Publication date: Jul 26, 2024

This SRMA reviewed and assessed the changes in the severity of disorders of gut-brain interaction (DGBI) symptoms during the COVID-19 pandemic, and evaluated factors associated with symptom severity changes. Electronic databases were searched until February 2024, for articles reporting on changes in symptom severity in DGBI patients during the COVID-19 pandemic. The proportion of DGBI patients who reported a change in their symptom severity were pooled using a random-effects model, and subgroup analyses were conducted to assess the effect of socio-cultural modifiers on symptom severity in DGBI. Twelve studies including 3610 DGBI patients found that 31. 4% (95% CI, 15. 9-52. 5) of DGBI patients experienced symptom deterioration, while 24. 3% (95% CI, 10. 2-47. 5) experienced improvement. Countries with high gross domestic product (GDP) had a 43. 5% (95% CI, 16. 3-75. 2) likelihood of symptom deterioration, compared to 9. 2% (95% CI, 1. 4-42. 2) in lower GDP countries. Similarly, countries with low COVID fatality rates had a 60. 1% (95% CI, 19. 7-90. 3) likelihood of symptom deterioration, compared to 18. 3% (95% CI, 7. 8-36. 9) in higher fatality rate countries. Countries with lenient COVID policies had a 58. 4% (95% CI, 14. 1-92. 3) likelihood of symptom deterioration, compared to 19% (95% CI, 8. 2-38. 1) in countries with stricter policies. Patients in high vaccine hesitancy countries had a 51. 4% (95% CI, 19. 5-82. 2) likelihood of symptom deterioration, compared to 10. 6% (95% CI, 2. 7-33. 4) in low vaccine hesitancy countries. This meta-analysis reveals that a significantly higher proportion of DGBI patients experienced deterioration of symptoms during the COVID-19 pandemic. Various sociocultural, economic and environmental factors potentially modify the effects of the COVID-19 pandemic on DGBI.

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