Incidence of persistent SARS-CoV-2 gut infection in patients with a history of COVID-19: Insights from endoscopic examination

• Published in: Endoscopy International Open 2024-01, Vol.12 (1), p.E11-E22
• Main Authors: Hany, Mohamed, Sheta, Eman, Talha, Ahmed, Anwar, Medhat, Selima, Mohamed, Gaballah, Muhammad, Zidan, Ahmed, Ibrahim, Mohamed, Agayby, Ann Samy Shafiq, Abouelnasr, Anwar Ashraf, Samir, Mohamed, Torensma, Bart
• Format: Article
• Language: English
• Subjects: Endoscopy Upper GI Tract; Epidemiology
• ISSN: 2364-3722; 2196-9736
• DOI: 10.1055/a-2180-9872

Background and study aims Gut infection is common during acute COVID-19, and persistent SARS-CoV-2 gut infection has been reported months after the initial infection, potentially linked to long-COVID syndrome. This study tested the incidence of persistent gut infection in patients with a history of COVID-19 undergoing endoscopic examination. Patients and methods Endoscopic biopsies were prospectively collected from patients with previous COVID-19 infection undergoing upper or lower gastrointestinal endoscopy (UGE or LGE). Immunohistochemistry was used to detect the presence of persistent SARS-CoV-2 nucleocapsid proteins. Results A total of 166 UGEs and 83 LGE were analyzed. No significant differences were observed between patients with positive and negative immunostaining regarding the number of previous COVID-19 infections, time since the last infection, symptoms, or vaccination status. The incidence of positive immunostaining was significantly higher in UGE biopsies than in LGE biopsies (37.34% vs. 16.87%, P=0.002). Smokers showed a significantly higher incidence of positive immunostaining in the overall cohort and UGE and LGE subgroups (P