New research says that Covid-19 patients who had been hospitalized with gastrointestinal (GI) complaints on initial presentation, failed to gain weight after discharge. This inability to gain weight continued for months, even as most GI symptoms such as gastroenteritis, GI bleeding and pancreatitis resolved in most patients at follow up.

The retrospective study published recently in the journal Clinical Gastroenterology and Hepatology found 50% of patients reported not gaining weight at 3 months and 32.4% reported an inability to gain weight even after 6 months. Malnourished patients were more likely to experience this with 56.4% individuals reporting failure to gain weight at 6 months.

This was a multicenter study involving 17,462 Covid patients who were hospitalized with Covid-related GI symptoms from March 2020 to January 2021. These patients had 3 months and/or 6 months of outpatient follow-up or were hospitalized again.

This study shows that GI symptoms are common in patients with Covid-19. A total of 18.5% patients were found to have GI symptoms. The most common presenting GI symptom was gastroenteritis (52.5%); the other common symptoms were bleeding (20.4%), malnutrition (23%) and idiopathic pancreatitis (0.5%).

This study also points out that the majority of GI symptoms usually settle down in most patients. Gastroenteritis resolved in 90.5% patients at 3 months and 89.4% at 6 months, while GI bleeding resolved in 92.0% patients at 3 months and 94.7% at 6 months. Pancreatitis also resolved in all patients at 3 months and 6 months. Endoscopy for GI bleeding was done in 19 patients, which revealed gastric and duodenal ulcers (21.1%) and gastritis or duodenitis (21.1%), whereas no pathology was detected in 21% patients.

The only symptom which persisted at 3 and 6 months follow up was malnutrition. In malnourished patients, the weight at the time of hospitalization was 156.4 pounds (~71 kg); the weight loss at 3 months was -4.9 pounds (2.2 kg) and at 6 months -2.2 pounds (~1kg); 59.1% patients could not gain weight at 3 months, while another 56.4 % patients were unable to gain weight at 6 months.

The study therefore concluded that GI symptoms like bleeding, gastroenteritis and pancreatitis in Covid-19 patients may improve with time; but, symptoms of malnutrition, weight loss and anorexia may not recover and persist in a large percentage of patients. They find it difficult to gain weight. Researchers recommend that patients who develop malnutrition during hospitalization should be paid special attention to. Also, post-Covid patients should also be screened for malnutrition.

Good nutrition is very important for good health. This means eating the right foods in the right quantities. This will help the immune system, which had been under siege because of Covid-19, to recover. The Health Ministry, in their Post COVID management protocol, has recommended eating a balanced nutritious diet, preferably easy to digest freshly cooked soft diet and avoiding smoking and consumption of alcohol

(Source: Medpage Today, July 2, 2021; Clinical Gastroenterology and Hepatology 2021, doi: https://doi.org/10.1016/j.cgh.2021.06.046)