COVID-19 and Digestive System in Children: A Retrospective Study.

Mohammadreza Esmaeili Dooki,Mohsen Mohammadi,Hadi Sorkhi,Sanaz Mehrabani,Mohamadreza Tabatabaie,Masood Kiani,Maryam Nikpour

doi:10.34172/aim.2020.104

Mohammadreza Esmaeili Dooki, Mohsen Mohammadi + Show 5 more

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https://doi.org/10.34172/aim.2020.104

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Abstract

The aim of this study was to identify gastrointestinal (GI) and liver injury presentations in children admitted with COVID-19 infection. In this retrospective study, we studied all children with suspected symptoms of COVID-19, referred to Amirkola Children's Hospital. Clinical manifestations of the digestive and respiratory systems and liver function tests were evaluated for all cases. Eighteen children were studied. The most common clinical symptoms were fever, anorexia, weakness, nausea and vomiting, cough, diarrhea, and abdominal pain, respectively. Also, 5/18 (27.8%) and 7/18 (38.9%) of cases had abnormally high alanine aminotransferase (ALT), aspartate aminotransferase (AST), respectively. Additionally, in icteric cases, direct bilirubin was raised. There was no significant relationship between pulmonary lesions and abnormal excess in ALT (P = 0.59) and AST (P = 0.62). The findings showed that there were no severe clinical GI symptoms in children with COVID-19 infection. Besides, children with increased liver enzymes did not have more respiratory involvement than those without a rise in liver enzymes.

Highlights

Coronaviruses (CoVs) are known as a cause of severe acute respiratory syndrome (SARS-CoV-2) since December 2019 in Wuhan, China.[1,2] It has become pandemic according to the World Health Organization (WHO) report in March 2020
COVID-19 leads to various degrees of liver injury, presenting with abnormal levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and albumin accompanied by slightly elevated bilirubin levels as well as elevated gamma-glutamyltransferase and alkaline phosphatase levels (ALP).[7]
Our result showed that on admission, 12/18 (66.2%) and 14/18 (77.8%) of cases had elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), respectively, which returned to normal levels in 7/18 (38.9%) and 4/18 (22.2%) children on discharge

Summary

Introduction

Coronaviruses (CoVs) are known as a cause of severe acute respiratory syndrome (SARS-CoV-2) since December 2019 in Wuhan, China.[1,2] It has become pandemic according to the World Health Organization (WHO) report in March 2020. COVID-19 can damage any vital organs like lung, heart, liver, neurologic system, kidney and gastrointestinal (GI) tract, but mostly causes respiratory and GI symptoms ranging from the common cold to coagulopathy, multiorgan failure and death.[1,2] The GI symptoms include anorexia, diarrhea, vomiting, nausea, abdominal pain and GI bleeding. A study reported that diarrhea was the most common GI symptom in children and adults, vomiting was more prominent in children.[5,6] COVID-19 leads to various degrees of liver injury, presenting with abnormal levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and albumin accompanied by slightly elevated bilirubin levels as well as elevated gamma-glutamyltransferase and alkaline phosphatase levels (ALP).[7] It is proposed that the virus binding to angiotensin-converting enzyme 2 (ACE2).

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