Clinic of Internal Medicine- Gastroenterology, University Hospital in Martin, Jessenius Faculty of Medicine in Martin (JFM CU), Comenius University in Bratislava.
Clinic of Infectology and Travel Medicine, University Hospital in Martin, Jessenius Faculty of Medicine in Martin (JFM CU), Comenius University in Bratislava.
Eur J Gastroenterol Hepatol. 2022 Sep 1;34(9):925-932. doi: 10.1097/MEG.0000000000002425. Epub 2022 Jul 27.
Post-coronavirus disease (post-COVID) symptoms arise mostly from impaired function of respiratory tract although in many patients, the dysfunction of gastrointestinal tract and liver among other organ systems may persist.
Primary data collection was based on a short gastrointestinal symptom questionnaire at the initial screening. A brief telephone survey within the patient and control group was performed 5-8 months after the initial screening. R ver. 4.0.5 and imbalanced RandomForest (RF) machine-learning algorithm were used for data explorations and analyses.
A total of 590 patients were included in the study. The general presence of gastrointestinal symptoms 208.2 days (153-230 days) after the initial acute severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection was 19% in patients with moderate-to-serious course of the disease and 7.3% in patients with mild course compared with 3.0% in SARS-CoV-2 negative controls (P < 0.001). Diarrhea and abdominal pain are the most prevalent post-COVID gastrointestinal symptoms. RF machine-learning algorithm identified acute diarrhea and antibiotics administration as the strongest predictors for gastrointestinal sequelae with area under curve of 0.68. Variable importance for acute diarrhea is 0.066 and 0.058 for antibiotics administration.
The presence of gastrointestinal sequelae 7 months after the initial SARS-CoV-2 infection is significantly higher in patients with moderate-to-severe course of the acute COVID-19 compared with asymptomatic patients or those with mild course of the disease. The most prevalent post-COVID gastrointestinal symptoms are diarrhea and abdominal pain. The strongest predictors for persistence of these symptoms are antibiotics administration and acute diarrhea during the initial infection.
新冠病毒病（COVID-19）后症状主要源于呼吸道功能障碍，尽管在许多患者中，胃肠道和肝脏等其他器官系统的功能障碍可能持续存在。
初步数据收集基于初始筛查时的简短胃肠道症状问卷。在初始筛查后 5-8 个月，对患者和对照组进行简短的电话调查。使用 R 版本 4.0.5 和不平衡随机森林（RF）机器学习算法进行数据探索和分析。
共有 590 名患者纳入研究。在初始严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染后 208.2 天（153-230 天），中度至重度疾病患者胃肠道症状的总体发生率为 19%，轻度疾病患者为 7.3%，而 SARS-CoV-2 阴性对照组为 3.0%（P<0.001）。腹泻和腹痛是 COVID-19 后最常见的胃肠道症状。RF 机器学习算法确定急性腹泻和抗生素治疗是胃肠道后遗症的最强预测因素，曲线下面积为 0.68。急性腹泻的变量重要性为 0.066，抗生素治疗为 0.058。
与无症状患者或轻症患者相比，中度至重度急性 COVID-19 患者在初始 SARS-CoV-2 感染后 7 个月出现胃肠道后遗症的发生率明显更高。COVID-19 后最常见的胃肠道症状是腹泻和腹痛。这些症状持续存在的最强预测因素是初始感染期间使用抗生素和急性腹泻。
