Post-acute COVID-19 gastrointestinal sequelae: Mechanisms of persistent dysbiosis, intestinal barrier dysfunction, and emerging long-COVID phenotypes

doi:10.5495/wjcid.124175

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World Journal of Clinical Infectious Diseases

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2220-3176

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World J Clin Infect Dis. Sep 8, 2026; 15(1): 124175
Published online Sep 8, 2026. doi: 10.5495/wjcid.124175

Table 2 Proposed biomarker-based stratification of post-acute coronavirus disease-19 gastrointestinal phenotypes (investigational)

Phenotype	Dominant biomarkers	Candidate targeted approach	Assay availability/caveats
Barrier-dominant	Raised zonulin; raised I-FABP	Barrier-restoring (butyrate/postbiotics)	Zonulin assay controversial; not standardized
Dysbiosis-dominant	Reduced alpha-diversity; reduced SCFA	Probiotics/synbiotics; FMT (investigational)	Metagenomics costly; not point-of-care
Immune-dominant	Raised fecal calprotectin; raised cytokines	Anti-inflammatory/immunomodulatory	Calprotectin available but non-specific

This framework is hypothesis-generating and not validated; overlap between phenotypes is expected, and assays vary in cost, availability, and standardization. SCFA: Short-chain fatty acid; FMT: Fecal microbiota transplantation.

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Citation: Salman A. Post-acute COVID-19 gastrointestinal sequelae: Mechanisms of persistent dysbiosis, intestinal barrier dysfunction, and emerging long-COVID phenotypes. World J Clin Infect Dis 2026; 15(1): 124175
URL: https://www.wjgnet.com/2220-3176/full/v15/i1/124175.htm
DOI: https://dx.doi.org/10.5495/wjcid.124175

Salman A. Post-acute COVID-19 gastrointestinal sequelae: Mechanisms of persistent dysbiosis, intestinal barrier dysfunction, and emerging long-COVID phenotypes. World J Clin Infect Dis 2026; 15(1): 124175 [DOI: 10.5495/wjcid.124175]

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