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World J Gastroenterol. Apr 28, 2021; 27(16): 1716-1727
Published online Apr 28, 2021. doi: 10.3748/wjg.v27.i16.1716
Paediatric gastrointestinal disorders in SARS-CoV-2 infection: Epidemiological and clinical implications
Mohammed Al-Beltagi, Nermin Kamal Saeed, Adel Salah Bediwy, Yasser El-Sawaf
Mohammed Al-Beltagi, Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31527, Algharbia, Egypt
Mohammed Al-Beltagi, Department of Pediatrics, University Medical Center, Arabian Gulf University, Manama 26671, Bahrain
Nermin Kamal Saeed, Microbiology Section, Pathology Department, Salmaniya Medical Complex, Manama 12, Bahrain
Nermin Kamal Saeed, Department of Microbiology, Royal College of Surgeons in Ireland - Bahrain, Bahrain, Busaiteen 15503, Muharraq, Bahrain
Adel Salah Bediwy, Department of Chest Diseases, Tanta University, Tanta 31527, Algharbia, Egypt
Adel Salah Bediwy, Department of Pulmonology, University Medical Center, Arabian Gulf University, Manama 26671, Bahrain
Yasser El-Sawaf, Department of Tropical Medicine, Tanta University, Tanta 31527, Algharbia, Egypt
Yasser El-Sawaf, Department of Gastroenterology, University Medical Center, Arabian Gulf University, Manama 26671, Bahrain
Author contributions: Al-Biltagi M, Saeed NK, Bediwy AS, and El-Sawaf Y collected the data and wrote and revised the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Beltagi, MD, PhD, Professor, Department of Pediatric, Faculty of Medicine, Tanta University, Medical Complex, El Bahr St. Tanta Qism 2, Tanta 31527, Algharbia, Egypt. mbelrem@hotmail.com
Received: December 16, 2020
Peer-review started: December 16, 2020
First decision: March 7, 2021
Revised: March 12, 2021
Accepted: April 5, 2021
Article in press: April 5, 2021
Published online: April 28, 2021
Processing time: 123 Days and 21.7 Hours
Abstract

The coronavirus disease 2019 (COVID-19) pandemic is a threat worldwide for individuals of all ages, including children. Gastrointestinal manifestations could be the initial presenting manifestation in many patients, especially in children. These symptoms are more common in patients with severe disease than in patients with non-severe disease. Approximately 48.1% of patients had a stool sample that was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA. Children typically form 1%-8% of all laboratory-confirmed cases of SARS-CoV-2. Gastrointestinal manifestations of COVID-19 in children are not rare, with a prevalence between 0 and 88%, and a wide variety of presentations, including diarrhoea, vomiting, and abdominal pain, can develop before, with or after the development of respiratory symptoms. Atypical manifestations such as appendicitis or liver injury could also appear, especially in the presence of multisystem inflammatory disease. In this review, we discussed the epidemiology of COVID-19 gastrointestinal diseases in children as well as their implications on the diagnosis, misdiagnosis, prognosis, and faecal-oral transmission route of COVID-19 and the impact of gastrointestinal diseases on the gut microbiome, child nutrition, and disease management.

Keywords: COVID-19; SARS-CoV-2; Gastrointestinal diseases; Children; Dysbiosis; Faecal-oral transmission

Core Tip: Coronavirus disease 2019 (COVID-19) presents with different manifestations, including gastrointestinal inflammation, especially in children. Gastrointestinal effects of COVID-19 have a significant impact on the diagnosis, misdiagnosis, prognosis, faecal-oral transmission route, gut microbiota, and child nutrition. The presence of gastrointestinal symptoms in children with COVID-19 should not be ignored.