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COVID-19 / SPECIALTY RESEARCH

GastroenterologyIn perspective.

The key COVID-19 findings in gastroenterology, distilled into a clear, readable brief. The evidence is here whenever you want to go deeper.

INSIDE THIS MONITOR
37cited sources
6available findings

Study findings updated

AI-assisted evidence summary. For general information. These findings are not individual medical advice or a clinician endorsement.

THE SHORT VERSION

What’s worth knowing.

The key findings, what they mean, and the context that matters.

THE HEADLINE TAKEAWAY68% vs. 35.7%

Fatigue response was more frequent with VSL#3® than placebo

After 4 weeks, 68% receiving VSL#3® were fatigue responders versus 35.7% receiving placebo; Chalder Fatigue Scale scores also fell more with VSL#3® than placebo.

This randomized placebo-controlled trial involved patients with long COVID and clinically relevant fatigue. The responder definition and safety findings are not available here; the reported outcomes cover 4 weeks.

See the evidence

Fatigue responder proportion with 4 weeks of VSL#3® versus placebo among patients with long COVID and clinically relevant fatigue (p = 0.019)

68% vs. 35.7%

Amoroso, Chiara et al.. VSL#3® supplementation improves fatigue in long COVID: results from the DELong#3 randomized placebo-controlled trial.. British journal of biomedical science. 2026.

Added

Reduction in Chalder Fatigue Scale score with 4 weeks of VSL#3® versus placebo among patients with long COVID and clinically relevant fatigue (p = 0.037)

24.24% vs. 6.06% reduction

Amoroso, Chiara et al.. VSL#3® supplementation improves fatigue in long COVID: results from the DELong#3 randomized placebo-controlled trial.. British journal of biomedical science. 2026.

Added

02

At 6 months, 22% of COVID-19 survivors reported persistent gastrointestinal symptoms

22%

At 6 months after infection, 22% of COVID-19 survivors reported persistent gastrointestinal symptoms.

This is a descriptive estimate among COVID-19 survivors, not a treatment comparison. The setting and symptom definition are not available, and the summary gives no trajectory beyond 6 months.

See the evidence

Of COVID-19 survivors report persistent GI symptoms

22%

Blackett JW, Wainberg M, Elkind MSV, et al. Potential Long Coronavirus Disease 2019 Gastrointestinal Symptoms 6 Months After Coronavirus Infection Are Associated With Mental Health Symptoms. Gastroenterology. 2022;162(2):648-650.e2.

03

Corticosteroid use was linked to severe COVID-19 in IBD

In an international IBD registry, corticosteroid use was associated with higher odds of severe COVID-19.

These registry findings are associations; the reference medication group is not identified in this summary.

See the evidence

Corticosteroids & Severe COVID (IBD)

+190%
OR 2.9 (95% CI: 1.8-4.7)

Ungaro RC, Brenner EJ, Gearry RB, et al. Effect of IBD medications on COVID-19 outcomes: results from an international registry. Gut. 2021;70(4):725-732.

04

Gut dysbiosis was associated with long COVID

A prospective cohort found that gut dysbiosis was associated with long COVID.

This cohort involved patients with post-acute COVID-19 syndrome. The reference group and dysbiosis definition are not available in this summary, and the association does not establish cause.

See the evidence

Gut Dysbiosis & Long COVID

+210%
OR 3.1 (95% CI: 1.8-5.3)

Liu Q, Mak JWY, Su Q, et al. Gut microbiota dynamics in a prospective cohort of patients with post-acute COVID-19 syndrome. Gut. 2022;71(3):544-552.

Study-specific findings. Different populations, treatments and follow-up periods can produce different results.

THE RESEARCH, AS IT ARRIVES

Latest studies.

The newest findings added to this collection.
The learning from each, already distilled.

  1. STUDY 01Findings added
    TL;DR

    Fatigue response was more frequent with VSL#3® than placebo

    68% vs. 35.7%

    After 4 weeks, 68% receiving VSL#3® were fatigue responders versus 35.7% receiving placebo; Chalder Fatigue Scale scores also fell more with VSL#3® than placebo.

