Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Sep 20, 2023; 13(4): 323-336
Published online Sep 20, 2023. doi: 10.5662/wjm.v13.i4.323
Potential long-term neurological and gastrointestinal effects of COVID-19: A review of adult cohorts
Zaki A Sherif, Mrinalini Deverapalli, Suryanarayana Reddy Challa, Zara Martirosyan, Peter Whitesell, Antonio Machado Pizuorno, Zainab Naqvi, Ingrid K Tulloch, Gholamreza Oskrochi, Hassan Brim, Hassan Ashktorab
Zaki A Sherif, Department of Biochemistry & Molecular Biology, Howard University College of Medicine, Washington, DC 20059, United States
Mrinalini Deverapalli, Howard University Cancer Center, Howard University, Washington, DC 20060, United States
Suryanarayana Reddy Challa, Zara Martirosyan, Department of Internal Medicine, Howard University Hospital, Washington, DC 20060, United States
Peter Whitesell, Department of Pulmonary Disease/Sleep Medicine, Howard University Hospital, Washington, DC 20060, United States
Antonio Machado Pizuorno, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, United States
Zainab Naqvi, Medical Center, Georgetown University, Washington, DC 20007, United States
Ingrid K Tulloch, Department of Psychology, Morgan State University, Baltimore, MD 21251, United States
Gholamreza Oskrochi, College of Engineering and Technology, American University of the Middle East, Kuwait Egaila 54200, Kuwait
Hassan Brim, Pathology & Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
Hassan Ashktorab, Medicine & Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
Author contributions: Ashktorab H contributed to conception and design; Sherif ZA and Deverapalli M contributed to literature review, citation, and referencing; Ashktorab H, Brim H, Gholamreza O, and Sherif ZA contributed to data analysis & interpretation; Sherif ZA and Deverapalli M contributed to manuscript writing and editing; Brim H, Ashktorab H, and Gholamreza O contributed to manuscript reading and editing; Suryanarayana RC, Martirosyan Z, Whitesell P, Pizuorno AM, Naqvi Z, Tulloch IK, Ashktorab H, Brim H, and Sherif ZA contributed to proofreading; Sherif ZA contributed to manuscript revising and responding to the reviewers.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Zaki A Sherif, PhD, Full Professor, Department of Biochemistry & Molecular Biology, Howard University College of Medicine, 520 W Street NW, Washington, DC 20059, United States. zaki.sherif@howard.edu
Received: May 1, 2023
Peer-review started: May 1, 2023
First decision: June 20, 2023
Revised: August 2, 2023
Accepted: August 21, 2023
Article in press: August 21, 2023
Published online: September 20, 2023
Processing time: 141 Days and 13.5 Hours
Abstract
BACKGROUND

The respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved into a multi-organ disorder, with long-term effects known as post-acute sequelae of SARS-CoV-2 infection or long coronavirus disease (COVID).

AIM

To examine the current knowledge and outcomes of long-term neurological and gastrointestinal (GI) symptoms in adult cohorts, including United States minority populations.

METHODS

PubMed and Google Scholar were searched using relevant terms, and data from five studies were analyzed, comprising 27383 patients with persistent neurological and GI sequelae.

RESULTS

The main symptoms included anxiety, depression, dysphagia, headache, vomiting, nausea, gastroesophageal reflux, fatigue, and abdominal pain. Patients with comorbidities and metabolic syndromes were at higher risk for long COVID. While most patients were European Americans, there was a need for further study on African Americans.

CONCLUSION

The underlying causes of these symptoms remain unclear, warranting more investigation into the long-term impact of the SARS-CoV-2 on different populations.

Keywords: Angiotensin converting enzyme; Long coronavirus disease; Post-acute sequalae of SARS-CoV-2 infection; Neurological; Gastrointestinal; Post-viral syndromes

Core Tip: Long coronavirus disease (COVID) or post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC) can lead to prolonged and debilitating symptoms beyond 30 d after infection. Neurological manifestations are prevalent, with encephalopathy, myalgia, headache, and anosmia being common symptoms. Females seem to be more susceptible to long COVID, and severe disease is associated with longer or more frequent neurological symptoms. Gastrointestinal (GI) sequelae are also reported, with symptoms like difficulty swallowing, nausea, vomiting, and abdominal pain being common. Anxiety, depression, dysphagia, headache, and fatigue are among the top symptoms observed, with potential neurological and GI associations. However, there is a need for further research to explore the underlying causes and potential discrepancies in symptom reporting among different populations affected by long COVID/PASC.