Zeng Xin, Li Xiang, Fu Yansong, Chen Jie, Yang Keyi, Qin Hong
Xiangya School of Public Health, Central South University, Changsha, Hunan, 410128, China.
Department of Emergency Medicine, Hunan Provincial People's Hospital, Changsha, Hunan, 410005, China.
Virol J. 2025 Jun 30;22(1):213. doi: 10.1186/s12985-025-02847-y.
BACKGROUND: Sequelae and complications have become a significant concern in the post-pandemic era of Coronavirus disease 2019 (COVID-19). However, it remains unclear whether there is a direct causal relationship between COVID-19 or vaccination and digestive diseases, as existing evidence is ambiguous and controversial. In this study, we investigated the associations between multiple COVID-19 infection phenotypes, vaccination, and 20 common digestive diseases, and explored their causal relationships through extensive Mendelian randomization (MR) analysis. METHODS: For individuals of European descent, we conducted an extensive two-sample Mendelian randomization (MR) analysis using genome-wide association study (GWAS) data. Six COVID-19 infection (six phenotypes) GWAS datasets and two vaccination (from the UK and Finland) GWAS datasets were used as exposure factors; 20 common digestive diseases were treated as outcome factors, with each disease having two or more GWAS datasets, mostly sourced from the UK Biobank and FinnGene platforms. Single nucleotide polymorphisms (SNPs) associated with the exposures were used as instrumental variables (IVs) to estimate the causal relationship between COVID-19, vaccination, and the 20 digestive diseases. Meta-analysis was conducted to assess the combined causal effect from multiple MR results. RESULTS: MR analysis revealed a causal relationship between COVID-19 and duodenal ulcer (P = 4.98E-03, OR = 1.00, 95% CI: 1.00-1.00). Additionally, COVID-19 hospitalization was associated with viral hepatitis (P = 4.94E-02, OR = 1.10, 95% CI: 1.00-1.21), cirrhosis (P = 1.72E-02, OR = 0.91, 95% CI: 0.85-0.98), and chronic pancreatitis (P = 1.48E-02, OR = 0.91, 95% CI: 0.84-0.98). Severe COVID-19 infection was linked to viral hepatitis (P = 3.57E-02, OR = 1.00, 95% CI: 1.00-1.00), cholelithiasis (P = 3.50E-02, OR = 1.00, 95% CI: 1.00-1.00), and Crohn's disease (P = 4.15E-02, OR = 0.96, 95% CI: 0.93-1.00). Meta-analysis further supported a causal link between COVID-19 and duodenal ulcer (P = 4.97E-03, OR = 1.00, 95% CI: 1.00-1.00), gastroesophageal reflux disease (P = 3.38E-02, OR = 1.04, 95% CI: 1.00-1.07), and chronic pancreatitis (P = 2.67E-03, OR = 0.92, 95% CI: 0.87-0.97). COVID-19 vaccination (Finland) was associated with an increased risk of gastroesophageal reflux disease (P = 3.38E-02, OR = 1.12, 95% CI: 1.01-1.24). After applying the Benjamini-Hochberg correction, no significant differences were observed in the meta-analysis results. CONCLUSIONS: This extensive MR study found no strong causal relationship between COVID-19 infection, vaccination, and 20 common digestive diseases based on genetic data. These results help clarify the longstanding uncertainty surrounding the potential causal links between COVID-19-related factors and digestive diseases. Our findings suggest that genetic variants associated with COVID-19 infection and vaccination do not significantly influence the risk of these diseases, which could inform clinical treatment strategies and public health guidelines.
背景:在2019冠状病毒病(COVID-19)大流行后的时代,后遗症和并发症已成为一个重大问题。然而,由于现有证据模糊且存在争议,COVID-19或疫苗接种与消化系统疾病之间是否存在直接因果关系仍不清楚。在本研究中,我们调查了多种COVID-19感染表型、疫苗接种与20种常见消化系统疾病之间的关联,并通过广泛的孟德尔随机化(MR)分析探索它们的因果关系。 方法:对于欧洲血统的个体,我们使用全基因组关联研究(GWAS)数据进行了广泛的两样本孟德尔随机化(MR)分析。六个COVID-19感染(六种表型)GWAS数据集和两个疫苗接种(来自英国和芬兰)GWAS数据集用作暴露因素;20种常见消化系统疾病作为结局因素,每种疾病有两个或更多GWAS数据集,大多来自英国生物银行和芬兰基因平台。与暴露相关的单核苷酸多态性(SNP)用作工具变量(IV),以估计COVID-19、疫苗接种与20种消化系统疾病之间的因果关系。进行荟萃分析以评估多个MR结果的综合因果效应。 结果:MR分析显示COVID-19与十二指肠溃疡之间存在因果关系(P = 4.98E-03,OR = 1.00,95% CI:1.00-1.00)。此外,COVID-19住院与病毒性肝炎(P = 4.94E-02,OR = 1.10,95% CI:1.00-1.21)、肝硬化(P = 1.72E-02,OR = 0.91,95% CI:0.85-0.98)和慢性胰腺炎(P = 1.48E-02,OR = 0.91,95% CI:0.84-0.98)相关。严重COVID-19感染与病毒性肝炎(P = 3.57E-02,OR = 1.00,95% CI:1.00-1.00)、胆石症(P = 3.50E-02,OR = 1.00,95% CI:1.00-1.00)和克罗恩病(P = 4.15E-02,OR = 0.96,95% CI:0.93-1.00)有关。荟萃分析进一步支持了COVID-19与十二指肠溃疡(P = 4.97E-03,OR = 1.00,95% CI:1.00-1.00)、胃食管反流病(P = 3.38E-02,OR = 1.04,95% CI:1.00-1.07)和慢性胰腺炎(P = 2.67E-03,OR = 0.92,95% CI:0.87-0.97)之间的因果联系。COVID-19疫苗接种(芬兰)与胃食管反流病风险增加相关(P = 3.38E-02,OR = 1.12,95% CI:1.01-1.24)。应用本雅明尼-霍奇伯格校正后,荟萃分析结果未观察到显著差异。 结论:这项广泛的MR研究基于遗传数据未发现COVID-19感染、疫苗接种与20种常见消化系统疾病之间存在强因果关系。这些结果有助于澄清围绕COVID-19相关因素与消化系统疾病之间潜在因果联系的长期不确定性。我们的研究结果表明,与COVID-19感染和疫苗接种相关的基因变异不会显著影响这些疾病的风险,这可为临床治疗策略和公共卫生指南提供参考。
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