Published online May 21, 2023. doi: 10.3748/wjg.v29.i19.3013
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
Prolonged symptoms after corona virus disease 2019 (Long-COVID) in dialysis-dependent patients and kidney transplant (KT) recipients are important as a possible risk factor for organ dysfunctions, especially gastrointestinal (GI) problems, during immunosuppressive therapy.
To identify the characteristics of GI manifestations of Long-COVID in patients with dialysis-dependent or KT status.
This observational, prospective study included patients with COVID-19 infection, confirmed by reverse transcription polymerase chain reaction, with the onset of symptoms between 1 January 2022 and 31 July 2022 which was explored at 3 mo after the onset, either through the out-patient follow-up or by telephone interviews.
The 645 eligible participants consisted of 588 cases with hemodialysis (HD), 38 patients with peritoneal dialysis (PD), and 19 KT recipients who were hospitalized with COVID-19 infection during the observation. Of these, 577 (89.5%) cases agreed to the interviews, while 64 (10.9%) patients with HD and 4 (10.5%) cases of PD were excluded. The mean age was 52 ± 11 years with 52% women. The median dialysis duration was 7 ± 3 and 5 ± 1 years for HD and PD groups, respectively, and the median time post-transplantation was 6 ± 2 years. Long-COVID was identified in 293/524 (56%) and 21/34 (62%) in HD and PD, respectively, and 7/19 (37%) KT recipients. Fatigue was the most prevalent (96%) of the non-GI tract symptoms, whereas anorexia (90.9%), loss of taste (64.4%), and abdominal pain (62.5%) were the first three common GI manifestations of Long-COVID. Notably, there were 6 cases of mesenteric panniculitis from 19 patients with GI symptoms in the KT group.
Different from patients with non-chronic kidney disease, there was a high prevalence of GI manifestations of Long-COVID in dialysis-dependent patients and KT recipients. An appropriate long-term follow-up in these vulnerable populations after COVID-19 infection is possibly necessary.
Core Tip: Prolonged symptoms after coronavirus disease 2019 (COVID-19) or prolonged symptoms after COVID-19 (Long-COVID) in dialysis-dependent patients and kidney transplant (KT) recipients are important as a possible risk factor for organ dysfunctions, especially gastrointestinal (GI) problems. In this study, we observed that a GI manifestation of Long-COVID is a frequent condition in patients with dialysis-dependence and kidney-transplant recipients. Long-COVID was significantly more prevalent in peritoneal dialysis patients than in hemodialysis patient or KT cases. We also found that patients who experienced either abdominal pain or diarrhea had a longer duration of other GI manifestations of Long-COVID, suggesting a need for closer observation of these patients during COVID-19 infection.