Nutritional Risk and Persistent Gastrointestinal Symptoms in COVID-19 Survivors: A Retrospective–Prospective Cohort Study

Bin Ammar, Albandari, Eltoum, Nagat, Rathinaraj Antony Soundararajan, Leo, Elhussein, Nagwan, Fatima, Sayeda, Alkhalaf, Majid, Elshazley, Momen, Alammar, Abdullah, Mannickal Thankappan, Sreeja, Al-Faqiri, Ghosoun and Elkhalifa, Abd Elmoneim (2026) Nutritional Risk and Persistent Gastrointestinal Symptoms in COVID-19 Survivors: A Retrospective–Prospective Cohort Study. Gastroenterology Insights, 17 (1). p. 19. ISSN 2036-7422

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Abstract

Background/Objectives: Gastrointestinal (GI) manifestations may persist in COVID-19 survivors, potentially worsening pre-existing conditions and increasing the risk of malnutrition. Understanding the long-term association between GI symptoms and nutritional risk is essential. This study aimed to investigate this relationship in COVID-19 survivors, regardless of comorbidities. Methods: A retrospective cohort study with prospective follow-up was conducted among 103 adults (52 males and 51 females) with PCR-confirmed COVID-19 admitted to King Salman Specialist Hospital, Ha’il, Saudi Arabia, between January 2021 and January 2023. Participants were grouped based on the presence of comorbidities, mainly type 2 diabetes mellitus (DM) and hypertension (HTN), and GI symptoms. Demographic characteristics, COVID-19 severity, and clinical data were obtained from medical records and structured interviews. Nutritional risk was assessed using the Malnutrition Screening Tool (MST). Statistical analysis was performed using Chi-Square tests, with p < 0.05 considered significant. Results: Over a mean follow-up of 26.6 months, 40.8% of participants reported at least one persistent GI symptom. Patients with comorbidities were older than those without comorbidities (mean age 58.24 ± 13.23 vs. 48.22 ± 14.83 years), and malnutrition risk was commonly observed in both groups during hospitalization and follow-up. The most frequently reported symptoms were abdominal pain (15.5%), diarrhea (12.6%), appetite loss (9.7%), and vomiting (7.8%), with no significant differences between groups. GI symptoms were significantly associated with reduced food intake, weight loss, and increased malnutrition risk (p < 0.05). Conclusions: Some COVID-19 survivors reported persistent GI symptoms during long-term follow-up, with no significant differences based on comorbidity status. GI symptoms were associated with nutritional risk and lifestyle changes, supporting the need for nutritional screening in post-COVID-19 care.

Item Type:	Article
Additional Information:	** Article version: VoR ** From MDPI via Jisc Publications Router ** History: received 27-12-2025; rev-recd 09-02-2026; accepted 18-02-2026; collection 01-03-2026; epub 04-03-2026. ** Licence for VoR version of this article: https://creativecommons.org/licenses/by/4.0/ ** Acknowledgements: The authors extend their appreciation to the Scientific Research Deanship researcher, supporting project number (RG-21 132), University of Hail, Hail, Saudi Arabia. They also would like to express sincere gratitude to all the contributors, healthcare assistants, and doctors who played an essential role in collecting the data for this study. Their dedication, hard work, and commitment were invaluable to the success of this research.
Keywords:	COVID-19 survivors, malnutrition, nutritional risk, gastrointestinal symptoms, comorbidities
SWORD Depositor:	JISC Router
Depositing User:	JISC Router
Date Deposited:	16 Apr 2026 10:08
Last Modified:	16 Apr 2026 10:52
URI:	https://bnu.repository.guildhe.ac.uk/id/eprint/20924

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