Children Who Contracted COVID-19 Twice as Likely to Develop IBS, Study Finds

An analysis of data from more than 115,000 pediatric and adolescent patients found contracting COVID-19 was associated with a doubling in risk of developing irritable bowel syndrome (IBS).

Presented at the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) 2024 annual meeting, results of the study, which leveraged data from the Military Health System (MHS) Database, found children who had a recorded diagnosis of COVID-19 were twice as likely to develop IBS as their counterparts who did not contract COVID-19.¹

“I think this was a nod to what everyone already had an idea of post-COVID, but I'd like to see the actual numbers and the significance, right?,” explained study presenter Rian Calo, DO, a pediatrician and pediatric gastroenterology fellow in the Department of Pediatrics at the Walter Reed National Military Medical Center, in an interview with HCPLive. “It might be more significant if we put it out even another year, as that might pop up in more cases.”

As times distances society from the peak of the COVID-19 pandemic and early reports of increased risk of chronic diseases began to emerge among patients who contracted COVID-19, it has become clear the downstream effects of COVID-19 have become and will remain a prominent focal point for many research efforts for decades to come. Citing prior research linking new-onset IBS to bacterial, parasitic, and viral sources as well as the evidence base supporting the association between COVID-19 and IBS, Calo and fellow investigators from the Walter Reed National Military Medical Center and other military hospitals designed their study as a propensity score-matched analysis of patients from the MHS database aged 0 to 17 years.^1,2

In total, 1770 clinical variables were used in propensity score matching, with patients with COVID-19 exposure matched in a 2:1 ratio to non-exposed individuals. Investigators included 117,512 total participants in the study. Among this cohort, 39,182 had a recorded exposure to COVID-19 and 78,330 did not. Investigators highlighted the mean post-match standardized difference across all variables was 0.017, which suggests a successful match of children.¹

Analysis of baseline characteristics from the overall cohort of 117,512 individuals indicated the cohort had a median age of 12 (IQR, 7 to 15) years and 49.42% were female. Overall, 237 patients from the cohort developed IBS, with 120 (0.31%) occurring among those with history of COVID-19 infection and 117 (0.15%) occurring among patients without history of prior COVID-19 infection. Investigators pointed out adolescents (median age 15 years; IQR, 12-16) and females (64.14%) developed IBS at a greater rate than their younger and male counterparts, respectively.¹

Results of the investigators’ primary analysis suggested children who had a recorded diagnosis of COVID-19 were significantly more likely to develop IBS as their counterparts without a recorded diagnosis of COVID-19 (Hazard Ratio, 2.06; 95% CI, 1.60 to 2.67; P <.05). Investigators noted this association with increased risk was present even after controlling for all preexisting conditions, medication use, and healthcare utilization.¹

“While many of the immediate effects of the COVID-19 pandemic have subsided, understanding how COVID-19 exacerbates and affects the incidence of delayed gastrointestinal disease can lead to more effective diagnosis and treatment strategies,” investigators wrote.¹ “Pediatricians should be aware of these associations as early diagnosis and treatment of IBS can improve the quality of life for affected children.”

References:

1. Calo R, Prabhakar S, Susi A, Jacob Coene A, Nylund C.PANDEMIC PAINS: COVID-19 AND ITS ASSOCIATION WITH IRRITABLE BOWEL SYNDROME. Presented at NASPHGAN 2024 in Hollywood, Florida, from November 7 – November 9, 2024.
2. Hacker KA, Briss PA, Richardson L, Wright J, Petersen R. COVID-19 and Chronic Disease: The Impact Now and in the Future. Prev Chronic Dis. 2021;18:E62. Published 2021 Jun 17. doi:10.5888/pcd18.210086