S6256 Idiopathic Gastroparesis in Patients With Long COVID: A Case Series

Introduction: Gastroparesis, a condition characterized by delayed gastric emptying in the absence of mechanical obstruction, is increasingly being identified as a potential sequela of long coronavirus disease 2019 (COVID-19). Idiopathic gastroparesis following COVID-19 infection may result from post viral autonomic dysfunction, inflammation, or altered motility. This case series highlights 5 patients who developed idiopathic gastroparesis after recovering from acute COVID-19, exploring their clinical presentations, diagnostic challenges, and outcomes. Case Description/Methods: Five patients (ages 28–60) presented with persistent gastrointestinal (GI) symptoms, including nausea, bloating, early satiety, and vomiting, within 3 months of recovering from mild-to-moderate COVID-19. 1. A 28-year-old woman developed significant weight loss and chronic nausea 2 months post-COVID-19. Gastric scintigraphy confirmed delayed gastric emptying, and dietary modifications improved symptoms. 2. A 35-year-old man reported early satiety and postprandial fullness. Gastroparesis was diagnosed through a gastric emptying study. Prokinetic therapy provided partial relief. 3. A 60-year-old woman with diabetes developed exacerbated bloating and vomiting post-COVID-19. Her symptoms were resistant to standard therapies, requiring jejunal feeding support. 4. A 55-year-old man experienced severe vomiting and abdominal pain post-COVID-19. Scintigraphy confirmed delayed gastric emptying, and he responded to a combination of dietary changes and prokinetics. 5. A 45-year-old woman with no prior GI history reported persistent nausea and reflux. Testing revealed idiopathic gastroparesis, managed with dietary adjustments and symptom-specific medications. Discussion: Post-viral gastroparesis is a recognized but rare outcome, and long COVID appears to increase its prevalence. Possible mechanisms include autonomic neuropathy, inflammation, and direct viral effects on the enteric nervous system. Delayed diagnosis often leads to complications such as malnutrition and poor quality of life. This case series emphasizes the importance of early recognition and tailored management strategies, including dietary modifications, prokinetics, and, in severe cases, enteral nutrition support. Idiopathic gastroparesis may be a notable complication of long COVID, with significant implications for patient management. Further research is needed to understand its pathophysiology and to establish effective treatment protocols.