Covid-19 with gastrointestinal symptoms: a narrative review
DOI:
https://doi.org/10.62486/agsalud2025184Keywords:
Gastrointestinal problems, COVID-19, symptoms, sequelaeAbstract
Objective: This study aims to conduct a brief literature review on gastrointestinal problems caused by COVID-19, characterized by symptoms and sequelae.
Design: Literature review based on a narrative synthesis.
Data sources: Databases: Scopus, Web of Science, Science Direct, Scielo, Google Scholar.
Study selection: The documents were selected and analyzed under a critical literature review, considering inclusion and exclusion criteria.
Results: Out of a total of 461,161 potentially relevant articles, the analysis was based on 19 studies, of which 10 were statistical analyses, 5 were narrative reviews, and 3 were systematic reviews. Patients involved in these studies not only exhibited gastrointestinal conditions due to COVID-19 but also experienced neurological, cardiovascular issues, and pneumonia. The study populations included children, young adults, adults, and pregnant women, with studies conducted in the United States, China, Morocco, Iran, Mexico, Colombia, and Brazil.
Conclusions: COVID-19 has caused gastrointestinal problems such as diarrhea, abdominal pain, vomiting, and persistent sequelae like irritable bowel syndrome (IBS), erectile dysfunction, and functional dyspepsia. Adults also face psychosocial disorders, such as anxiety and depression. Long-term sequelae include cognitive disorders, fatigue, hypertension, and chronic respiratory problems. Severe patients are at higher risk for coagulopathies and require intensive care. These sequelae significantly impact quality of life, increase psychological stress, and contribute to economic burdens.
References
Alanazi, A., Alturki, A., Alosaimi, M., Alnajmi, N., Alrajeh, M., Kentab, A., & Habib, F. (2024). Risk factors determining severity in COVID-19 positive patients admitted to the intensive care unit (ICU) at NGHA. Journal of Medicinal and Pharmaceutical Chemistry Research, 6(2), 213–222. https://doi.org/10.48309/JMPCR.2024.422900.1028
Aninagyei, E., Ayivor-Djanie, R., Gyamfi, J., Owuani, T., Ameke, S. L., Kpeli, G. S., Agbogli, H. K., Essandoh, P., & Duedu, K. O. (2024). Faecal shedding of SARS-CoV-2 from patients with asymptomatic and mild COVID-19 without gastrointestinal symptoms in Ghana. BMC Research Notes, 17(1). https://doi.org/10.1186/s13104-024-06790-z
Anteneh, A. B., LeBlanc, M., Natnael, A. A., & Asfaw, Z. G. (2024). Survival of hospitalised COVID-19 patients in Hawassa, Ethiopia: a cohort study. BMC Infectious Diseases, 24(1), 1055. https://doi.org/10.1186/s12879-024-09905-w
Antia, A., Alvarado, D. M., Zeng, Q., Casorla-Perez, L. A., Davis, D. L., Sonnek, N. M., Ciorba, M. A., & Ding, S. (2024). SARS-CoV-2 Omicron BA.1 Variant Infection of Human Colon Epithelial Cells. Viruses, 16(4). https://doi.org/10.3390/v16040634
Belogianni, K., Khandige, P., Silverio, S. A., Windgassen, S., Moss-Morris, R., & Lomer, M. (2024). Exploring Dietitians’ Perspectives Toward Current Practices and Services in Relation to Irritable Bowel Syndrome Management in Clinical Settings Across the United Kingdom: A Qualitative Study. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2024.07.169
Chen, Y., Yang, W., Chen, F., & Cui, L. (2022). COVID-19 and cognitive impairment: neuroinvasive and blood‒brain barrier dysfunction. In Journal of Neuroinflammation (Vol. 19, Issue 1). BioMed Central Ltd. https://doi.org/10.1186/s12974-022-02579-8
da Costa, A. C. F. G. S., & da Fonseca Neto, O. C. L. (2024a). Gastrointestinal bleeding in patients with COVID-19: an integrative review. In Revista do Colegio Brasileiro de Cirurgioes (Vol. 51). Colegio Brasileiro de Cirurgioes. https://doi.org/10.1590/0100-6991e-20243600-en
