Bowel symptoms associated with coronavirus disease 19 in hospitalized patients with moderate to severe illness

Abstract

Bowel symptoms, such as diarrhea, have higher prevalence during coronavirus disease 2019 (COVID-19). The correlation between the severity of these symptoms and their prognosis has not been defined yet. Furthermore, higher prevalence of gastrointestinal symptoms after recovery from COVID-19 has been reported. This study aimed to analyze the correlation of potential factors with the severity of diarrhea during COVID-19 and to assess the progression of post-COVID-19 bowel symptoms. This prospective longitudinal cohort included 109 patients with moderate to severe COVID-19 symptoms who were hospitalized from May to July 2021. Patients were interviewed to assess the presence and intensity of bowel symptoms during COVID-19 and 3–6 months after hospital discharge using the Gastrointestinal Symptom Rating Scale questionnaire. Demographic and clinical data were obtained and their correlations with the intensity of bowel symptoms were examined. The presence of severe diarrhea was correlated with the need for ventilatory support and the use of anticoagulants but not with the use of antibiotics. In addition, bowel symptoms, such as loose stools and incomplete evacuation but not diarrhea, constipation, or abdominal pain, persisted for at least 3–6 months after hospital discharge. These results suggest that the severity of diarrhea during COVID-19 may be associated with worsening of the disease and that only loose stools and incomplete evacuation are present after COVID-19. The chronicity of these bowel symptoms should be evaluated to improve the treatment of patients with COVID-19.