Over 70% of Black adults with long COVID-19 who have gastrointestinal (GI) symptoms, abnormal liver function tests, or a medical history of liver disease have sleep and neurologic issues, according to study results presented at Digestive Disease Week (DDW), held from May 6 to 9, 2023 in Chicago, Illinois, and virtually.
Researchers sought to evaluate the frequency of GI manifestations of long COVID-19 and determine whether they are associated with sleep or neurologic symptoms.
The analysis included patients with a positive polymerase chain reaction (PCR) result for SARS-CoV-2 (N=747) who were hospitalized from February 2020 to May 2021 at a university hospital. The patients were interviewed 6 to 12 months from discharge, and GI, sleep, and neurologic symptoms (Montreal Cognitive Assessment [MoCA]) were assessed using a standardized questionnaire. Statistical significance was determined with linear regression analysis, chi-square test, and Fisher exact test.
Of study participants hospitalized with SARS-CoV-2 (mean age, 58 years; women, 51.6%; Black, 73.6% [n=550]), 108 died during their initial hospital stay, and the remaining 639 patients were included in the follow-up. Of this group, 350 responded to the questionnaire and 57 patients died during the follow-up.
Among the participants, 13.3% reported GI-related symptoms, of whom 6.4% had persistent GI symptoms and 6.8% had new-onset GI symptoms. Nausea and vomiting were the most frequently occurring symptoms (61.5%), followed by abdominal pain (18%), diarrhea (12.8%), and other symptoms (7.6%). The patients who presented with vomiting during acute COVID-19 infection were likely to have long COVID-19 GI manifestations (P =.023).
Use of angiotensin-converting enzyme inhibitors, an abnormal lymphocyte count, and increased ferritin level also had significant associations with long COVID-19 GI manifestations (P =.03, .006, and .03, respectively). During the follow-up, 9.5% of participants reported difficulty with sleep and 27% had abnormal MoCA assessment.
Additional analysis revealed a linear trend between GI symptoms at admission with MoCA assessment, abnormal liver function test, and a history of liver disease with sleep problems. Baseline characteristics, clinical comorbidities, other laboratory values, hospital length of stay, mechanical ventilation, medications during hospitalization, readmission, and influenza or COVID-19 vaccination were not associated with follow-up GI symptoms.
“Further large population studies are encouraged to determine if COVID-19 leads to GI symptom-associated long COVID phenotype and its importance for other long COVID phenotypes through the gut-brain axis,” the study authors noted.
This article originally appeared on Gastroenterology Advisor
Challa SR, Singh GP, Ibrahim M, et al. Gastrointestinal manifestations and their association with neurologic and sleep problems in long COVID-19 minority patients: a prospective follow-up study. Abstract presented at: DDW 2023; May 6-9, 2023; Chicago, IL. Abstract Su1112.