ABSTRACT
Introduction Post-Infectious Irritable Bowel Syndrome May Occur After 10% Of Acute Gastrointestinal (Gi) Infections And Can Cause Significant Long-Term Morbidity. Covid-19 Frequently Presents With Acute Gi Symptoms, But It Is Unclear How Often These Persist After Recovery. The Purpose Of This Study Was To Estimate The Prevalence Of Persistent Gi Symptoms After Covid-19 And To Identify Risk Factors For This. Methods Adult Patients Who Were Hospitalized With Covid-19 At Columbia University Medical Center Between March 1 And June 30, 2020 And Had A Primary Care Appointment 30 To 180 Days After Discharge Were Reviewed For The Presence Or Absence Of Documented Gi Symptoms (Diarrhea, Abdominal Pain, Nausea/Vomiting, Or Constipation) At Initial Presentation With Covid-19 And At Primary Care Follow Up. Patients Were Excluded If They Had A Pre Existing History Of Irritable Bowel Syndrome, Other Chronic Gi Conditions, Or Acute Enteric Infections During Hospitalization With Covid-19 (E.G., Clostridioides Difficile Infection). The Prevalence Of Persistent Gi Symptoms After Covid-19 Hospitalization Was Estimated, And Risk Factors Were Assessed. Results 187 Patients Hospitalized With Covid-19 Met Study Inclusion Criteria. Of These, 37 Were Excluded For Pre-Existing Gi Symptoms And 3 For C. Difficile Infection, Leaving 147 Patients In The Cohort. The Most Common Gi Symptoms At Initial Presentation With Covid-19 Were Diarrhea (23%), Nausea/Vomiting (21%), And Abdominal Pain (6.1%). After A Median Follow-Up Time Of 106 Days (Iqr 78-141), 16% Of Patients Had Persistent Gi Symptoms (95% Confidence Interval 11 To 23%). An Additional 5% Of Patients Experienced Transient Gi Symptoms Which Resolved. At The Time Of Most Recent Follow-Up, 7.5% Of Patients Had New Abdominal Pain, 6.8% New Constipation, 4.1% New Diarrhea, And 4.1% New Nausea/ Vomiting (Table 1). The Prevalence Of Persistent Gi Symptoms After Covid-19 Was Significantly Higher Than The Estimated Prevalence Of Post-Infectious Irritable Bowel Syndrome After Acute Gastroenteritis (16% Vs. 10%, P=0.01) But May Decline Over Time (Figure 1). The Presence Of Gi Symptoms At The Time Of Initial Presentation Was A Risk Factor For Persistent Symptoms After Hospitalization For Covid-19 (22% Vs. 14%, P=0.21). Prior History Of Depression Was Also A Risk Factor For Persistent Gi Symptoms (28% Vs. 13%, P=0.04). Conclusion At A Median Of 106 Days After Discharge Following Hospitalization For Covid-19, 16% Of Patients Reported Persistent New Gi Symptoms. The Long-Term Gi Effects Of Covid-19 Should Be Further Studied.