한빛사논문
Kwanjoo Lee1, Jaeyu Park2,3, Jinseok Lee4, Myeongcheol Lee2,3, Hyeon Jin Kim2,3, Yejun Son2,3, Sang Youl Rhee2,5, Lee Smith6, Masoud Rahmati7,8,9, Jiseung Kang10,11, Hayeon Lee2,4, Yeonjung Ha1, Dong Keon Yon2,3,12
1Department of Gastroenterology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
2Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
3Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
4Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea
5Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, South 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, 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, South Korea
Correspondence : Hayeon Lee, Yeonjung Ha, Dong Keon Yon
*Kwanjoo Lee, Jaeyu Park and Jinseok Lee contributed equally to this work.
Abstract
Background/aims: Considering emerging evidence on long COVID, comprehensive analyses of the post-acute complications of long COVID 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 outcomes and other digestive abnormalities in various follow-up periods.
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). 10,027,506 Korean, 12,218,680 Japanese, and 468,617 UK patients aged ≥20 years, including those with SARS-CoV-2 infection between 2020 and 2021 matched to non-infected control patients. Seventeen gastrointestinal and eight hepatobiliary outcomes as well as nine other digestive abnormalities following SARS-CoV-2 infection were identified and compared with contemporary controls.
Results: The discovery cohort, consisting of 10,027,506 individuals (mean age 48.4 years; 49.9% female), revealed heightened risks of gastrointestinal diseases (HR: 1.15; 95% CI: 1.08-1.22), hepatobiliary diseases (1.30; 1.09-1.55), and other digestive abnormalities (1.05; 1.01-1.10) beyond the first 30 days after infection, following exposure-driven propensity score-matching. These results indicate a pronounced association as the severity of COVID-19 increases. 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. Over time, 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 incidences 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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