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新型冠状病毒病后感染后功能性胃肠疾病:病例对照研究。

Post-infection functional gastrointestinal disorders following coronavirus disease-19: A case-control study.

机构信息

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

Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

出版信息

J Gastroenterol Hepatol. 2022 Mar;37(3):489-498. doi: 10.1111/jgh.15717. Epub 2021 Nov 4.

Abstract

BACKGROUND AND AIM

Because acute infectious gastroenteritis may cause post-infection irritable bowel syndrome and functional dyspepsia and the severe acute respiratory syndrome coronavirus-2 affects gastrointestinal (GI) tract, coronavirus disease-19 (COVID-19) may cause post-infection-functional GI disorders (FGIDs). We prospectively studied the frequency and spectrum of post-infection-FGIDs among COVID-19 and historical healthy controls and the risk factors for its development.

METHODS

Two hundred eighty 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 overlap, respectively; among healthy controls, none developed dyspeptic symptoms and one developed CBD at 3 months (P < 0.05). At 6 months, 15 (5.3%), 6 (2.1%), and 5 (1.8%) of the 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 months included symptoms (particularly GI), anosmia, ageusia, and presence of CBD, dyspeptic symptoms, or their overlap at 1 and 3 months and the psychological comorbidity.

CONCLUSIONS

This is the first study showing COVID-19 led to post-COVID-19 FGIDs. Post-COVID-19 FGIDs may pose a significant economic, social, and healthcare burden to the world.

摘要

背景与目的

由于急性感染性胃肠炎可能导致感染后肠易激综合征和功能性消化不良,而严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)会影响胃肠道(GI),因此新型冠状病毒病(COVID-19)可能导致感染后功能性胃肠疾病(FGIDs)。我们前瞻性研究了 COVID-19 患者与历史健康对照者中感染后 FGIDs 的发生频率和谱,并研究了其发生的危险因素。

方法

使用罗马问卷对 280 例 COVID-19 患者和 264 例历史健康对照者进行随访,以评估慢性肠功能紊乱(CBD)、消化不良症状及其重叠的发生,并在 6 个月时评估肠易激综合征(IBS)、未调查消化不良(UD)及其重叠的发生。使用罗马 III 型心理社会警报问卷评估心理合并症。

结果

在 1 个月和 3 个月时,COVID-19 患者分别有 16 例(5.7%)、16 例(5.7%)、11 例(3.9%)和 24 例(8.6%)出现 CBD、消化不良症状及其重叠;在健康对照组中,均无患者出现消化不良症状,仅 1 例在 3 个月时出现 CBD(P<0.05)。在 6 个月时,COVID-19 患者分别有 15 例(5.3%)、6 例(2.1%)和 5 例(1.8%)出现 IBS、UD 和 IBS-UD 重叠,而健康对照组中有 1 例在 6 个月时出现 IBS(除 IBS-UD 重叠外,P<0.05)。COVID-19 后 FGIDs 的 6 个月风险因素包括症状(特别是胃肠道)、嗅觉丧失、味觉丧失以及 1 个月和 3 个月时 CBD、消化不良症状或其重叠的存在,以及心理合并症。

结论

这是第一项表明 COVID-19 导致 COVID-19 后 FGIDs 的研究。COVID-19 后 FGIDs 可能会给世界带来重大的经济、社会和医疗保健负担。

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