Psychological and Clinical Factors Mediate Post-COVID-19 Irritable Bowel Syndrome

Hod, K.; Marasco, G.; Colecchia, L.; Cremon, C.; Barbaro, M. R.; Cacciari, G.; Falangone, F.; Kagramanova, A.; Bordin, D.; Drug, V.; Miftode, E.; Fusaroli, P.; Mohamed, S. Y.; Ricci, C.; Bellini, M.; Rahman, M. M.; Melcarne, L.; Santos, J.; Lobo, B.; Bor, S.; Yapali, S.; Akyol, D.; Sapmaz, F. P.; Urun, Y. Y.; Eskazan, T.; Celebi, A.; Kacmaz, H.; Ebik, B.; Binicier, H. C.; Bugdayci, M. S.; Yagci, M. B.; Pullukcu, H.; Kaya, B. Y.; Tureyen, A.; Hatemi, I.; Koc, E. S.; Sirin, G.; Caliskan, A. R.; Bengi, G.; Alis, E. E.; Lukic, S.; Trajkovska, M.; Dumitrascu, D.; Pietrangelo, A.; Corradini, E.; Simren, M.; Sjolund, J.; Tornkvist, N.; Ghoshal, U. C.; Kolokolnikova, O.; Colecchia, A.; Serra, J.; Maconi, G.; De Giorgio, R.; Danese, S.; Portincasa, P.; Di Sabatino, A.; Maggio, M.; Philippou, E.; Lee, Y. Y.; Salvi, D.; Venturi, A.; Borghi, C.; Zoli, M.; Gionchetti, P.; Viale, P.; Stanghellini, V.; Barbara, G.

doi:10.1111/nmo.70079

Background: Exposure to COVID-19 has been shown previously to be associated with a higher risk for irritable bowel syndrome (IBS). This study aimed to better explain this relationship using mediation analysis. Methods: This post hoc analysis of a multicenter cohort study includes 623 patients with and without COVID-19 infection. All participants completed the ROME IV criteria, gastrointestinal symptom rating scale (GSRS), and hospital anxiety and depression scale (HADS) over 1 year. Mediation analysis utilized the PROCESS macro and Baron and Kenny's method for parametric and nonparametric mediating variables, respectively. Key Results: The impact of COVID-19 on the development of post-COVID-19 IBS is completely mediated by dyspnea at baseline (adjusted OR = 3.561, p = 0.012), severity of acid regurgitation at 1 month [indirect effect, log-odds metric = 0.090, 95% CI (0.006–0.180)], hunger pains at 1 [indirect effect, log-odds metric = 0.094, 95% CI (0.024–0.178)], and 6 months [indirect effect, log-odds metric = 0.074, 95% CI (0.003–0.150)], depression at 6 [indirect effect, log-odds metric = 0.106, 95% CI (0.009–0.225)] and 12 months [indirect effect, log-odds metric = 0.146, 95% CI (0.016–0.311)] as well as borborygmus [indirect effect, log-odds metric = 0.095, 95% CI (0.009–0.203)], abdominal distention [indirect effect, log-odds metric = 0.162, 95% CI (0.047–0.303)], and increased flatus [indirect effect, log-odds metric = 0.110, 95% CI (0.005–0.234)] at 12 months. Conclusions and Inferences: Our findings provide evidence for psychological and clinical mediators between COVID-19 and post-COVID-19 IBS, which may be promising targets for interventions tailored for treating or preventing depression. The presence of specific GI symptoms at COVID-19 onset and their persistence should increase awareness of a potential new onset of IBS diagnosis.

Psychological and Clinical Factors Mediate Post-COVID-19 Irritable Bowel Syndrome / Hod, K.; Marasco, G.; Colecchia, L.; Cremon, C.; Barbaro, M. R.; Cacciari, G.; Falangone, F.; Kagramanova, A.; Bordin, D.; Drug, V.; Miftode, E.; Fusaroli, P.; Mohamed, S. Y.; Ricci, C.; Bellini, M.; Rahman, M. M.; Melcarne, L.; Santos, J.; Lobo, B.; Bor, S.; Yapali, S.; Akyol, D.; Sapmaz, F. P.; Urun, Y. Y.; Eskazan, T.; Celebi, A.; Kacmaz, H.; Ebik, B.; Binicier, H. C.; Bugdayci, M. S.; Yagci, M. B.; Pullukcu, H.; Kaya, B. Y.; Tureyen, A.; Hatemi, I.; Koc, E. S.; Sirin, G.; Caliskan, A. R.; Bengi, G.; Alis, E. E.; Lukic, S.; Trajkovska, M.; Dumitrascu, D.; Pietrangelo, A.; Corradini, E.; Simren, M.; Sjolund, J.; Tornkvist, N.; Ghoshal, U. C.; Kolokolnikova, O.; Colecchia, A.; Serra, J.; Maconi, G.; De Giorgio, R.; Danese, S.; Portincasa, P.; Di Sabatino, A.; Maggio, M.; Philippou, E.; Lee, Y. Y.; Salvi, D.; Venturi, A.; Borghi, C.; Zoli, M.; Gionchetti, P.; Viale, P.; Stanghellini, V.; Barbara, G.. - In: NEUROGASTROENTEROLOGY AND MOTILITY. - ISSN 1350-1925. - (2025). [10.1111/nmo.70079]