da Costa, A. C. F. G. S., & da Fonseca Neto, O. C. L. (2024b). Gastrointestinal bleeding in patients with COVID-19: an integrative review. In Revista do Colegio Brasileiro de Cirurgioes (Vol. 51). Colegio Brasileiro de Cirurgioes. https://doi.org/10.1590/0100-6991e-20243600-en
Desconsi, D., Araujo, J. P., Furtado, M. D., Pimenta, R. A., & Zani, A. V. (2024). Relationship between gastrointestinal symptoms and COVID-19 infection in the pediatric population: a scoping review. In Revista da Escola de Enfermagem da U S P (Vol. 58, p. e20230365). https://doi.org/10.1590/1980-220X-REEUSP-2023-0365en
Díaz, C. F. F., & Taboada, O. Y. Z. (2020). Gastrointestinal features of the “new coronavirus” infection. Revista Colombiana de Gastroenterologia, 35, 69–72. https://doi.org/10.22516/25007440.541
Feth, M., Weaver, N., Fanning, R. B., Cho, S. M., Griffee, M. J., Panigada, M., Zaaqoq, A. M., Labib, A., Whitman, G. J. R., Arora, R. C., Kim, B. S., White, N., Suen, J. Y., Li Bassi, G., Peek, G. J., Lorusso, R., Dalton, H., Fraser, J. F., Fanning, J. P., … Fraser, J. F. (2024). Hemorrhage and thrombosis in COVID-19-patients supported with extracorporeal membrane oxygenation: an international study based on the COVID-19 critical care consortium. Journal of Intensive Care, 12(1). https://doi.org/10.1186/s40560-024-00726-2
Hazzi, C., Villemure-Poliquin, N., Nadeau, S., & Champagne, P. O. (2024). SARS-CoV-2 Infection, A Risk Factor for Pituitary Apoplexy? A Case Series and Literature Review. Ear, Nose and Throat Journal, 103(1_suppl), 153S-161S. https://doi.org/10.1177/01455613231179714
Issa, A., Lawal, A. F., Oyebanji, J. S., Ahmed, A. O., Abdullkadri, M. B., Ibrahim, O. R., & Mosunmola, F. R. (2023). Prevalence and outcomes of COVID-19 in children with respiratory and gastrointestinal symptoms. Journal of the National Medical Association, 115(4), 398–402. https://doi.org/10.1016/j.jnma.2023.05.006
Jallouli, A., El Fakiri, K., Nassih, H., El Qadiry, R., Bourrahouat, A., Sab, I. A., Rada, N., Draiss, G., & Bouskraoui, M. (2023a). Digestive manifestations of Covid-19 in children: a retrospective study. African Health Sciences, 23(3), 181–185. https://doi.org/10.4314/ahs.v23i3.22
Jallouli, A., El Fakiri, K., Nassih, H., El Qadiry, R., Bourrahouat, A., Sab, I. A., Rada, N., Draiss, G., & Bouskraoui, M. (2023b). Digestive manifestations of Covid-19 in children: a retrospective study. African Health Sciences, 23(3), 181–185. https://doi.org/10.4314/ahs.v23i3.22
Khongsiri, W., Poolchanuan, P., Dulsuk, A., Thippornchai, N., Phunpang, R., Runcharoen, C., Boonprakob, T., Hemtong, O., Chowplijit, S., Chuapaknam, V., Siripoon, T., Piyaphanee, W., Luvira, V., Rotejanaprasert, C., Leaungwutiwong, P., Chantratita, W., Chantratita, N., & Kosoltanapiwat, N. (2024). Associations between clinical data, vaccination status, antibody responses, and post-COVID-19 symptoms in Thais infected with SARS-CoV-2 Delta and Omicron variants: a 1-year follow-up study. BMC Infectious Diseases, 24(1), 1116. https://doi.org/10.1186/s12879-024-09999-2
Martio, A. E., Soares, P. de M. R., Karam, O. R., Padua, W. L., Manzato, L. B., & Mesquita Filho, P. M. (2023). Intracranial hemorrhage and Covid-19: A retrospective analysis of 1675 hospitalized Covid-19 Brazilian patients. Brain Hemorrhages, 4(2), 57–64. https://doi.org/10.1016/j.hest.2023.01.002
Matar-Khalil, S. (2022). Neurocovid-19: efectos del COVID-19 en el cerebro. Revista Panamericana de Salud Pública, 1–5. https://doi.org/10.26633/rpsp.2022.108
McDonald, E., Pittet, L. F., Barry, S. E., Bonten, M., Campbell, J., Croda, J., Croda, M. G., Dalcolmo, M. P., Davidson, A., de Almeida e Val, F. F., dos Santos, M. G., Gardiner, M. K., Gell, M. G., Gwee, A., Krastev, M. A., Lacerda, M. V. G., Lucas, M., Lynn, D. J., Manning, L., … Curtis, N. (2024). Antecedent and persistent symptoms in COVID-19 and other respiratory illnesses: insights from prospectively collected data in the BRACE trial. Journal of Infection, 106267. https://doi.org/10.1016/j.jinf.2024.106267
