Neurogastro LATAM Reviews (Apr 2022)

Disorders of gut-brain interaction post-COVID-19: a literature review

  • Gabriel Mendoza-Domínguez,
  • Danielle S. Miller,
  • Max J. Schmulson

DOI
https://doi.org/10.24875/NGL.22000018
Journal volume & issue
Vol. 6, no. 2

Abstract

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Gastrointestinal (GI) manifestations in COVID-19 have been extensively reported. These are possibly related to the high expression of the angiotensin converting enzyme 2 receptors in the enteric cells, which are required by severe acute respiratory syndrome (SARS-CoV-2) to bind and infect the human cells. This interaction triggers an inflammatory process, increased permeability, and gut dysbiosis. These factors, along with psychological distress also present during the pandemic, have been related to the presence of post-infection disorders of gut-brain interaction (PI-DGBI), and we accordingly proposed the inevitable surge of post-COVID-19 DGBI. Therefore, we conducted a review in PubMed of original studies analyzing the impact of COVID-19 in patients previously diagnosed with DGBI, as well as the prevalence and risk factors for developing post-COVID-19 DGBI. Searched terms were “COVID-19” AND “Disorders of Gut-Brain interaction”, OR “DGBI”, OR “IBS”, OR “Functional dyspepsia”. Twenty-one papers were identified. We found that 11.8%-90% of patients with DGBI reported exacerbations of their GI symptoms during the pandemic. The prevalence of post-COVID-19 DGBI varied between 9.2% to 49% depending on the study methodology. The most common post-COVID-19 DGBI were FD, at 2.1-29.0%, and IBS, less frequent at 1.0-15.8%. However, post-COVID-19 DGBI also included esophageal and anorectal DGBI. One study reported that in 14% of the post-COVID-19 DGBI-patients there were no GI symptoms during the acute illness. Finally, for the female sex, anxiety, and depression were risk factors for post-COVID-19 DGBI. In conclusion, COVID-19 and associated psychosocial factors can exacerbate the symptoms of DGBI. In addition, a subgroup of patients with COVID-19 can develop post-COVID-19 DGBI, some without GI symptoms during the acute illness. The future studies need to determine the long-term prognosis and treatment of the post-COVID-19 DGBI.

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