    This randomized placebo-controlled trial involved patients with long COVID and clinically relevant fatigue. The responder definition and safety findings are not available here; the reported outcomes cover 4 weeks.

    Study details & original results

    Amoroso, Chiara et al.. VSL#3® supplementation improves fatigue in long COVID: results from the DELong#3 randomized placebo-controlled trial.. British journal of biomedical science. 2026.

    Fatigue responder proportion with 4 weeks of VSL#3® versus placebo among patients with long COVID and clinically relevant fatigue (p = 0.019)

    68% vs. 35.7%

    Reduction in Chalder Fatigue Scale score with 4 weeks of VSL#3® versus placebo among patients with long COVID and clinically relevant fatigue (p = 0.037)

    24.24% vs. 6.06% reduction

    Citation in Gastroenterology
1 of 1 study updates

Dates show when findings were added here, not when papers were published. Study populations and comparisons differ.

WHEN YOU WANT TO GO DEEPER
See all 6 findingsOriginal results, comparisons and study details.
4 of 4 source groupsFindings stay together with their study.
SOURCE 372 findings

Amoroso, Chiara et al.. VSL#3® supplementation improves fatigue in long COVID: results from the DELong#3 randomized placebo-controlled trial.. British journal of biomedical science. 2026.

Reduction in Chalder Fatigue Scale score with 4 weeks of VSL#3® versus placebo among patients with long COVID and clinically relevant fatigue (p = 0.037)

Added
24.24% vs. 6.06% reductionSource [37]

Fatigue responder proportion with 4 weeks of VSL#3® versus placebo among patients with long COVID and clinically relevant fatigue (p = 0.019)

Added
68% vs. 35.7%Source [37]
SOURCE 101 finding

Liu Q, Mak JWY, Su Q, et al. Gut microbiota dynamics in a prospective cohort of patients with post-acute COVID-19 syndrome. Gut. 2022;71(3):544-552.

Gut Dysbiosis & Long COVID

+210%OR 3.1 (95% CI: 1.8-5.3)Source [10]
SOURCE 162 findings

Ungaro RC, Brenner EJ, Gearry RB, et al. Effect of IBD medications on COVID-19 outcomes: results from an international registry. Gut. 2021;70(4):725-732.

Corticosteroids & Severe COVID (IBD)

+190%OR 2.9 (95% CI: 1.8-4.7)Source [16]

TNF Inhibitors (Protective)

-40%OR 0.6 (95% CI: 0.4-0.9)Source [16]
SOURCE 221 finding

Prasad R, Patton MJ, Floyd JL, et al. Plasma Microbiome in COVID-19 Subjects: An Indicator of Gut Barrier Defects and Dysbiosis. International Journal of Molecular Sciences. 2022;23(16):9141.

Elevated LPS in Severe COVID

+220%OR 3.2 (95% CI: 1.8-5.7)Source [22]
Browse the 37 original sourcesThe complete bibliography behind this monitor.
  1. [1]

    Mao R, Qiu Y, He JS, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis. Lancet Gastroenterology & Hepatology. 2020;5(7):667-678.

    Open original source in a new tab
  2. [2]

    Cheung KS, Hung IFN, Chan PPY, et al. Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis. Gastroenterology. 2020;159(1):81-95.

    Open original source in a new tab
  3. [3]

    Parasa S, Desai M, Thoguluva Chandrasekar V, et al. Prevalence of Gastrointestinal Symptoms and Fecal Viral Shedding in Patients With Coronavirus Disease 2019: A Systematic Review and Meta-analysis. JAMA Network Open. 2020;3(6):e2011335.

    Open original source in a new tab
  4. [4]

    Sultan S, Altayar O, Siddique SM, et al. AGA Institute Rapid Review of the Gastrointestinal and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19. Gastroenterology. 2020;159(1):320-334.e27.

    Open original source in a new tab
  5. [5]

    Wu Y, Guo C, Tang L, et al. Prolonged presence of SARS-CoV-2 viral RNA in faecal samples. Lancet Gastroenterology & Hepatology. 2020;5(5):434-435.

