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Paediatric COVID-19 and the GUT

Rohit Gupta1, Saman Beg2, Alok Jain1

  • 1Department of Gastroenterology, AIIMS, Rishikesh, Uttarakhand, India.

Indian Journal of Medical Microbiology
|November 6, 2020
PubMed

Insights

Children with COVID-19 can experience gastrointestinal symptoms, suggesting potential fecal-oral transmission. The gastrointestinal tract may shed the virus even after respiratory symptoms resolve.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Gastroenterology

Background:

  • Novel coronavirus infection (COVID-19) in children often presents with fever and respiratory symptoms.
  • Gastrointestinal (GI) symptoms like vomiting and diarrhea are also reported in pediatric COVID-19 cases.
  • The GI tract's role in COVID-19 shedding and transmission is an emerging area of concern.

Purpose of the Study:

  • To explore the significance of gastrointestinal symptoms in pediatric COVID-19.
  • To investigate the potential for fecal-oral transmission of SARS-CoV-2 in children.
  • To understand the implications of COVID-19 for children with chronic digestive conditions.

Main Methods:

  • Analysis of viral RNA detection in fecal samples compared to nasopharyngeal swabs.
  • Review of the expression of key SARS-CoV-2 entry proteins (ACE2, TMPRSS2) in the GI tract.
  • Discussion of clinical implications for pediatric patients.

Main Results:

  • Continuous detection of viral RNA in feces suggests the GI tract as a shedding source.
  • Viral shedding from the GI tract may persist even after negative respiratory tests.
  • Presence of SARS-CoV-2 entry receptors in the GI tract explains observed digestive symptoms.

Conclusions:

  • The gastrointestinal tract plays a role in SARS-CoV-2 shedding in children.
  • Fecal-oral transmission is a potential route for COVID-19 spread in pediatric populations.
  • COVID-19 management requires consideration of GI symptoms and risks for children with inflammatory bowel disease.

Keywords:
COVID-19Chronic luminal diseasesintestine

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