Figure 1.

Risk and mechanisms of post-COVID-19 IBS. Hospitalization during COVID-19 infection and high stress during or subsequent to the acute infection might increase the risk of PI-IBS development. Invasion of SARS-CoV-2 in the intestinal epithelium may mediate immune dysregulation, barrier dysfunction, and neuromuscular plasticity. Additionally, changes in luminal milieu caused by altered microbiota or metabolites may mediate changes in sensory-motor function. Patients may develop central sensitization because of the ongoing stress associated with the pandemic. Lastly, established mechanisms of long-COVID, such as autonomic dysfunction and altered taste perception, might influence gut function and eating patterns or diet, thereby leading to chronic gastrointestinal symptomatology. POTS, postural orthostatic tachycardia syndrome.