COVID-19-Related Intussusception: A Case Series and Review of the Literature

Area of Science:

• Pediatric Gastroenterology
• Infectious Diseases
• Surgical Emergencies

Background:

• Ileocolic intussusception is a common infant emergency, often linked to lead points like Peyer's patches.
• The relationship between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and intussusception is not well-established.
• Coronavirus disease 2019 (COVID-19) typically presents with respiratory symptoms, but gastrointestinal manifestations are possible.

Purpose of the Study:

• To investigate the association between COVID-19 and intussusception in pediatric patients.
• To determine if SARS-CoV-2 can act as a lead point in intussusception.
• To compare treatment outcomes for intussusception in COVID-19-positive versus COVID-19-negative children.

Main Methods:

• Case report of two pediatric patients with intussusception and concurrent COVID-19.
• Literature review of English-language studies on intussusception in COVID-19 patients.
• Polymerase chain reaction (PCR) testing of lead point tissue for SARS-CoV-2.

Main Results:

• Intussusception occurred in COVID-19-positive patients, with one case confirmed by PCR in the lead point (lymph node).
• COVID-19-associated intussusception appears to be increasing and more frequently requires surgical intervention.
• Intussusception can be the primary presenting symptom of COVID-19, even without respiratory signs.

Conclusions:

• SARS-CoV-2 infection should be considered in pediatric intussusception, particularly in the absence of respiratory symptoms.
• There is a trend towards increased operative treatment for intussusception in COVID-19-positive children.
• Early suspicion and diagnosis of intussusception are crucial for timely management in pediatric COVID-19 cases.