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

GI-COVID19 study group

doi:10.1111/nmo.70079

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

GI-COVID19 study group

Department of Life Sciences

O.M. Filatov Municipal Clinical Hospital no 15
Clinic for Infectious and Tropical Diseases
Clinical Center of Serbia
Meir Hospital Sapir Medical Center
Azienda Ospedaliero-Universitaria di Bologna
S. Orsola-Malpighi Polyclinic
Gastroenterology Department
Hospital del Mar
Department of Experimental and Clinical Biomedical Science
University of Florence
Faculty of Medicine
Transilvania University of Brasov
Clinic of Infectology
IRCCS Istituto Clinico Humanitas - Rozzano (Milano)
Ariel University
Assuta Medical Center
University of Bologna
University of Rome La Sapienza
Moscow Clinical Scientific Center
Research Institute of Health Organization and Medical Management
Tver State Medical University
Russian University of Medicine
Grigore T. Popa University of Medicine and Pharmacy
Imola Hospital
Zagazig University
University of Brescia
University of Pisa
Sheikh Russel National Gastroliver Institute and Hospital
Sabadell—CIBEREHD Centro de Investigación Biomédica en Red
Vall d’Hebron University Hospital
Vall d'Hebron Research Institute
CIBER - Center for Biomedical Research Network
Ege University
Acibadem Mehmet Ali Aydinlar Universitesi
University of Health Sciences
Eskisehir City Hospital
Istanbul University - Cerrahpaşa
Kocaeli University
Adiyaman Education and Research Hospital
Dokuz Eylul University
Istanbul Aydin University
Darica Farabi Education and Research Hospital
Clinic of Gastroenterohepatology
Iuliu Hatieganu University of Medicine and Pharmacy
University of Modena and Reggio Emilia
Sahlgrenska University Hospital
Apollo Hospitals Group

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English
Journal	Neurogastroenterology and Motility
DOIs	https://doi.org/10.1111/nmo.70079
Publication status	Accepted/In press - 2025

Keywords

COVID-19
depression
dyspnea
gastrointestinal symptoms
irritable bowel syndrome
mediation analysis

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10.1111/nmo.70079

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@article{e4f56dad68d7433494601b12d5d08de2,

title = "Psychological and Clinical Factors Mediate Post-COVID-19 Irritable Bowel Syndrome",

abstract = "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.",

keywords = "COVID-19, depression, dyspnea, gastrointestinal symptoms, irritable bowel syndrome, mediation analysis",

author = "\{GI-COVID19 study group\} and Keren Hod and Giovanni Marasco and Luigi Colecchia and Cesare Cremon and Barbaro, \{Maria Raffaella\} and Giulia Cacciari and Francesca Falangone and Anna Kagramanova and Dmitry Bordin and Vasile Drug and Egidia Miftode and Pietro Fusaroli and Mohamed, \{Salem Youssef\} and Chiara Ricci and Massimo Bellini and Rahman, \{M. Masudur\} and Luigi Melcarne and Javier Santos and Beatriz Lobo and Serhat Bor and Suna Yapali and Deniz Akyol and Sapmaz, \{Ferdane Pirincci\} and Urun, \{Yonca Yilmaz\} and Tugce Eskazan and Altay Celebi and Huseyin Kacmaz and Berat Ebik and Binicier, \{Hatice Cilem\} and Bugdayci, \{Mehmet Sait\} and Yağcı, \{Munkhtsetseg Banzragch\} and Husnu Pullukcu and Kaya, \{Berrin Yalınbas\} and Ali Tureyen and İbrahim Hatemi and Koc, \{Elif Sitre\} and Goktug Sirin and Calıskan, \{Ali Riza\} and Goksel Bengi and Alıs, \{Esra Ergun\} and Snezana Lukic and Meri Trajkovska and Dan Dumitrascu and Antonello Pietrangelo and Elena Corradini and Magnus Simren and Jessica Sjolund and Navkiran Tornkvist and Ghoshal, \{Uday C.\} and Elena Philippou",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). Neurogastroenterology \& Motility published by John Wiley \& Sons Ltd.",

year = "2025",

doi = "10.1111/nmo.70079",

language = "English",

journal = "Neurogastroenterology and Motility",

issn = "1350-1925",

publisher = "Wiley-Blackwell Publishing Ltd",

}

TY - JOUR

T1 - Psychological and Clinical Factors Mediate Post-COVID-19 Irritable Bowel Syndrome

AU - GI-COVID19 study group

AU - Hod, Keren

AU - Marasco, Giovanni

AU - Colecchia, Luigi

AU - Cremon, Cesare

AU - Barbaro, Maria Raffaella

AU - Cacciari, Giulia

AU - Falangone, Francesca

AU - Kagramanova, Anna

AU - Bordin, Dmitry

AU - Drug, Vasile

AU - Miftode, Egidia

AU - Fusaroli, Pietro

AU - Mohamed, Salem Youssef

AU - Ricci, Chiara

AU - Bellini, Massimo

AU - Rahman, M. Masudur

AU - Melcarne, Luigi

AU - Santos, Javier

AU - Lobo, Beatriz

AU - Bor, Serhat

AU - Yapali, Suna

AU - Akyol, Deniz

AU - Sapmaz, Ferdane Pirincci

AU - Urun, Yonca Yilmaz

AU - Eskazan, Tugce

AU - Celebi, Altay

AU - Kacmaz, Huseyin

AU - Ebik, Berat

AU - Binicier, Hatice Cilem

AU - Bugdayci, Mehmet Sait

AU - Yağcı, Munkhtsetseg Banzragch

AU - Pullukcu, Husnu

AU - Kaya, Berrin Yalınbas

AU - Tureyen, Ali

AU - Hatemi, İbrahim

AU - Koc, Elif Sitre

AU - Sirin, Goktug

AU - Calıskan, Ali Riza

AU - Bengi, Goksel

AU - Alıs, Esra Ergun

AU - Lukic, Snezana

AU - Trajkovska, Meri

AU - Dumitrascu, Dan

AU - Pietrangelo, Antonello

AU - Corradini, Elena

AU - Simren, Magnus

AU - Sjolund, Jessica

AU - Tornkvist, Navkiran

AU - Ghoshal, Uday C.

AU - Philippou, Elena

PY - 2025

Y1 - 2025

N2 - 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.

AB - 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.

KW - COVID-19

KW - depression

KW - dyspnea

KW - gastrointestinal symptoms

KW - irritable bowel syndrome

KW - mediation analysis

UR - https://www.scopus.com/pages/publications/105005402477

U2 - 10.1111/nmo.70079

DO - 10.1111/nmo.70079

M3 - Article

AN - SCOPUS:105005402477

SN - 1350-1925

JO - Neurogastroenterology and Motility

JF - Neurogastroenterology and Motility

ER -

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

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Keywords

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