Post-infection functional gastrointestinal disorders following Corona Virus Disease-19: A case-control study.

Ghoshal, Uday C; Ghoshal, Ujjala; Rahman, M Masudur; Mathur, Akash; Rai, Sushmita; Akhter, Mahfuza; Mostafa, Tanvir; Islam, Mohammad Shohidul; Haque, Sheikh Ahmedul; Pandey, Ankita; Kibria, Md Golam; Ahmed, Faruque

BACKGROUND Since acute infectious gastroenteritis may cause post-infection irritable bowel syndrome (PI-IBS) and functional dyspepsia (FD) and the Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) affects gastrointestinal (GI) tract, Corona Virus Disease-19 (COVID-19) may cause PI-functional GI disorders (FGID). We prospectively studied the frequency and spectrum of PI-FGIDs among COVID-19 and historical healthy controls and the risk factors for its development. METHODS 280 patients with COVID-19 and 264 historical healthy controls were followed up at 1, and 3 months using translated validated Rome Questionnaires for the development of chronic bowel dysfunction (CBD), dyspeptic symptoms, and their overlap and at 6-month for IBS, uninvestigated dyspepsia (UD) and their overlap. Psychological comorbidity was studied using Rome III Psychosocial Alarm Questionnaire. RESULTS At 1-, and 3-months, 16 (5.7%), 16 (5.7%), 11 (3.9%) and 24 (8.6%), 6 (2.1%), 9 (3.2%) of COVID-19 patients developed CBD, dyspeptic symptoms, and their verlap, respectively; among healthy controls, none developed dyspeptic symptoms and one developed CBD at 3-month (p<0.05). At six-month, 15 (5.3%), 6 (2.1%), and 5 (1.8%) 280 COVID-19 patients developed IBS, UD, and IBS-UD overlap, respectively and one healthy control developed IBS at 6-months (p<0.05 for all except IBS-UD overlap). The risk factors for post-COVID-19 FGIDs at 6-month included symptoms (particularly GI), anosmia, ageusia, and presence of CBD, dyspeptic symptoms, or their overlap at one and 3-months and the psychological comorbidity. CONCLUSIONS This is the first study showing COVID-19 lead to post-COVID-19 FGIDs. Post-COVID-19 FGIDs may pose a significant economic, social, healthcare burden to the world.