Progressive Increase in Small Intestinal Bacterial Overgrowth Risk Following COVID-19 Infection: A Global Population-Based Study.

IF 3 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Yilin Song, Thai Hau Koo, Benjamin D Liu, Linda L D Zhong, Tao Bai, Xiaohua Hou, Lei Tu, Gengqing Song
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引用次数: 0

Abstract

Background/objectives: Coronavirus disease 2019 (COVID-19) is associated with gastrointestinal (GI) symptoms. Small intestinal bacterial overgrowth (SIBO) is emerging as a significant GI sequela post-COVID-19 infection. This study aimed to evaluate the prevalence and incidence of SIBO post-COVID-19 infection across different age groups and to identify associated risk factors in a global cohort.

Methods: A retrospective study utilized the TriNetX database and included adult patients (≥18 years) diagnosed with SIBO following COVID-19 infection (1 January 2022-30 May 2024). A propensity score matching (1:1) was used to adjust for demographics and SIBO risk factors. Kaplan-Meier survival analysis assessed the SIBO incidence within 12 months.

Results: Among 1,660,092 COVID-19 patients and 42,322,017 controls, SIBO was diagnosed in 353 COVID-19 patients without hydrogen breath tests (BT) and 78 with BT, compared to 3368 controls without BT and 871 with BT. Age-specific analysis demonstrated a clear, progressive increase in the SIBO incidence, becoming distinctly significant by 6 months and highest at 12 months post-infection. The highest risks were noted in ages 60-69 (0.011% vs. 0.004%, OR 2.6, p = 0.0003) and 70-79 (0.011% vs. 0.005%, OR 2.0, p = 0.0004), with younger age groups (30-49 years) also showing significantly increased risks. The medication analysis revealed strong associations with chronic opioid, proton pump inhibitor, and antidiarrheal medication.

Conclusions: COVID-19 significantly increased the risk of SIBO, particularly within the first 12 months post-infection, across various age groups and, notably, in association with certain chronic medications. Clinical vigilance and targeted management strategies are recommended to mitigate long-term GI consequences.

COVID-19感染后小肠细菌过度生长风险的进行性增加:一项基于全球人群的研究
背景/目的:冠状病毒病2019 (COVID-19)与胃肠道(GI)症状相关。小肠细菌过度生长(SIBO)正在成为covid -19感染后的重要胃肠道后遗症。本研究旨在评估不同年龄组covid -19感染后SIBO的患病率和发病率,并在全球队列中确定相关危险因素。方法:采用TriNetX数据库进行回顾性研究,纳入了2019年1月1日至2024年5月30日感染COVID-19后诊断为SIBO的成年患者(≥18岁)。倾向评分匹配(1:1)用于调整人口统计学和SIBO危险因素。Kaplan-Meier生存分析评估12个月内SIBO的发病率。结果:在1660,092例COVID-19患者和42,322,017例对照组中,353例未进行氢呼吸试验(BT)的患者和78例进行了氢呼吸试验,相比之下,3368例未进行氢呼吸试验的对照组和871例进行了氢呼吸试验。年龄特异性分析显示,SIBO发病率明显呈进行性增加,在感染后6个月变得明显,在感染后12个月达到最高。60-69岁(0.011% vs. 0.004%, OR 2.6, p = 0.0003)和70-79岁(0.011% vs. 0.005%, OR 2.0, p = 0.0004)的风险最高,年龄较小的年龄组(30-49岁)的风险也显著增加。药物分析显示与慢性阿片类药物、质子泵抑制剂和止泻药物有很强的相关性。结论:在不同年龄组中,COVID-19显著增加了SIBO的风险,特别是在感染后的头12个月内,特别是与某些慢性药物有关。临床警惕和有针对性的管理策略建议减轻长期胃肠道后果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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