Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2023; 11(22): 5252-5272
Published online Aug 6, 2023. doi: 10.12998/wjcc.v11.i22.5252
COVID-19-induced gastrointestinal autonomic dysfunction: A systematic review
Reem Elbeltagi, Mohammed Al-Beltagi, Nermin Kamal Saeed, Adel Salah Bediwy
Reem Elbeltagi, Department of Medicine, The Royal College of Surgeons in Ireland-Medical University of Bahrain, Busiateen ‎15503‎, Muharraq, Bahrain
Mohammed Al-Beltagi, Department of Paediatrics, Faculty of Medicine, Tanta University, Tanta ‎31511‎, Algharbia, Egypt
Mohammed Al-Beltagi, Department of Paediatrics, University Medical Center, Arabian Gulf University, Manama ‎26671‎, Manama, Bahrain
Mohammed Al-Beltagi, Department of Paediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Dr ‎Sulaiman Al Habib Medical Group, Manama ‎26671‎, Manama, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Pathology Department, Salmaniya Medical Complex, Ministry of Health, Kingdom of Bahrain, Manama 12, Manama, Bahrain
Nermin Kamal Saeed, Microbiology Section, Pathology Department, The Royal College of Surgeons in Ireland-Medical University of Bahrain, Busaiteen 15503, Muharraq, Bahrain
Adel Salah Bediwy, Department of Chest Disease, Faculty of Medicine, Tanta University, Tanta ‎31527‎, Algharbia, Egypt
Adel Salah Bediwy, Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Dr ‎Sulaiman Al Habib Medical Group, Manama ‎26671‎, Manama, Bahrain
Author contributions: Elbeltagi R, Al-Biltagi M, Saeed NK, and Bediwy AS contributed equally to this work; all the authors collaborated to collect the data, and write and revise the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
PRISMA 2009 Checklist statement: The manuscript was prepared and revised according to the PRISMA 2009 Checklist statement.
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: Mohammed Al-Beltagi, MBChB, MD, MSc, PhD, Academic Editor, Chairman, Consultant Physician-Scientist, Professor, Researcher, Department of Paediatrics, Faculty of Medicine, Tanta University, AlBahr street, Tanta ‎31511‎, Algharbia, Egypt. mbelrem@hotmail.com
Received: April 20, 2023
Peer-review started: April 20, 2023
First decision: June 7, 2023
Revised: June 10, 2023
Accepted: July 3, 2023
Article in press: July 3, 2023
Published online: August 6, 2023
Processing time: 104 Days and 12.6 Hours
ARTICLE HIGHLIGHTS
Research background

It is typical for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to affect the gastrointestinal tract, which may manifest as an early warning sign. The frequency of gastrointestinal symptoms often indicates the seriousness of coronavirus disease 2019 (COVID-19). COVID-19 may impair the nerve supply to the digestive system, resulting in autonomic dysfunction of the gastrointestinal tract. There is still much to discover about the impact of COVID-19 on the autonomic nervous system and the gastrointestinal tract.

Research motivation

Due to the importance of gastrointestinal tract autonomic dysfunction in patients with COVID-19, we are motivated to conduct this systematic review concerning this newly emerged condition that has become a concern during the pandemic.

Research objectives

Our objective is to thoroughly investigate the epidemiology, clinical manifestations, potential mechanisms, diagnosis, differential diagnosis, and impact of gastrointestinal autonomic dysfunctions on the quality of life and prognosis of individuals who have contracted SARS-CoV-2. Additionally, we will explore management and prevention strategies.

Research methods

We conducted a comprehensive and systematic exploration of multiple databases, followed by an extensive analysis of the relevant literature. Our review included 113 studies published in English between January 2000 and April 18, 2023.

Research results

According to most of the literature, gastrointestinal autonomic dysfunction can greatly impact a patient's quality of life and prognosis. Many factors can affect the functioning of the gastrointestinal autonomic nervous system. Studies have shown that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a documented affinity for both neural and gastrointestinal tissues, which can lead to various gastrointestinal symptoms. These symptoms include anorexia, dysgeusia, heartburn, belching, chest pain, regurgitation, vomiting, epigastric burn, diarrhea, abdominal pain, bloating, irregular bowel movements, and constipation. Diarrhea is the most common symptom, followed by anorexia, nausea, vomiting, and abdominal pain. While COVID-19 vaccination may rarely cause autonomic dysfunction and gastrointestinal symptoms, COVID-19-induced autonomic effects can significantly impact a patient's health, prognosis, and quality of life. Early diagnosis and proper recognition of the condition are crucial for better outcomes. It is important to consider other potential causes of these symptoms, as they may not always be caused by COVID-19-induced autonomic dysfunction. Treating this condition can be a challenging task.

Research conclusions

To achieve optimal results for individuals with COVID-19, it is crucial to adopt a multidisciplinary approach, which includes providing supportive care, treating the underlying infection, managing any dysfunction, monitoring for complications, and offering nutritional assistance. It is imperative to closely monitor the patient's condition and take swift action if necessary. Additionally, conducting comprehensive research on the gastrointestinal autonomic dysfunction caused by COVID-19 is critical for effective management.

Research perspectives

A multi-faceted approach is essential to ensure the best outcome for those affected by coronavirus disease 2019 (COVID-19). This includes providing supportive care, addressing the root infection, managing dysfunctions, monitoring for complications, and providing nutritional aid. It is crucial to closely monitor the patient's condition and take prompt action if needed. Furthermore, in-depth research on COVID-19-induced gastrointestinal autonomic dysfunction is vital for proper management.