Moura, D. T. H. de, Proença, I. M., McCarty, T. R., Sagae, V. M. T., Ribeiro, I. B., Oliveira, G. H. P. de, Souza, G. M. V. de, Hirsch, B. S., Scatimburgo, M. V. C. V., Thompson, C. C., Carrilho, F. J., Cecconello, I., & Moura, E. G. H. de. (2020a). Gastrointestinal Manifestations and Associated Health Outcomes of COVID-19: A Brazilian Experience From the Largest South American Public Hospital. Clinics, 75. https://doi.org/10.6061/clinics/2020/e2271
Moura, D. T. H. de, Proença, I. M., McCarty, T. R., Sagae, V. M. T., Ribeiro, I. B., Oliveira, G. H. P. de, Souza, G. M. V. de, Hirsch, B. S., Scatimburgo, M. V. C. V., Thompson, C. C., Carrilho, F. J., Cecconello, I., & Moura, E. G. H. de. (2020b). Gastrointestinal Manifestations and Associated Health Outcomes of COVID-19: A Brazilian Experience From the Largest South American Public Hospital. Clinics, 75. https://doi.org/10.6061/clinics/2020/e2271
Nikhat, S., & Fazil, M. (2024a). Shortening the long-COVID: An exploratory review on the potential of Unani medicines in mitigating post-Covid-19 sequelae. Phytomedicine Plus, 4(2). https://doi.org/10.1016/j.phyplu.2024.100570
Nikhat, S., & Fazil, M. (2024b). Shortening the long-COVID: An exploratory review on the potential of Unani medicines in mitigating post-Covid-19 sequelae. Phytomedicine Plus, 4(2). https://doi.org/10.1016/j.phyplu.2024.100570
Nikhat, S., & Fazil, M. (2024c). Shortening the long-COVID: An exploratory review on the potential of Unani medicines in mitigating post-Covid-19 sequelae. Phytomedicine Plus, 4(2). https://doi.org/10.1016/j.phyplu.2024.100570
Oshima, T., Siah, K. T. H., Yoshimoto, T., Miura, K., Tomita, T., Fukui, H., & Miwa, H. (2021). Impacts of the COVID-19 pandemic on functional dyspepsia and irritable bowel syndrome: A population-based survey. Journal of Gastroenterology and Hepatology (Australia), 36(7), 1820–1827. https://doi.org/10.1111/jgh.15346
Parotto, M., Gyöngyösi, M., Howe, K., Myatra, S. N., Ranzani, O., Shankar-Hari, M., & Herridge, M. S. (2023). Post-acute sequelae of COVID-19: understanding and addressing the burden of multisystem manifestations. In The Lancet Respiratory Medicine (Vol. 11, Issue 8, pp. 739–754). Elsevier Ltd. https://doi.org/10.1016/S2213-2600(23)00239-4
Peng, T., Huang, X., Zhu, M., Hou, X., Xiong, Y., Fang, X., Lin, Z., Liu, L., Lan, W., & Lin, X. (2022). Effect of different acupuncture and moxibustion methods on functional dyspepsia caused by sequelae of COVID-19: A protocol for systematic review and meta-analysis. In Medicine (United States) (Vol. 101, Issue 38, p. E30770). Lippincott Williams and Wilkins. https://doi.org/10.1097/MD.0000000000030770
Sha, S., Qi, S., & Qindong, S. (2024). Multisite spontaneous hematomas and bleeding in critically ill Chinese patients with COVID-19: two case reports and a literature review. BMC Infectious Diseases, 24(1). https://doi.org/10.1186/s12879-024-09012-w
Sierra-Arango, F., Vergara-Cabra, C., Vásquez-Roldan, M., & Pérez-Riveros, E. D. (2021). Acute surgical‐like abdomen as a gastrointestinal manifestation of COVID-19 infection: a case report in Colombia. BMC Gastroenterology, 21(1). https://doi.org/10.1186/s12876-021-01762-0
Singh, S. J., Baldwin, M. M., Daynes, E., Evans, R. A., Greening, N. J., Jenkins, R. G., Lone, N. I., McAuley, H., Mehta, P., Newman, J., Novotny, P., Smith, D. J. F., Stanel, S., Toshner, M., & Brightling, C. E. (2023). Respiratory sequelae of COVID-19: pulmonary and extrapulmonary origins, and approaches to clinical care and rehabilitation. In The Lancet Respiratory Medicine (Vol. 11, Issue 8, pp. 709–725). Elsevier Ltd. https://doi.org/10.1016/S2213-2600(23)00159-5
Soheilipour, M., Ahoon, S., Ghaderi, A., Tabesh, E., & Adibi, P. (2024). Frequency and Risk Factors for Post-COVID-19 Functional Gastrointestinal Disorders After One Year. Shiraz E-Med J, 25(5), 1–9.
