Sadness and Anxiety Modify the Relationship Between COVID-19 and Gastrointestinal Symptoms at 6–12 Months of Follow-up
Background and Aims: It is unclear to what degree post-COVID-19 gastrointestinal (GI) symptoms are caused by the SARS-CoV-2 virus vs psychological factors related to the stress of the pandemic. To evaluate this, we compared rates of long-term GI and mental health symptoms in patients testing positiv...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Gastro Hep Advances |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772572323000924 |
| _version_ | 1797657874925617152 |
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| author | John W. Blackett Mitchell S.V. Elkind Sheila O’Byrne Milton Wainberg Lawrence Purpura Lin Chang Daniel E. Freedberg |
| author_facet | John W. Blackett Mitchell S.V. Elkind Sheila O’Byrne Milton Wainberg Lawrence Purpura Lin Chang Daniel E. Freedberg |
| author_sort | John W. Blackett |
| collection | DOAJ |
| description | Background and Aims: It is unclear to what degree post-COVID-19 gastrointestinal (GI) symptoms are caused by the SARS-CoV-2 virus vs psychological factors related to the stress of the pandemic. To evaluate this, we compared rates of long-term GI and mental health symptoms in patients testing positive vs negative for SARS-CoV-2. Methods: Adults presenting for SARS-CoV-2 testing from April to November 2020 were prospectively enrolled in a longitudinal cohort. Six to 12 months later, the presence and severity of current GI and mental health symptoms were assessed on a 5-point Likert scale. A multivariable logistic regression model was used to estimate the odds of a positive COVID test for predicting GI symptoms, stratified by sadness/anxiety. Results: 749 COVID-positive and 107 COVID-negative patients completed the survey. The prevalence of at least one GI symptom was higher in patients with COVID-19 (29 vs 18%, P = .01). However, after stratifying by sadness/anxiety, differences in GI symptoms according to COVID status were no longer significant. On multivariable analysis, the adjusted odds ratio for GI symptoms was 8.26 (95% CI 4.04–16.9) for positive COVID with sadness/anxiety, 8.74 (95% CI 2.63–29.0) for negative COVID with sadness/anxiety, and 1.16 (95% CI 0.57–2.39) for positive COVID without sadness/anxiety, compared to a reference group of negative COVID without sadness/anxiety. Conclusion: After accounting for sadness and anxiety, there was no association between COVID-19 and the development of long-term GI symptoms. Post-COVID GI symptoms may be mediated bidirectionally through coexisting anxiety and depression, similar to disorders of gut-brain interaction. |
| first_indexed | 2024-03-11T17:50:53Z |
| format | Article |
| id | doaj.art-4f2fc7a9f3c943108d771440167866a5 |
| institution | Directory Open Access Journal |
| issn | 2772-5723 |
| language | English |
| last_indexed | 2024-03-11T17:50:53Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gastro Hep Advances |
| spelling | doaj.art-4f2fc7a9f3c943108d771440167866a52023-10-18T04:31:49ZengElsevierGastro Hep Advances2772-57232023-01-0127918924Sadness and Anxiety Modify the Relationship Between COVID-19 and Gastrointestinal Symptoms at 6–12 Months of Follow-upJohn W. Blackett0Mitchell S.V. Elkind1Sheila O’Byrne2Milton Wainberg3Lawrence Purpura4Lin Chang5Daniel E. Freedberg6Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, New York, New York; Correspondence: Address correspondence to: John W. Blackett, MD, MS, Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, 161 Fort Washington Avenue, New York, New York 10032.Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New YorkDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New YorkDepartment of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute, New York, New YorkDivision of Infectious Diseases, Columbia University Irving Medical Center, New York, New YorkDavid Geffen School of Medicine at UCLA, Vatche and Tamar Manoukian Division of Digestive Diseases and G. Oppenheimer Center for Neurobiology of Stress and Resilience, Los Angeles, CaliforniaDivision of Digestive and Liver Diseases, Columbia University Irving Medical Center, New York, New YorkBackground and Aims: It is unclear to what degree post-COVID-19 gastrointestinal (GI) symptoms are caused by the SARS-CoV-2 virus vs psychological factors related to the stress of the pandemic. To evaluate this, we compared rates of long-term GI and mental health symptoms in patients testing positive vs negative for SARS-CoV-2. Methods: Adults presenting for SARS-CoV-2 testing from April to November 2020 were prospectively enrolled in a longitudinal cohort. Six to 12 months later, the presence and severity of current GI and mental health symptoms were assessed on a 5-point Likert scale. A multivariable logistic regression model was used to estimate the odds of a positive COVID test for predicting GI symptoms, stratified by sadness/anxiety. Results: 749 COVID-positive and 107 COVID-negative patients completed the survey. The prevalence of at least one GI symptom was higher in patients with COVID-19 (29 vs 18%, P = .01). However, after stratifying by sadness/anxiety, differences in GI symptoms according to COVID status were no longer significant. On multivariable analysis, the adjusted odds ratio for GI symptoms was 8.26 (95% CI 4.04–16.9) for positive COVID with sadness/anxiety, 8.74 (95% CI 2.63–29.0) for negative COVID with sadness/anxiety, and 1.16 (95% CI 0.57–2.39) for positive COVID without sadness/anxiety, compared to a reference group of negative COVID without sadness/anxiety. Conclusion: After accounting for sadness and anxiety, there was no association between COVID-19 and the development of long-term GI symptoms. Post-COVID GI symptoms may be mediated bidirectionally through coexisting anxiety and depression, similar to disorders of gut-brain interaction.http://www.sciencedirect.com/science/article/pii/S2772572323000924Irritable Bowel SyndromeSARS-CoV-2COVID-19Post-Acute COVID-19 SyndromeDisorders of Gut-Brain Interaction |
| spellingShingle | John W. Blackett Mitchell S.V. Elkind Sheila O’Byrne Milton Wainberg Lawrence Purpura Lin Chang Daniel E. Freedberg Sadness and Anxiety Modify the Relationship Between COVID-19 and Gastrointestinal Symptoms at 6–12 Months of Follow-up Gastro Hep Advances Irritable Bowel Syndrome SARS-CoV-2 COVID-19 Post-Acute COVID-19 Syndrome Disorders of Gut-Brain Interaction |
| title | Sadness and Anxiety Modify the Relationship Between COVID-19 and Gastrointestinal Symptoms at 6–12 Months of Follow-up |
| title_full | Sadness and Anxiety Modify the Relationship Between COVID-19 and Gastrointestinal Symptoms at 6–12 Months of Follow-up |
| title_fullStr | Sadness and Anxiety Modify the Relationship Between COVID-19 and Gastrointestinal Symptoms at 6–12 Months of Follow-up |
| title_full_unstemmed | Sadness and Anxiety Modify the Relationship Between COVID-19 and Gastrointestinal Symptoms at 6–12 Months of Follow-up |
| title_short | Sadness and Anxiety Modify the Relationship Between COVID-19 and Gastrointestinal Symptoms at 6–12 Months of Follow-up |
| title_sort | sadness and anxiety modify the relationship between covid 19 and gastrointestinal symptoms at 6 12 months of follow up |
| topic | Irritable Bowel Syndrome SARS-CoV-2 COVID-19 Post-Acute COVID-19 Syndrome Disorders of Gut-Brain Interaction |
| url | http://www.sciencedirect.com/science/article/pii/S2772572323000924 |
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