Clin Mol Hepatol.
2024 Oct;30(4):943-958. 10.3350/cmh.2024.0203.
Long-term gastrointestinal and hepatobiliary outcomes of COVID-19: A multinational population-based cohort study from South Korea, Japan, and the UK
- Lee K1
- Park J2,3
- Lee J4
- Lee M2,3
- Kim HJ2,3
- Son Y2,3
- Rhee SY2,5
- Smith L6
- Rahmati M7,8,9
- Kang J10,11
- Lee H
2,4 - Ha Y1
- Yon DK2,3,12
- Affiliations
-
- 1Department of Gastroenterology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
- 2Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea
- 3Department of Regulatory Science, Kyung Hee University, Seoul, Korea
- 4Department of Biomedical Engineering, Kyung Hee University, Yongin, Korea
- 5Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
- 6Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
- 7Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- 8Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
- 9CEReSS-Health Service Research and Quality of Life Center, Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, Marseille, France
- 10Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- 11Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- 12Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Korea
- KMID: 2560095
- DOI: http://doi.org/10.3350/cmh.2024.0203
Abstract
- Background/Aims
Considering emerging evidence on long COVID, comprehensive analyses of the post-acute complications of SARS-CoV-2 infection in the gastrointestinal and hepatobiliary systems are needed. We aimed to investigate the impact of COVID-19 on the long-term risk of gastrointestinal and hepatobiliary diseases and other digestive abnormalities.
Methods
We used three large-scale population-based cohorts: the Korean cohort (discovery cohort), the Japanese cohort (validation cohort-A), and the UK Biobank (validation cohort-B). A total of 10,027,506 Korean, 12,218,680 Japanese, and 468,617 UK patients aged ≥20 years who had SARS-CoV-2 infection between 2020 and 2021 were matched to non-infected controls. Seventeen gastrointestinal and eight hepatobiliary outcomes as well as nine other digestive abnormalities following SARS-CoV-2 infection were identified and compared with controls.
Results
The discovery cohort revealed heightened risks of gastrointestinal diseases (HR 1.15; 95% CI 1.08–1.22), hepatobiliary diseases (HR 1.30; 95% CI 1.09–1.55), and other digestive abnormalities (HR 1.05; 95% CI 1.01–1.10) beyond the first 30 days of infection, after exposure-driven propensity score-matching. The risk was pronounced according to the COVID-19 severity. The SARS-CoV-2 vaccination was found to lower the risk of gastrointestinal diseases but did not affect hepatobiliary diseases and other digestive disorders. The results derived from validation cohorts were consistent. The risk profile was most pronounced during the initial 3 months; however, it persisted for >6 months in validation cohorts, but not in the discovery cohort.
Conclusions
The incidence of gastrointestinal disease, hepatobiliary disease, and other digestive abnormalities increased in patients with SARS-CoV-2 infection during the post-acute phase.
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