{
  "abstract": "BackgroundSevere COVID-19 is associated with immune dysregulation, microbiome disruption, and increased vulnerability to secondary infections. However, the longer-term risk of acute gastroenteritis (AGE) following COVID-19 remains poorly studied. We compared AGE incidence among community-managed and hospitalised COVID-19 patients with test-negative controls and hospitalised sepsis patients.\n\nMethodsWe conducted a retrospective cohort study using electronic healthcare data. Patients with a recorded SARS-CoV-2 PCR test between 01 March 2020 and 01 March 2022 were allocated to test-negative, community COVID-19, or hospitalised COVID-19 cohorts. A hospitalised sepsis cohort was assembled for an age-, sex- and time-matched analysis. AGE incidence rates were calculated for the two years before enrolment and during follow-up. Negative binomial regression and conditional Poisson models estimated incidence rate ratios (IRRs) adjusting for demographic and clinical covariates.\n\nResultsAmong 788 103 patients, AGE incidence in the pre-pandemic period was higher among individuals later hospitalised with COVID-19 or sepsis compared with community cases. During follow-up, AGE incidence was slightly lower in community COVID-19 cases than test-negative controls (adjusted IRR 0{middle dot}88 [95% CI 0{middle dot}85-0{middle dot}92]), but substantially higher among hospitalised COVID-19 patients (IRR 5{middle dot}80 [95% CI: 5{middle dot}38-6{middle dot}25]). Matched analyses confirmed increased AGE rates compared with community controls (IRR 4{middle dot}63 [95% CI: 4{middle dot}15-5{middle dot}17]) and hospitalised sepsis controls (IRR 1{middle dot}41 [95% CI 1{middle dot}21-1{middle dot}64]).\n\nConclusionsCOVID-19 hospitalisation is associated with a marked increase in AGE risk after discharge, exceeding that associated with sepsis hospitalisation. By contrast, lower AGE rates in community COVID-19 cases likely reflect baseline differences rather than protective effects of infection. Overall, these findings demonstrate heightened post-discharge vulnerability to gastrointestinal illness after COVID-19 hospitalisation and support the need for improved follow-up and surveillance strategies.\n\nFundingNational Institute for Health Research",
  "abstract_shown": true,
  "affiliations": [
    "University of Liverpool"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "M. J. Hawkings"
    },
    {
      "name": "D. M. Hughes"
    },
    {
      "name": "A. J. Elliot"
    },
    {
      "name": "I. E. Buchan"
    },
    {
      "name": "D. Hungerford"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6ath4kpzrsvwn.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.07.26362439",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.07.26362439v1.full",
  "id": "6ath4kpzrsvwn",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.07.26362439v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "epidemiology"
    ],
    [
      "openalex",
      "2725|COVID-19 Clinical Research Studies"
    ]
  ],
  "openalex": "W7212046204",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.07.26362439v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/6ath4kpzrsvwn.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:11Z",
      "native_id": "10.64898/2026.09.07.26362439",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.07.26362439v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:epidemiology",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Risk of acute gastroenteritis following COVID-19 exposure: a retrospective population-based analysis conducted in England",
  "title_text": "Risk of acute gastroenteritis following COVID-19 exposure: a retrospective population-based analysis conducted in England",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:11Z",
  "url": "https://research.draconitic.com/paper/6ath4kpzrsvwn",
  "venue": "medRxiv",
  "versions": []
}