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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Gastrointestinal manifestations of long-term effects after COVID-19 infection in patients with dialysis or kidney transplantation: An observational cohort study
Wiwat Chancharoenthana, Supitcha Kamolratanakul, Asada Leelahavanichkul, Wassawon Ariyanon, Sutatip Chinpraditsuk, Rattanaporn Saelim, Somratai Vadcharavivad, Weerapong Phumratanaprapin, Polrat Wilairatana
Wiwat Chancharoenthana, Supitcha Kamolratanakul, Weerapong Phumratanaprapin, Polrat Wilairatana, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
Asada Leelahavanichkul, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Wassawon Ariyanon, Cardiometabolic Centre, Department of Medicine, Bangkok Nursing Hospital, Bangkok 10500, Thailand
Sutatip Chinpraditsuk, Rattanaporn Saelim, Dialysis Center, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
Somratai Vadcharavivad, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand
Author contributions: Chancharoenthana W and Kamolratanakul S designed the research study; Chancharoenthana W, Kamolratanakul S, Ariyanon W, Chinpraditsuk S, and Saelim R performed the research and collected data; Chancharoenthana W, Kamolratanakul S, Ariyanon W, and Chinpraditsuk S analysed the data; Chancharoenthana W and Kamolratanakul drafted the manuscript. Chancharoenthana W, Kamolratanakul S, Leelahavanichkul A, Vadcharavivad S, Phumratanaprapin W, and Wilairatana P edited the manuscript; all authors have read and approve the final manuscript.
Institutional review board statement: The study was approved by the Human Research Ethics Committee of Faculty of Tropical Medicine, Mahidol University, Thailand (MUTM 2022-081-01).
Informed consent statement: Informed consent for participation in interviews was obtained either written or verbally over the phone from all participants in the study.
Conflict-of-interest statement: There are no conflicts of interest to disclose.
Data sharing statement: The data underlying this article will be shared on reasonable request to the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Supitcha Kamolratanakul, MD, Assistant Professor, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Rd, Thung Phaya Thai, Ratchathewi, Bangkok 10400, Thailand.
supitcha.kam@mahidol.edu
Received: January 12, 2023
Peer-review started: January 12, 2023
First decision: February 4, 2023
Revised: February 13, 2023
Accepted: April 21, 2023
Article in press: April 21, 2023
Published online: May 21, 2023
Processing time: 123 Days and 13.3 Hours
ARTICLE HIGHLIGHTS
Research background
The characteristics of persistent coronavirus disease 2019 (COVID-19) symptoms or Long-COVID in dialysis-dependent patients and kidney transplant (KT) is remain underestimate and urgent needs for investigation to prevent long-term complication in these vulnerable population.
Research motivation
End stage renal disease is a well-known condition for high mortality risk following COVID-19 infection. Thus, it is essential to explore the Long-COVID in these population as an early preventive strategy for preventing further morbidity and mortality.
Research objectives
To identify the characteristics of gastrointestinal (GI) manifestations of Long-COVID in patients with dialysis-dependent or KT status.
Research methods
A prospective, observational study was conducted during January 2022 to July 2022 in patients with COVID-19 infection to explore the Long-COVID symptoms in 3-months after the onset by interviewing.
Research results
As of 577 cases agreed to the interviews, the mean age was 52±11 years with 52% women. Long-COVID was identified in 56%, 62% and 37% in hemodialysis, peritoneal dialysis, and KT respectively. While fatigue was the most prevalent (96%) of the non-GI tract symptoms, anorexia (90.9%), loss of taste (64.4%), and abdominal pain (62.5%) were the first three common GI manifestations of Long-COVID. Of note, there were 6 cases of mesenteric panniculitis from 19 patients with GI symptoms in the KT group.
Research conclusions
Renal replacement therapy patients and KT recipients with COVID-19 show high rates of GI manifestations of Long-COVID after discharge following their initial episode.
Research perspectives
Further study should aim to explore the pathophysiology of the long-term GI effects of COVID-19 in renal replacement therapy and KT patients, which may have different immune response to Long-COVID symptoms compared to those with immunocompetent.
