GI Symptoms, Liver Disease in Long COVID-19 Linked to Sleep, Neurologic Disturbances in Black Adults

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