Previous reports suggest the occurrence of gastrointestinal (GI) post-COVID symptoms in 10-25% of the population; most of these have used cross-sectional designs.

This multicenter cohort study included patients diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the reverse transcription polymerase chain reaction (rPCR).  

Here, participants were enquired through telephonic interviews about their GI post-COVID symptoms, like diarrhea. Additional information was collected from hospital records. 

Overall, 1,593 individuals were selected; the mean age was 61.5±16 years. The results showed a decline in the diarrhea prevalence from the time of hospital admission – from 10% to 2.25% at 6-10 months after discharge, and thereafter, to 1% at 11-15 months post-discharge.

Moreover, 94% of the patients’ diarrhea symptoms resolved at 6-10 months after hospitalization. Meanwhile, those who still had diarrhea symptoms until this time had developed the symptoms way after discharge. The overall diarrhea prevalence in this cohort was 6.7% at 6-10 months and 4.5% at 11-15 months post-discharge. These rates were consistent with the existing literature. 

The high prevalence of GI inflammation is because the GI cells expressing the angiotensin-converting enzyme II receptor (ACE2), as well as transmembrane serine protease 2 (TMPRSS3) – which act as docking sites for the causative pathogen––SARS-CoV-2. Of note, although the GI symptoms are reversible, they may persist >3 years post-hospitalization due to SARS-CoV-2 infection. 

It was inferred that early identification of the contributors to GI symptoms may aid in long-COVID management.

Source: Journal of Medical Virology. 2022 Jul; 94(7): 2925–2927. Published online 2022 Mar 26. doi: 10.1002/jmv.27727