Post-infection irritable bowel syndrome following Coronavirus disease-19: A systematic review and meta-analysis

Akash Mathur; Umair Shams; Piyush Mishra; Shikha Sahu; Mahesh K Goenka; Ujjala Ghoshal; Uday C Ghoshal

doi:10.1007/s12664-023-01486-x

Post-infection irritable bowel syndrome following Coronavirus disease-19: A systematic review and meta-analysis

Indian J Gastroenterol. 2024 Jan 23. doi: 10.1007/s12664-023-01486-x. Online ahead of print.

Authors

Akash Mathur¹, Umair Shams¹, Piyush Mishra¹, Shikha Sahu¹, Mahesh K Goenka², Ujjala Ghoshal³, Uday C Ghoshal^{4

5}

Affiliations

¹ Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India.
² Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, 700 054, India.
³ Department of Microbiology, All India Institute of Medical Science, Kalyani, 741 245, India.
⁴ Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India. udayghoshal@gmail.com.
⁵ Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, 700 054, India. udayghoshal@gmail.com.

PMID: 38261245
DOI: 10.1007/s12664-023-01486-x

Abstract

BACKGROUND AND OBJECTIVES: Persistent gastrointestinal (GI) symptoms and functional gastrointestinal disorders (FGIDs) are increasingly being recognized after Coronavirus disease-19 (COVID-19). Though quite a few studies addressed irritable bowel syndrome (IBS) following COVID-19, the disorders' prevalence varies greatly. We evaluated, (i) overall frequency of post-COVID-19 IBS, (ii) relative risk of development of IBS among COVID-19 patients compared to healthy controls using systematic review and meta-analysis techniques.

Methods: Literature search was performed for studies on GI symptoms and FGIDs after COVID-19 using electronic databases (Medline, Scopus, Cochrane Central Register of Controlled Trials, Google Scholar and Web of Science) till April 28, 2023. We included studies reporting IBS after COVID-19 with any duration of follow-up and any number of subjects. Studies on pediatric population and those not providing relevant information were excluded. Relative risk of development of IBS using Rome criteria among COVID-19 patients compared to healthy controls was calculated. Analysis was done using MedCalc (Applied Math, Mariakerke, Belgium, version 7.2) and Comprehensive Meta-Analysis version 3.3.070 (Biostat Inc. Englewood, NJ 07631, USA).

Results: Of the available studies, 13 (four case-control) reporting on IBS after COVID-19 met inclusion criteria. Among 3950 COVID-19 patients and 991 controls, 7.2% of COVID-19 patients and 4.9% of healthy controls developed IBS. Of the four case-control studies reporting post-COVID-19 IBS, patients with COVID-19 were 2.65 (95% confidence interval [CI] 0.538 to 13.039) times more likely to have post-COVID-19 IBS as compared to healthy controls.

Conclusions: Patients with COVID-19 are more likely to develop post-COVID-19 IBS than healthy controls. The heterogeneity of studies, different criteria used by various studies to diagnose post-COVID-19 IBS and some studies not meeting the six-month follow-up duration of the Rome criteria for diagnosing IBS are limitations of this systematic review.

Keywords: COVID-19; Functional bowel disorders; Functional dyspepsia; Irritable bowel syndrome; Post-infection IBS.

Publication types

Review