Exacerbated gastrointestinal symptoms and long COVID in IBD patients with SARS-CoV-2 infection: A multi-center study from taiwan

Tsung-Yu Tsai; Jia-Feng Wu; Meng-Tzu Weng; Chiao-Hsiung Chuang; Tien-Yu Huang; Wei-Chen Tai; Chi-Ming Tai; Chen-Shuan Chung; Chih-Cheng Chen; Ching-Pin Lin; Yuan-Yao Tsai; Shu-Chen Wei

doi:10.1016/j.jfma.2024.03.016

Exacerbated gastrointestinal symptoms and long COVID in IBD patients with SARS-CoV-2 infection: A multi-center study from taiwan

J Formos Med Assoc. 2024 Mar 28:S0929-6646(24)00177-3. doi: 10.1016/j.jfma.2024.03.016. Online ahead of print.

Authors

Affiliations

¹ Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Center for Translational Genomics & Regenerative Medicine Research, China Medical University Hospital, Taichung, Taiwan.
² Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
³ Department of Medical Research, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan; Division of Gastroenterology, National Taiwan University Hospital, Taipei, Taiwan.
⁴ Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁵ Division of Gastroenterology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
⁶ Division of Gastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
⁷ Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
⁸ Division for Gastroenterology and Hepatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
⁹ Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; Division of Gastroenterology and Hepatology, Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan; The School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan.
¹⁰ Division of Gastroenterology, Chung Shan Medical University Hospital, Taichung, Taiwan.
¹¹ Department of Colorectal Surgery, China Medical University Hospital, Taichung, Taiwan.
¹² Division of Gastroenterology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: shuchenwei@ntu.edu.tw.

PMID: 38553294
DOI: 10.1016/j.jfma.2024.03.016

Abstract

Background/purpose: Limited studies have addressed the exacerbation of symptoms and long COVID in inflammatory bowel disease (IBD) patients following non-severe COVID-19 infection, particularly with post-COVID-19 vaccination. We aim to investigate factors associated with exacerbated gastrointestinal symptoms (EGS) and long COVID in IBD patients with non-severe COVID-19, which is most common situation in daily practice.

Methods: This is an observational study by multiple centers in Taiwan from May 2020 to March 2023. We collected clinical manifestation, data, and medication information from IBD patients with non-severe COVID-19. EGS was defined as increased frequency of diarrhea, bloody stool, and abdomen pain within 14 days after SARS-COV-2 infection. Long COVID was defined following the guidelines of the World Health Organization.

Results: Out of 90 patients, most of them (88.9%) received at least standard two doses of COVID-19 vaccination and the majority (87.8%) were mild diseases of COVID-19.30% of patients experienced EGS during COVID-19 with higher ESR levels serving as a predictive factor (Odds ratio: 3.6, 95% confidence interval: 1.2-10.5, P = 0.02). 38.1% of those patients developed long COVID. The patients who experienced EGS during COVID-19 and with a history of longer IBD duration showed a significant association with long COVID (p = 0.03 and p = 0.02).

Conclusions: Our study revealed that EGS and long COVID occurred in one third of IBD patients with non-severe COVID-19, even though most of them had received the standard plus booster vaccination. We identified associated factors for EGS and long COVID, emphasizing the importance of post-COVID-19 follow-up in IBD patients.

Keywords: Exacerbated GI-Related symptoms; Inflammatory bowel disease; Long COVID.