Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan.
Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan.
BMC Gastroenterol. 2023 Apr 5;23(1):108. doi: 10.1186/s12876-023-02746-y.
Intestinal microinflammation with immune dysfunction due to severe acute respiratory syndrome coronavirus 2 reportedly precipitates post-infectious irritable bowel syndrome. This study aimed to elucidate potential risk factors for subsequent development of irritable bowel syndrome, hypothesizing that it is associated with specific symptoms or patient backgrounds.
This single-center retrospective observational study (2020-2021) included adults with confirmed coronavirus disease requiring hospital admission and was conducted using real-world data retrieved from a hospital information system. Patient characteristics and detailed gastrointestinal symptoms were obtained and compared between patients with and without coronavirus disease-induced irritable bowel syndrome. Multivariate logistic models were used to validate the risk of developing irritable bowel syndrome. Moreover, daily gastrointestinal symptoms during hospitalization were examined in patients with irritable bowel syndrome.
Among the 571 eligible patients, 12 (2.1%) were diagnosed with irritable bowel syndrome following coronavirus disease. While nausea and diarrhea during hospitalization, elevated white blood cell count on admission, and intensive care unit admission were associated with the development of irritable bowel syndrome, nausea and diarrhea were identified as risk factors for its development following coronavirus disease, as revealed by the adjusted analyses (odds ratio, 4.00 [1.01-15.84] and 5.64 [1.21-26.31], respectively). Half of the patients with irritable bowel syndrome had both diarrhea and constipation until discharge, and constipation was frequently followed by diarrhea.
While irritable bowel syndrome was rarely diagnosed following coronavirus disease, nausea and diarrhea during hospitalization precede the early signs of irritable bowel syndrome following coronavirus disease.
据报道，严重急性呼吸综合征冠状病毒 2 引起的肠道微炎症伴免疫功能障碍可引发感染后肠易激综合征。本研究旨在阐明感染后发生肠易激综合征的潜在危险因素，假设其与特定症状或患者背景相关。
这项单中心回顾性观察性研究（2020-2021 年）纳入了因确诊的新型冠状病毒病而需要住院治疗的成年人，并使用从医院信息系统中检索到的真实世界数据进行。比较了患有和不患有新型冠状病毒病引起的肠易激综合征的患者的特征和详细的胃肠道症状。使用多变量逻辑模型验证发生肠易激综合征的风险。此外，还检查了肠易激综合征患者住院期间的每日胃肠道症状。
在 571 名合格患者中，12 名（2.1%）在新型冠状病毒病后被诊断为肠易激综合征。虽然住院期间的恶心和腹泻、入院时白细胞计数升高以及入住重症监护病房与肠易激综合征的发生相关，但调整后的分析显示，恶心和腹泻是新型冠状病毒病后发生肠易激综合征的危险因素（比值比，4.00[1.01-15.84]和 5.64[1.21-26.31]）。肠易激综合征患者中有一半在出院前既有腹泻又有便秘，而且便秘后常伴有腹泻。
虽然新型冠状病毒病后很少诊断出肠易激综合征，但住院期间的恶心和腹泻先于新型冠状病毒病后肠易激综合征的早期迹象。
