Long-term gastrointestinal and hepatobiliary outcomes of COVID-19: A multinational populationbased cohort study from South Korea, Japan, and the UK

• Published in: Clinical and molecular hepatology pp. 943 - 958
• Main Authors: Kwanjoo Lee, Jaeyu Park(Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea, Department of Regulatory Science, Kyung Hee University, Seoul, Korea), Jinseok Lee, Myeongcheol Lee(Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea, Hyeon Jin Kim(Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea, Yejun Son(Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea, Sang Youl Rhee(Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea, Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea), Lee Smith, Masoud Rahmati(Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran, Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of), Jiseung Kang(Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA, Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA), Hayeon Lee(Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea, Department of Biomedical Engineering, Kyung Hee University, Yongin, Korea), Yeonjung Ha, Dong Keon Yon(Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Korea, Department of Regulatory Science, Kyung Hee University, Seoul, Korea, Department of Pediatrics, Kyung Hee University College of Med)
• Format: Journal Article
• Language: English
• Published: 대한간학회 01.10.2024
• Subjects: 내과학
• ISSN: 2287-2728; 2287-285X
• DOI: 10.3350/cmh.2024.0203

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. KCI Citation Count: 11