Gastrointestinal and hepatic involvement during COVID-19 pandemic: A focus on pediatric population and possible...

Area of Science:

• Pediatric infectious diseases
• Gastroenterology
• Hepatology
• Critical care medicine

Background:

• The COVID-19 pandemic, caused by SARS-CoV-2, has revealed limited understanding of its full clinical spectrum.
• While children are less commonly affected by severe COVID-19, a distinct condition, MIS-C, has emerged.
• MIS-C can lead to critical complications including shock and multi-organ failure, necessitating intensive care.

Purpose of the Study:

• To highlight the significance of extrapulmonary manifestations, specifically gastrointestinal (GI) and hepatic involvement, in COVID-19 and MIS-C.
• To emphasize that GI and hepatic symptoms are common presenting features and potential sequelae in both pediatric and adult cases.
• To underscore the importance of diagnostic tools and long-term follow-up for these conditions.

Main Methods:

• Review of clinical presentations of COVID-19 and MIS-C, focusing on extrapulmonary symptoms.
• Consideration of diagnostic utility of abdominal ultrasonography for GI and hepatic assessment.
• Emphasis on the necessity for longitudinal studies to determine long-term outcomes.

Main Results:

• Gastrointestinal and hepatic involvement are frequently observed in both pediatric and adult patients with COVID-19 and MIS-C.
• These manifestations can present as initial symptoms and may also represent long-term consequences of the infection/syndrome.
• Abdominal ultrasonography is a valuable tool for detecting potential GI and liver abnormalities.

Conclusions:

• Extrapulmonary involvement, particularly GI and hepatic issues, should be actively investigated in patients with COVID-19 and MIS-C.
• Early identification and monitoring using methods like abdominal ultrasound are crucial for managing these conditions.
• Long-term follow-up is essential to fully understand and manage the sequelae of MIS-C and COVID-19 in children and adolescents.