Gastrointestinal Symptoms in Severe COVID-19 Children
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Since the first outbreak, a global effort has been made to collect clinical and laboratory findings on patients with SARS-CoV-2 infection. The lower airway is the primary target of the infection. Also, there is growing evidence of clinical manifestations other than acute respiratory syndrome in pediatrics suggesting that the COVID-19 spectrum and pathogenesis in children are yet to unravel. In this report, researchers describe the results of a preliminary analysis of a cohort of hospitalized pediatrics COVID-19 patients focusing on the mode of presentation, presence of comorbidities, the severity of the disease, and early outcome.

Researchers conducted a multicenter retrospective analysis of the clinical record of SARS-CoV-2-infected children in 23 different sites in Italy. Overall, 127 children were included; 44 were female (34.9%) and the median age was 4.8 years. Thirty-six out of 127 (28.3%) had GI symptoms (vomit, diarrhea, abdominal pain), of the twenty-eight (22%) had diarrhea, 12 (9,4%) vomit, and 8 (6.3%) abdominal pain.

The presence of GI symptoms at the admission was differently distributed throughout severity classes. Having GI symptoms was more frequently associated with severe and critical phenotype. Interestingly, a history of GI symptoms was positively associated with cardiac involvement as clinical complications, in presence of other symptoms or alone. GI symptoms seem to be a clinical warning for children evaluated in any clinical setting when SARS-CoV-2 infection is suspected, independently of comorbidities.