Bowel Damage as a COVID-19 Manifestation in a 4-Year-Old Child

Abstract

Objective of the Paper: To represent a case of the novel coronavirus infection COVID-19 in a 4-year-old child with isolated bowel damage. Key Points. COVID-19 impacts several systems and organs. Usually, children have mild or asymptomatic disease. Clinical manifestations of COVID-19 in children can be damage not only of respiratory tract, but also of GIT, requiring differential diagnosis of enteric infections (both viral and bacterial). Prompt diagnosis of COVID-19 is essential for antiepidemic measures and suppression an infectious process. The case shows challenges faced by clinicians when diagnosing COVID-19 in patients with isolated GIT damages without catarrhal signs. Course of the disease in this patient was characterised by a number of features indicative of a bacterial enteric infection: abdominal pain, diarrhoea, increased CRP, colitis syndrome in stool test, warranting differential diagnosis of acute enteric bacterial infections. Negative bacterial culture, detection of SARS-CoV2 RNA in oropharynx and nasopharynx mucous, fast stool normalisation and dyspeptic events arrest allowed diagnosing that the diarrhoea was associated with COVID-19. One month of metabolic and probiotic therapy normalised stool, arrested abdominal pain, and improved exercise tolerance. Conclusion. GIT damage in paediatric COVID-19 patients is essential and unexplored. COVID-19 should be added to differential diagnosis in case of clinical manifestations of an acute enteric infection. Keywords: children, novel coronavirus infection, COVID-19, GIT.