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Gastrointestinal coronavirus disease 2019 manifestations in childhood

Naire Sansotta1, Lorenzo Norsa, Lorenzo D'Antiga

  • 1Paediatric Hepatology Gastroenterology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy.

Current Opinion in Clinical Nutrition and Metabolic Care
|February 24, 2022
PubMed

Insights

Gastrointestinal symptoms are common in children with COVID-19 and can be the only sign of infection. Early recognition of these symptoms is crucial for preventing transmission and severe outcomes like MIS-C.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Virology

Background:

  • The COVID-19 pandemic, caused by SARS-CoV-2, presents a global health crisis.
  • ACE2 receptors, crucial for SARS-CoV-2 entry, are present in the gastrointestinal tract.
  • SARS-CoV-2 RNA has been detected in stool samples, indicating fecal-oral transmission potential.

Purpose of the Study:

  • To review the pathophysiology and transmission of SARS-CoV-2.
  • To focus on gastrointestinal manifestations in children with COVID-19.
  • To summarize the impact of COVID-19 on pediatric patients with pre-existing GI conditions.

Main Methods:

  • Literature review of recent evidence on SARS-CoV-2.
  • Analysis of gastrointestinal symptom presentation in pediatric COVID-19 cases.
  • Examination of the relationship between SARS-CoV-2 and pediatric inflammatory conditions.

Main Results:

  • Gastrointestinal symptoms like diarrhea, abdominal pain, and vomiting are frequent in children with COVID-19.
  • Some pediatric patients present exclusively with gastrointestinal symptoms.
  • Multisystem Inflammatory Syndrome in Children (MIS-C) associated with SARS-CoV-2 frequently involves the GI tract.

Conclusions:

  • Clinicians must consider GI symptoms in pediatric COVID-19 diagnosis, even if mild or isolated.
  • Underestimating GI symptoms can lead to missed diagnoses, viral transmission, and progression to severe conditions like MIS-C.
  • Further research into the etiopathogenesis of GI involvement in pediatric COVID-19 is warranted.
Abstract

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