S1653 Identification of Trends in Post COVID-19 Infection Gastroenterology Clinic Referrals

Abstract

Introduction: Post-viral gastrointestinal symptoms are well recognized. Over 50% of patients hospitalized with COVID-19 experienced at least one GI symptom. Here we aim to look at longer-lasting sequelae of COVID infections on the digestive system by identifying trends in patients after the resolution of acute COVID symptoms. Methods: A retrospective chart review was performed on all patients referred to the Northwestern Medicine post-COVID GI clinic from November 2020 - June 2021. For each patient, data regarding demographics and hospitalization/ICU stays during their COVID infection, psychiatric comorbidities, and GI history/medications were reviewed. EMR was reviewed to determine if they had changes in bowel habits, loss of appetite, nausea, GE reflux, abdominal pain, and/or bloody stools. Results: 45 patients were referred to the clinic during this 8 month period; however, 6 missed their appointments and thus a total of 39 patients were evaluated. There were 10 males and 29 females (avg age 42). Five of these patients were hospitalized during their COVID infection (3 were in the ICU). The most common reported symptoms were change in bowel habits (85%), abdominal pain (69%), nausea (51%), GE reflux (38%), loss of appetite (31%), and/or bloody stools (15%). Of the 85% of patients who endorsed change in bowel habits, 8/33 reported constipation, 19/33 reported diarrhea, and 6/33 had a mixed picture. 51% of patients had a psychiatric comorbidity of anxiety or depression. 62% of patients had a prior GI history, of which GERD and IBS were the most common. 74% of patients were noted to be on a prior GI medication, of which a PPI or H2 blocker were most common. Conclusion: The majority of patients seen in the post-COVID GI clinic reported a change in bowel habits (primarily diarrhea). A large percentage of patients were also noted to have concomitant psychiatric comorbidities of depression and/or anxiety. As with other GI tract diseases (e.g. IBS, IBD), it is not unexpected that pre-existing psychiatric comorbidities contribute to a heightened GI sensitivity or reporting of GI symptoms. As SARS-CoV-2 binds to ACE-2 receptors located along the GI tract, and viral RNA is shed into feces, it is also possible that the infection can impact GI tract motility and/or gut flora leading to prolonged symptoms after the resolution of respiratory symptoms. Future longitudinal studies are anticipated to determine whether the impacts on GI function are transient or long-lasting.