Tarik, A., Soukaina, R., Samir, M., Asmae, S., Ahlame, B., Rida, B., Yasser, A., Ilham, E., Noureddine, E., Hassan, S., & Ahmed, B. (2021). Gastrointestinal manifestations with COVID-19 virus infection: A Moroccan prospective study. Arab Journal of Gastroenterology, 22(4), 305–309. https://doi.org/10.1016/j.ajg.2021.07.004
Tsai, T. Y., Wu, J. F., Weng, M. T., Chuang, C. H., Huang, T. Y., Tai, W. C., Tai, C. M., Chung, C. S., Chen, C. C., Lin, C. P., Tsai, Y. Y., & Wei, S. C. (2024). Exacerbated gastrointestinal symptoms and long COVID in IBD patients with SARS-CoV-2 infection: A multi-center study from taiwan. Journal of the Formosan Medical Association, 123(8), 866–874. https://doi.org/10.1016/j.jfma.2024.03.016
Wu, K., Li, Y., Pan, Y., Qiu, J., Chen, X., Fan, Y., Xing, Y., & Zhou, X. (2023). Impact of closed management on gastrointestinal function and mental health of Chinese university students during COVID-19. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-16145-1
Wysokiński, A., Szczepocka, E., & Szczakowska, A. (2023). Improved cognitive performance, increased theta, alpha, beta and decreased delta powers after cognitive rehabilitation augmented with tDCS in a patient with post-COVID-19 cognitive impairment (brain-fog). Psychiatry Research Case Reports, 2(2), 100164. https://doi.org/10.1016/j.psycr.2023.100164
Zhang, D., Chen, C., Xie, Y., Zeng, F., Chen, S., Chen, R., Zhang, X., Huang, S., Li, D., & Bai, F. (2023a). Post-infection functional gastrointestinal disorders following coronavirus disease-19: a prospective follow-up cohort study. BMC Infectious Diseases, 23(1). https://doi.org/10.1186/s12879-023-08401-x
Zhang, D., Chen, C., Xie, Y., Zeng, F., Chen, S., Chen, R., Zhang, X., Huang, S., Li, D., & Bai, F. (2023b). Post-infection functional gastrointestinal disorders following coronavirus disease-19: a prospective follow-up cohort study. BMC Infectious Diseases, 23(1). https://doi.org/10.1186/s12879-023-08401-x
Zhang, D., Chen, C., Xie, Y., Zeng, F., Chen, S., Chen, R., Zhang, X., Huang, S., Li, D., & Bai, F. (2023c). Post-infection functional gastrointestinal disorders following coronavirus disease-19: a prospective follow-up cohort study. BMC Infectious Diseases, 23(1). https://doi.org/10.1186/s12879-023-08401-x
Zhang, Z., Li, Q., Zhang, S., Liu, Y., Lu, G., Wen, Q., Cui, B., Zhang, F., & Zhang, F. (2023). Washed microbiota transplantation targeting both gastrointestinal and extraintestinal symptoms in patients with irritable bowel syndrome. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 127. https://doi.org/10.1016/j.pnpbp.2023.110839
Zhou, Z., Zhao, N., Shu, Y., Han, S., Chen, B., & Shu, X. (2020). Effect of Gastrointestinal Symptoms in Patients With COVID-19. Gastroenterology, 158(8), 2294–2297. https://doi.org/10.1053/j.gastro.2020.03.020
Zulfitri, Z., Maghfirah, D., Eljatin, M. R. A., Firdausa, S., & Zahra, Z. (2023). Anxiety level and functional dyspepsia incidence during COVID-19 pandemic. International Journal of Public Health Science, 12(1), 409–416. https://doi.org/10.11591/ijphs.v12i1.22215.
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Copyright (c) 2025 Janeth Vásquez-Granda, Jessy C.Tarrillo-Olivos, Naomy R.Pereyra-Urbina, Jhanina Paola P- Santa-Cruz, Víctor Álvarez-Manrique, Mardel Morales-García , Liset Z. Sairitupa-Sanchez, Wilter C. Morales-García (Author)
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