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  6. [6]

    Ramachandran P, Onukogu I, Ghanta S, et al. Gastrointestinal Symptoms and Outcomes in Hospitalized Coronavirus Disease 2019 Patients. Digestive Diseases. 2020;38(5):373-379.

    Open original source in a new tab
  7. [7]

    Yeoh YK, Zuo T, Lui GC, et al. Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19. Gut. 2021;70(4):698-706.

    Open original source in a new tab
  8. [8]

    Zuo T, Zhang F, Lui GCY, et al. Alterations in Gut Microbiota of Patients With COVID-19 During Time of Hospitalization. Gastroenterology. 2020;159(3):944-955.e8.

    Open original source in a new tab
  9. [9]

    Gu S, Chen Y, Wu Z, et al. Alterations of the Gut Microbiota in Patients With Coronavirus Disease 2019 or H1N1 Influenza. Clinical Infectious Diseases. 2020;71(10):2669-2678.

    Open original source in a new tab
  10. [10]

    Liu Q, Mak JWY, Su Q, et al. Gut microbiota dynamics in a prospective cohort of patients with post-acute COVID-19 syndrome. Gut. 2022;71(3):544-552.

    Open original source in a new tab
  11. [11]

    Zuo T, Zhan H, Zhang F, et al. Alterations in Fecal Fungal Microbiome of Patients With COVID-19 During Time of Hospitalization until Discharge. Gastroenterology. 2020;159(4):1302-1310.e5.

    Open original source in a new tab
  12. [12]

    Gaebler C, Wang Z, Lorenzi JCC, et al. Evolution of antibody immunity to SARS-CoV-2. Nature. 2021;591(7851):639-644.

    Open original source in a new tab
  13. [13]

    Natarajan A, Zlitni S, Brooks EF, et al. Gastrointestinal symptoms and fecal shedding of SARS-CoV-2 RNA suggest prolonged gastrointestinal infection. Med. 2022;3(6):371-387.e9.

    Open original source in a new tab
  14. [14]

    Zollner A, Koch R, Jukic A, et al. Postacute COVID-19 is Characterized by Gut Viral Antigen Persistence in Inflammatory Bowel Diseases. Gastroenterology. 2022;163(2):495-506.e8.

    Open original source in a new tab
  15. [15]

    Swank Z, Senussi Y, Manickas-Hill Z, et al. Persistent Circulating Severe Acute Respiratory Syndrome Coronavirus 2 Spike Is Associated With Post-acute Coronavirus Disease 2019 Sequelae. Clinical Infectious Diseases. 2023;76(3):e487-e490.

    Open original source in a new tab
  16. [16]

    Ungaro RC, Brenner EJ, Gearry RB, et al. Effect of IBD medications on COVID-19 outcomes: results from an international registry. Gut. 2021;70(4):725-732.

    Open original source in a new tab
  17. [17]

    Brenner EJ, Ungaro RC, Gearry RB, et al. Corticosteroids, But Not TNF Antagonists, Are Associated With Adverse COVID-19 Outcomes in Patients With Inflammatory Bowel Diseases: Results From an International Registry. Gastroenterology. 2020;159(2):481-491.e3.

    Open original source in a new tab
  18. [18]

    Rubin DT, Feuerstein JD, Baidoo L, et al. AGA Clinical Practice Update on Management of Inflammatory Bowel Disease During the COVID-19 Pandemic: Expert Commentary. Gastroenterology. 2020;159(1):350-357.

    Open original source in a new tab
  19. [19]

    Kennedy NA, Lin S, Goodhand JR, et al. Infliximab is associated with attenuated immunogenicity to BNT162b2 and ChAdOx1 nCoV-19 SARS-CoV-2 vaccines in patients with IBD. Gut. 2021;70(10):1884-1893.

    Open original source in a new tab
  20. [20]

    Giron LB, Dweep H, Yin X, et al. Plasma Markers of Disrupted Gut Permeability in Severe COVID-19 Patients. Frontiers in Immunology. 2021;12:686240.

    Open original source in a new tab
  21. [21]

    Effenberger M, Grabherr F, Mayr L, et al. Faecal calprotectin indicates intestinal inflammation in COVID-19. Gut. 2020;69(8):1543-1544.

