Дифференциальный диагноз колитов при COVID-19 и бактериальных кишечных инфекциях у детей

Abstract

Diarrhea with COVID-19 develops in 2–79% of patients. The causes and clinical features of gastrointestinal lesions in patients are different, and the differential diagnosis with acute intestinal infections is difficult. The purpose is to provide a comparative clinical and laboratory characteristics of distal colitis in COVID-19 and classical bacterial diarrhea (salmonellosis, campylobacteriosis). Material and methods. As part of the case-control study, two groups of patients were formed: main group (continuous sample) — 48 children with COVID-19 and negative results of a standard examination for acute respiratory infections pathogens; and control group — 48 children with bacterial colitis. Statistica 8 (USA) and StatTech v 3.1.8. software were used for statistical data analysis. Additionally, multivariate logistic regression and ROC curve analyses were performed. Result and conclusions. Among all children hospitalized with COVID-19 in 2022, 26.2% (48/183) had evidence of distal colon involvement. The most important factors for the differential diagnosis were: the frequency of stool and vomiting, the signs of hemocolitis and dehydration, a concomitant pathology, and the number of red blood cells in the general clinical blood test. The prognostic model developed based on these features has a sensitivity of 93.8% and a specificity of 93.6%. In addition, patients with COVID-19 with a clinical picture of distal colitis were distinguished from bacterial infections by febrile (not pyretic, as in bacterial acute intestinal infections) fever, lymphopenia, and a shorter duration of hospitalization.