新冠病毒病对肠-脑相互作用障碍的长期影响：发病率、症状负担及心理合并症

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核心技术专利：CN118964589B侵权必究

Suppr 超能文献

核心技术专利：CN118964589B侵权必究

Marasco Giovanni, Hod Keren, Colecchia Luigi, Cremon Cesare, Barbaro Maria Raffaella, Cacciari Giulia, Falangone Francesca, Kagramanova Anna, Bordin Dmitry, Drug Vasile, Miftode Egidia, Fusaroli Pietro, Mohamed Salem Youssef, Ricci Chiara, Bellini Massimo, Rahman M Masudur, Melcarne Luigi, Santos Javier, Lobo Beatriz, Bor Serhat, Yapali Suna, Akyol Deniz, Sapmaz Ferdane Pirincci, Urun Yonca Yilmaz, Eskazan Tugce, Celebi Altay, Kacmaz Huseyin, Ebik Berat, Binicier Hatice Cilem, Bugdayci Mehmet Sait, Yağcı Munkhtsetseg Banzragch, Pullukcu Husnu, Kaya Berrin Yalınbas, Tureyen Ali, Hatemi İbrahim, Koc Elif Sitre, Sirin Goktug, Calıskan Ali Riza, Bengi Goksel, Alıs Esra Ergun, Lukic Snezana, Trajkovska Meri, Dumitrascu Dan, Pietrangelo Antonello, Corradini Elena, Simren Magnus, Sjolund Jessica, Tornkvist Navkiran, Ghoshal Uday C, Kolokolnikova Olga, Colecchia Antonio, Serra Jordi, Maconi Giovanni, De Giorgio Roberto, Danese Silvio, Portincasa Piero, Di Sabatino Antonio, Maggio Marcello, Philippou Elena, Lee Yeong Yeh, Salvi Daniele, Venturi Alessandro, Borghi Claudio, Zoli Marco, Gionchetti Paolo, Viale Pierluigi, Stanghellini Vincenzo, Barbara Giovanni

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

United European Gastroenterol J. 2025 Jun;13(5):798-818. doi: 10.1002/ueg2.70005. Epub 2025 Mar 21.

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has highlighted the potential exacerbation of gastrointestinal symptoms in patients with disorders of gut-brain interaction (DGBIs). However, the distinct symptom trajectories and psychological burden in patients with post-COVID-19 DGBIs compared with patients with pre-existing irritable bowel syndrome (IBS)/functional dyspepsia (FD) and non-DGBI controls remain poorly understood. OBJECTIVES: To examine the long-term gastrointestinal symptom progression and psychological comorbidities in patients with post-COVID-19 DGBI, patients with pre-existing IBS/FD and non-DGBI controls. METHODS: This post hoc analysis of a prospective multicenter cohort study reviewed patient charts for demographic data and medical history. Participants completed the Gastrointestinal Symptom Rating Scale at four time points: baseline, 1, 6, and 12 months, and the Hospital Anxiety and Depression Scale at 6 and 12 months. The cohort was divided into three groups: (1) post-COVID-19 DGBIs (2) non-DGBI, and (3) pre-existing IBS/FD, with the post-COVID-19 DGBIs group compared to the latter two control groups. RESULTS: Among 599 eligible patients, 27 (4.5%) were identified as post-COVID-19 DGBI. This group experienced worsening abdominal pain, hunger pain, heartburn, and acid regurgitation, unlike symptom improvement or stability in non-DGBI controls (p < 0.001 for all symptoms, except hunger pain, p = 0.001). While patients with pre-existing IBS/FD improved in most gastrointestinal symptoms but worsened in constipation and incomplete evacuation, patients with post-COVID-19 DGBI exhibited consistent symptom deterioration across multiple gastrointestinal domains. Anxiety and depression remained unchanged in patients with post-COVID-19 DGBI, contrasting with significant reductions in controls (non-DGBI: p = 0.003 and p = 0.057; pre-existing IBS/FD: p = 0.019 and p = 0.007, respectively). CONCLUSIONS: COVID-19 infection is associated with the development of newly diagnosed DGBIs and distinct symptom trajectories when compared with patients with pre-existing IBS/FD. Patients with post-COVID-19 DGBI experience progressive gastrointestinal symptom deterioration and persistent psychological distress, underscoring the need for tailored management strategies for this unique subgroup.

背景：严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行凸显了肠道-脑互动障碍（DGBIs）患者胃肠道症状可能加重的情况。然而，与患有既往肠易激综合征（IBS）/功能性消化不良（FD）的患者及非DGBI对照组相比，新冠病毒感染后DGBIs患者独特的症状轨迹和心理负担仍知之甚少。目的：研究新冠病毒感染后DGBI患者、患有既往IBS/FD的患者及非DGBI对照组的胃肠道症状长期进展情况及心理合并症。方法：这项对一项前瞻性多中心队列研究的事后分析回顾了患者病历以获取人口统计学数据和病史。参与者在四个时间点完成胃肠道症状评定量表：基线、1个月、6个月和12个月，并在6个月和12个月时完成医院焦虑抑郁量表。该队列分为三组：（1）新冠病毒感染后DGBIs组；（2）非DGBI组；（3）患有既往IBS/FD组，将新冠病毒感染后DGBIs组与后两个对照组进行比较。结果：在599名符合条件的患者中，27名（4.5%）被确定为新冠病毒感染后DGBI患者。与非DGBI对照组症状改善或稳定不同，该组患者出现腹痛、饥饿痛、烧心和反酸加重（除饥饿痛外，所有症状p<0.001，饥饿痛p = 0.001）。虽然患有既往IBS/FD的患者大多数胃肠道症状有所改善，但便秘和排便不尽症状加重，而新冠病毒感染后DGBI患者在多个胃肠道领域均出现症状持续恶化。新冠病毒感染后DGBI患者的焦虑和抑郁状况保持不变，这与对照组的显著降低形成对比（非DGBI组：p = 0.003和p = 0.057；患有既往IBS/FD组：分别为p = 0.019和p = 0.007）。结论：与患有既往IBS/FD的患者相比，新冠病毒感染与新诊断的DGBIs的发生及独特的症状轨迹相关。新冠病毒感染后DGBI患者经历胃肠道症状的渐进性恶化和持续的心理困扰，这凸显了针对这一独特亚组制定个性化管理策略的必要性。