    Open original source in a new tab
  22. [22]

    Prasad R, Patton MJ, Floyd JL, et al. Plasma Microbiome in COVID-19 Subjects: An Indicator of Gut Barrier Defects and Dysbiosis. International Journal of Molecular Sciences. 2022;23(16):9141.

    Open original source in a new tab
  23. [23]

    Blackett JW, Wainberg M, Elkind MSV, et al. Potential Long Coronavirus Disease 2019 Gastrointestinal Symptoms 6 Months After Coronavirus Infection Are Associated With Mental Health Symptoms. Gastroenterology. 2022;162(2):648-650.e2.

    Open original source in a new tab
  24. [24]

    Marasco G, Cremon C, Barbaro MR, et al. Post COVID-19 irritable bowel syndrome. Gut. 2023;72(3):484-492.

    Open original source in a new tab
  25. [25]

    Weng J, Li Y, Li J, et al. Gastrointestinal sequelae 90 days after discharge for COVID-19. Lancet Gastroenterology & Hepatology. 2021;6(5):344-346.

    Open original source in a new tab
  26. [26]

    Ghoshal UC, Ghoshal U, Rahman MM, et al. Post-infection functional gastrointestinal disorders following coronavirus disease-19: A case-control study. Journal of Gastroenterology and Hepatology. 2022;37(3):489-498.

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  27. [27]

    Kow CS, Hasan SS. Gastroparesis as a post-COVID-19 sequela. Digestive and Liver Disease. 2021;53(10):1356-1357.

    Open original source in a new tab
  28. [28]

    Wolfel R, Corman VM, Guggemos W, et al. Virological assessment of hospitalized patients with COVID-2019. Nature. 2020;581(7809):465-469.

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  29. [29]

    Xiao F, Tang M, Zheng X, et al. Evidence for Gastrointestinal Infection of SARS-CoV-2. Gastroenterology. 2020;158(6):1831-1833.e3.

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  30. [30]

    Lamers MM, Beumer J, van der Vaart J, et al. SARS-CoV-2 productively infects human gut enterocytes. Science. 2020;369(6499):50-54.

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  31. [31]

    Al-Aly Z, Bowe B, Xie Y. Long COVID after breakthrough SARS-CoV-2 infection. Nature Medicine. 2022;28(7):1461-1467.

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  32. [32]

    Bowe B, Xie Y, Al-Aly Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nature Medicine. 2022;28(11):2398-2405.

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  33. [33]

    Nobel YR, Phipps M, Zucker J, et al. Gastrointestinal Symptoms and Coronavirus Disease 2019: A Case-Control Study From the United States. Gastroenterology. 2020;159(1):373-375.e2.

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  34. [34]

    Redd WD, Zhou JC, Hathorn KE, et al. Prevalence and Characteristics of Gastrointestinal Symptoms in Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in the United States: A Multicenter Cohort Study. Gastroenterology. 2020;159(2):765-767.e2.

    Open original source in a new tab
  35. [35]

    Phipps MM, Baez LM, Martinez JL, et al. Acute Liver Injury in COVID-19: Prevalence and Association with Clinical Outcomes in a Large U.S. Cohort. Hepatology. 2020;72(3):807-817.

    Open original source in a new tab
  36. [36]

    Xu R, Lu R, Zhang T, et al. Temporal association between human upper respiratory and gut microbiomes and COVID-19 severity. Nature Communications. 2022;13:1-12.

    Open original source in a new tab
  37. [37]

    Amoroso, Chiara et al.. VSL#3® supplementation improves fatigue in long COVID: results from the DELong#3 randomized placebo-controlled trial.. British journal of biomedical science. 2026.

    Open original source in a new tab
ABOUT THIS MONITOR

Understanding includes the limits.

This is an AI-assisted evidence summary, not a clinician endorsement. Read each original paper for its complete methods, population and limitations. Different studies can ask different questions and report different kinds of results.

Dates marked “added” describe when a finding entered this monitor, not when the study was published or clinically reviewed. Personal health and treatment decisions belong in a conversation with a qualified clinician.

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