Effects of COVID-19 in Patients with Gastroparesis: A GpCRC Supplement

ABSTRACT:Coronavirus Disease 2019 (COVID-19), a disease caused by infection with Severe Acute RespiratorySyndrome Coronavirus 2 (SARS-CoV-2), commonly presents with symptoms including fever, cough, andshortness 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-2infection of the GI tract or a systemic effect from the respiratory viral infection. In patients with chronic GIillnesses, such as gastroparesis, COVID-19 may present as a flare of their underlying GI condition asviruses 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 presentingpredominantly with nausea, vomiting and diarrhea. They may be at risk for developing post-viralgastroparesis, which is an important and poorly understood potential chronic inflammation-based cause of"idiopathic gastroparesis". The NIH Gastroparesis Clinical Research Consortium (GpCRC), consisting of sixclinical centers and its Scientific and Data Research Center (SDRC), is following the largest number ofpatients with gastroparesis and dyspepsia symptoms. These patients are well phenotyped. In addition todetailed physiological phenotyping, every 6 months we obtain detailed questionnaires, and store plasmaand serum. The overall goals of this supplemental grant are to determine if COVID-19 affects clinicalcourse of patients with gastroparesis and whether COVID-19 is associated with development ofpost-infection gastroparesis and/or functional dyspepsia. We will accomplish these goals byundertaking 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 assessif SARS-CoV-2 infection disproportionately affects patients with gastroparesis compared to generalcommunity population in same geographic location. Aim 2: Determine if COVID-19 affects the clinicalcourse of patients with gastroparesis by causing more flares than usual, increasing the severity ofgastroparesis symptoms, and decreasing gastric emptying. Aim 3: Characterize patients developing newonset gastroparesis and functional dyspepsia after COVID-19 in patients. Currently, the GpCRC is the onlylarge, NIH-funded registry of patients with chronic GI symptoms from gastric dysmotility (gastroparesis). TheGI epithelial involvement with SARS-CoV-2 as well as the existing rationale that such infections can led tochronic gut dysfunction, makes GpCRC ideally poised to conduct this research. This research project will beaccomplished within 1 year timeline to produce impactful clinical data to understand GI implications ofSARS-CoV-2 infection. This proposed study will be implemented at all six clinical sites of the GpCRC withSDRC for coordination and Mayo Clinic core of the GpCRC will be used for SARS-CoV-2 serology testing.