University Florya Liv Hospital, Istanbul, Turkey.

²⁷Division of Gastroenterology, Darica Farabi Education and Research Hospital, Kocaeli, Turkey.

²⁸Department of Infectious Diseases, Istanbul Aydin University Florya Liv Hospital, Istanbul, Turkey.

²⁹Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Beograd, Beograd, Serbia.

³⁰Clinic of Gastroenterohepatology, Skopje, Macedonia (the former Yugoslav Republic of).

³¹Research Division, Assuta Medical Center, Tel Aviv, Tel Aviv, Israel.

³²2nd Medical Department of Internal Medicine, University of Medicine and Pharmacy, Cluj-Napoca, Romania.

³³Division of Internal Medicine, University of Modena and Reggio Emilia, Modena, Italy.

³⁴Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.

³⁵Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

³⁶Medsi Clinical Hospital, Moscow, Russian Federation.

³⁷Division of Gastroenterology, University of Modena and Reggio Emilia, Modena, Italy.

³⁸CIBERehd, University Hospital Germans Trias i Pujol, Barcelona, Spain.

³⁹Gastroenterology, L.Sacco University Hospital, Milan, Italy.

⁴⁰Department of Translational Medicine, University of Ferrara, Ferrara, Italy.

⁴¹Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milano, Italy.

⁴²Division of Internal Medicine "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.

⁴³First Department of Internal Medicine, Università degli Studi di Pavia Facoltà di Medicina e Chirurgia, PV, Lombardia, Italy.

⁴⁴Geriatric Clinic Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.

⁴⁵Department of Life and Health Sciences, Cyprus University of Nicosia, Nicosia, Cyprus.

⁴⁶School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.

⁴⁷Azienda Ospedaliero-Universitaria di Bologna IRCCS, Bologna, Emilia-Romagna, Italy giovanni.barbara@unibo.it.

PMID: 36591612

DOI: 10.1136/gutjnl-2022-328483

Abstract

Objectives: The long-term consequences of COVID-19 infection on the gastrointestinal tract remain unclear. Here, we aimed to evaluate the prevalence of gastrointestinal symptoms and post-COVID-19 disorders of gut-brain interaction after hospitalisation for SARS-CoV-2 infection.

Design: GI-COVID-19 is a prospective, multicentre, controlled study. Patients with and without COVID-19 diagnosis were evaluated on hospital admission and after 1, 6 and 12 months post hospitalisation. Gastrointestinal symptoms, anxiety and depression were assessed using validated questionnaires.

Results: The study included 2183 hospitalised patients. The primary analysis included a total of 883 patients (614 patients with COVID-19 and 269 controls) due to the exclusion of patients with pre-existing gastrointestinal symptoms and/or surgery. At enrolment, gastrointestinal symptoms were more frequent among patients with COVID-19 than in the control group (59.3% vs 39.7%, p<0.001). At the 12-month follow-up, constipation and hard stools were significantly more prevalent in controls than in patients with COVID-19 (16% vs 9.6%, p=0.019 and 17.7% vs 10.9%, p=0.011, respectively). Compared with controls, patients with COVID-19 reported higher rates of irritable bowel syndrome (IBS) according to Rome IV criteria: 0.5% versus 3.2%, p=0.045. Factors significantly associated with IBS diagnosis included history of allergies, chronic intake of proton pump inhibitors and presence of dyspnoea. At the 6-month follow-up, the rate of patients with COVID-19 fulfilling the criteria for depression was higher than among controls.

Conclusion: Compared with controls, hospitalised patients with COVID-19 had fewer problems of constipation and hard stools at 12 months after acute infection. Patients with COVID-19 had significantly higher rates of IBS than controls.

Trial registration number: NCT04691895.