S2993 The COVID-19 Pandemic's Lasting Impact on Public Awareness of Gastrointestinal Symptoms: A National Google Trends Analysis

Introduction: The coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of gastrointestinal symptoms, particularly loss of taste and smell, as early indicators of infection. However, the long-term impact of pandemic awareness campaigns on public health-seeking behavior for gastrointestinal (GI) symptoms remains unclear. We analyzed Google search patterns to quantify pandemic-driven changes in GI symptom awareness and assess their persistence over time. Methods: Google Trends data were collected for 5 key search terms; “loss of taste and smell,” “nausea and vomiting,” “diarrhea,” “stomach pain,” and “digestive problems”, from January 2018 through May 2025 across all U.S. states. We defined 3 distinct periods: pre-pandemic (January 2018 to February 2020), pandemic peak (March 2020 to December 2021), and post-pandemic (January 2022 to May 2025). Relative search interest was compared across time periods using interrupted time series analysis and t-tests, with geographic distribution patterns analyzed separately. Results: Searches for loss of taste and smell demonstrated the most dramatic increase, rising from a pre-pandemic baseline of 2.6 to a peak of 100 in December 2020 (3,724% increase, P < 0.001), with a sustained post-pandemic elevation to 13.0 (398% above baseline, P < 0.001). Diarrhea-related searches increased 27% at peak and remained elevated by 16% post-pandemic (P < 0.05). Nausea and vomiting searches showed a 12% peak increase and a 14% sustained elevation (P < 0.05). Digestive problems peaked 15% above baseline but declined 16% post-pandemic, suggesting a shift toward more specific health inquiries. Stomach pain, used as a negative control, showed minimal change (3% peak, 1% sustained; P = 0.45). Geographic analysis revealed highest sustained interest in Pennsylvania, Montana, Iowa, and North Dakota, with marked rural-urban disparities and correlations between search intensity and regional COVID-19 outbreak severity. Conclusion: The COVID-19 pandemic permanently altered public health-seeking behavior, creating unprecedented awareness of specific GI symptoms while increasing overall health literacy. These population-level behavioral changes demonstrate the effectiveness of pandemic health communication and provide a novel framework for measuring public health education impact. Geographic disparities reveal opportunities for targeted interventions, while the digital epidemiology methodology offers valuable insights for future health emergency preparedness.