Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India.
Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, 700 054, India.
Indian J Gastroenterol. 2024 Jun;43(3):557-566. doi: 10.1007/s12664-023-01486-x. Epub 2024 Jan 23.
UNLABELLED: BACKGROUND AND OBJECTIVES: Persistent gastrointestinal (GI) symptoms and functional gastrointestinal disorders (FGIDs) are increasingly being recognized after Coronavirus disease-19 (COVID-19). Though quite a few studies addressed irritable bowel syndrome (IBS) following COVID-19, the disorders' prevalence varies greatly. We evaluated, (i) overall frequency of post-COVID-19 IBS, (ii) relative risk of development of IBS among COVID-19 patients compared to healthy controls using systematic review and meta-analysis techniques. METHODS: Literature search was performed for studies on GI symptoms and FGIDs after COVID-19 using electronic databases (Medline, Scopus, Cochrane Central Register of Controlled Trials, Google Scholar and Web of Science) till April 28, 2023. We included studies reporting IBS after COVID-19 with any duration of follow-up and any number of subjects. Studies on pediatric population and those not providing relevant information were excluded. Relative risk of development of IBS using Rome criteria among COVID-19 patients compared to healthy controls was calculated. Analysis was done using MedCalc (Applied Math, Mariakerke, Belgium, version 7.2) and Comprehensive Meta-Analysis version 3.3.070 (Biostat Inc. Englewood, NJ 07631, USA). RESULTS: Of the available studies, 13 (four case-control) reporting on IBS after COVID-19 met inclusion criteria. Among 3950 COVID-19 patients and 991 controls, 7.2% of COVID-19 patients and 4.9% of healthy controls developed IBS. Of the four case-control studies reporting post-COVID-19 IBS, patients with COVID-19 were 2.65 (95% confidence interval [CI] 0.538 to 13.039) times more likely to have post-COVID-19 IBS as compared to healthy controls. CONCLUSIONS: Patients with COVID-19 are more likely to develop post-COVID-19 IBS than healthy controls. The heterogeneity of studies, different criteria used by various studies to diagnose post-COVID-19 IBS and some studies not meeting the six-month follow-up duration of the Rome criteria for diagnosing IBS are limitations of this systematic review.
背景和目的：新冠肺炎（COVID-19）后，人们越来越多地认识到持续的胃肠道（GI）症状和功能性胃肠道疾病（FGIDs）。虽然有相当多的研究探讨了 COVID-19 后肠易激综合征（IBS），但这些疾病的患病率差异很大。我们评估了：（i）COVID-19 后 IBS 的总体发生率；（ii）使用系统评价和荟萃分析技术，比较 COVID-19 患者与健康对照组发生 IBS 的相对风险。
方法：使用电子数据库（Medline、Scopus、Cochrane 中央对照试验注册中心、Google Scholar 和 Web of Science）检索 COVID-19 后 GI 症状和 FGIDs 的研究文献，检索时间截至 2023 年 4 月 28 日。我们纳入了报告 COVID-19 后任何持续时间和任何数量受试者发生 IBS 的研究。排除了儿科人群和未提供相关信息的研究。计算 COVID-19 患者与健康对照组之间使用罗马标准诊断的 IBS 发展的相对风险。使用 MedCalc（Applied Math，Mariakerke，比利时，版本 7.2）和 Comprehensive Meta-Analysis version 3.3.070（Biostat Inc.，Englewood，NJ 07631，USA）进行分析。
结果：在可用的研究中，有 13 项（4 项病例对照）研究报告了 COVID-19 后发生 IBS，符合纳入标准。在 3950 名 COVID-19 患者和 991 名对照中，7.2%的 COVID-19 患者和 4.9%的健康对照发生了 IBS。在 4 项报告 COVID-19 后 IBS 的病例对照研究中，COVID-19 患者发生 COVID-19 后 IBS 的可能性是健康对照组的 2.65 倍（95%置信区间[CI]0.538 至 13.039）。
结论：COVID-19 患者比健康对照组更有可能发生 COVID-19 后 IBS。本系统评价的局限性包括研究的异质性、不同研究使用的不同标准来诊断 COVID-19 后 IBS 以及一些研究不符合罗马标准诊断 IBS 的 6 个月随访时间。
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