Coronavirus Disease 2019 (COVID-19), a disease caused by infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), commonly presents with symptoms including fever, cough, and shortness of breath. Some patients have tested positive for SARS-CoV-2 after developing gastrointestinal (GI) symptoms either solely or in conjunction with pulmonary symptoms. This may be due to SARS-CoV-2 infection of the GI tract or a systemic effect from the respiratory viral infection. In patients with chronic GI illnesses, such as gastroparesis, COVID-19 may present as a flare of their underlying GI condition as viruses have historically been implicated in exacerbations of chronic GI disorders, including gastroparesis. Some patients with no underlying GI conditions have been diagnosed with COVID-19 after presenting predominantly with nausea, vomiting and diarrhea. They may be at risk for developing post-viral gastroparesis, which is an important and poorly understood potential chronic inflammation-based cause of ?idiopathic gastroparesis?. The NIH Gastroparesis Clinical Research Consortium (GpCRC), consisting of six clinical centers and its Scientific and Data Research Center (SDRC), is following the largest number of patients with gastroparesis and dyspepsia symptoms. These patients are well phenotyped. In addition to detailed physiological phenotyping, every 6 months we obtain detailed questionnaires, and store plasma and serum. The overall goals of this supplemental grant are to determine if COVID-19 affects clinical course of patients with gastroparesis and whether COVID-19 is associated with development of post-infection gastroparesis and/or functional dyspepsia. We will accomplish these goals by undertaking the following three specific aims involving patients in our gastroparesis registry.
Aim 1. Determine the prevalence of SARS-CoV-2 infection in patients with confirmed gastroparesis to help assess if SARS-CoV-2 infection disproportionately affects patients with gastroparesis compared to general community population in same geographic location.
Aim 2 : Determine if COVID-19 affects the clinical course of patients with gastroparesis by causing more flares than usual, increasing the severity of gastroparesis symptoms, and decreasing gastric emptying.
Aim 3 : Characterize patients developing new onset gastroparesis and functional dyspepsia after COVID-19 in patients. Currently, the GpCRC is the only large, NIH-funded registry of patients with chronic GI symptoms from gastric dysmotility (gastroparesis). The GI epithelial involvement with SARS-CoV-2 as well as the existing rationale that such infections can led to chronic gut dysfunction, makes GpCRC ideally poised to conduct this research. This research project will be accomplished within 1 year timeline to produce impactful clinical data to understand GI implications of SARS-CoV-2 infection. This proposed study will be implemented at all six clinical sites of the GpCRC with SDRC for coordination and Mayo Clinic core of the GpCRC will be used for SARS-CoV-2 serology testing.

Public Health Relevance

Gastrointestinal symptoms are becoming increasingly recognized in patients with Coronavirus Disease 2019 (COVID-19), and may even be the presenting symptoms. How COVID-19 affects the already compromised patients that have impaired gastric function with gastroparesis is the subject of this research. The goals of this research are to determine the effect of COVID-19 in patients with gastroparesis, and to determine if COVID-19 is followed by post-infection gastroparesis and/or functional dyspepsia.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZDK1)
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Serrano, Jose
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Temple University
Internal Medicine/Medicine
Schools of Medicine
United States
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