COVID-19 and pediatric inflammatory bowel disease: How to manage it?

Fragoso, Roberta Paranhos; Rodrigues, Maraci

doi:10.6061/clinics/2020/e1962

Cited by 10 publications

(7 citation statements)

References 27 publications

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“…Juntamente, crianças com talassemia e outras comorbidades subjacentes, como a diabetes (Yadav, & Pal, 2020), doenças inflamatórias intestinais (Turner et al, 2020;Fragoso, & Rodrigues, 2020), cardiopatias e doenças hepáticas crônicas, podem ter risco maior de complicações e mortalidade devido à COVID-19 (Yadav, & Pal, 2020). Talvez o fato de desconhecer as implicações do novo coronavírus pode impactar no tratamento adequado da patologia prévia (Turner et al, 2020;Fragoso, & Rodrigues, 2020). Em contrapartida, um estudo que realizou uma coorte com crianças portadoras de doença crônica, no caso, reumáticas, concluiu que não apresentam um maior risco à infecção ou pior prognóstico, em relação às crianças sem comorbidades prévias (Michelena et al, 2020).…”

Section: Discussionunclassified

A COVID-19 e as crianças com doenças crônicas: revisão de escopo

Antunes

Kinalski

Schneider

et al. 2020

RSD

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Diante do cenário da pandemia por coronavírus, que assola o mundo desde o final de 2019, ainda são muitas as incertezas que envolvem essa doença, COVID-19, e o público pediátrico, principalmente as crianças portadoras de doenças crônicas. Considerando essa realidade, o objetivo deste artigo é conhecer as publicações científicas sobre COVID-19 em crianças com doenças crônicas. Trata-se de um estudo de revisão sistematizada da literatura do tipo Scoping Reviews. A busca foi realizada nos meses de maio de 2020 a agosto de 2020, nas bases eletrônicas de dados SciVerse Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Public MEDLINE, Current Nursing and Allied Health Literature e Embase, e totalizaram 5.570 produções científicas. A amostra final foi composta por 46 artigos na íntegra, que tiveram os conteúdos extraídos por categorias conceituais: suscetibilidade/fatores de risco; manifestações clínicas; hospitalização; estratégias de cuidado e medidas preventivas em relação à COVID-19 em crianças com doenças crônicas. A pesquisa permite concluir que crianças com doenças crônicas representam um grupo da população que pode apresentar um risco aumentado para complicações da COVID-19. Contudo, os estudos analisados demonstram que não há motivos para suspender o tratamento de crianças com doenças crônicas durante a pandemia e que é fundamental avaliar o risco versus o benefício de iniciar ou manter o tratamento em casos de crianças confirmadas para COVID-19.

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Section: Discussionunclassified

A COVID-19 e as crianças com doenças crônicas: revisão de escopo

Antunes

Kinalski

Schneider

et al. 2020

RSD

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“…A vizsgált betegpopulációkban a SARS-CoV-2-RNS 2-5 nappal a légúti minták pozitivitása után lett pozitív, majd ez 1-12 napig tartott még azután is, hogy a vírus már nem volt kimutatható a légúti mintákból. Érdekes kutatási eredmény, hogy a gyermekek általában hosszabb időn keresztül ürítik a székletükkel a vírust (akár 5 héten keresztül), mint a felnőtt betegek [2,7,9]. Egy Kínában végzett kutatásban azt találták, hogy 10ből 8 gyermek rectalis mintái mutatnak PCR-pozitivitást, miután a nasopharyngealis minták már negatív eredményt adtak [10].…”

Section: Transzmisszióunclassified

A COVID–19-fertőzés gastrointestinalis hatásai gyermekkorban és a gyulladásos bélbeteg gyermekekben

Tóbi

Prehoda

Balogh

et al. 2022

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Összefoglaló. A SARS-CoV-2-infekció változatos kórlefolyású, a gyermekpopulációban növekvő incidenciát mutató fertőzés. Ebben a korcsoportban a felnőttekkel szemben sokkal gyakrabban tapasztalhatók gasztroenterológiai tünetek a betegség során, 18–32%-ban jelentkezik legalább egy szimptóma. Ezek nem specifikusak, gyakran megegyezhetnek a virális enteritisek, a gyulladásos bélbetegségek vagy a vakbélgyulladás tüneteivel. A gyermekkori SARS-CoV-2-infekciónak egy viszonylag ritkán megjelenő, de súlyos, akár életveszélyes szövődménye a gyermekkori sokszervi gyulladásos szindróma (multisystem inflammatory syndrome in children, MIS-C). Ilyenkor a gastrointestinalis tünetek gyakorisága 60–100%-ra nő, sok esetben akut has benyomását keltve. A jelenlegi kutatások eredményei alapján a gyulladásos bélbeteg gyerekek az alapbetegségük miatt nincsenek nagyobb veszélynek kitéve az átlagpopulációhoz képest a COVID–19-fertőzés szempontjából. A terápiájukban alkalmazott gyógyszereik közül a nagy dózisú szteroidkezelés okoz nagyobb kockázatot a megfertőződésre, illetve ebben az esetben a súlyosabb kórlefolyásra. Az éppen remisszióban lévő gyulladásos bélbetegek fenntartó terápiájának módosítások nélküli folytatása javasolt, kiemelt figyelmet fordítva a biológiai terápiák időben történő, megszakítás nélküli alkalmazására. Törekedni kell a személyes vizitek számának csökkentésére a pandémia idején, ezek telemedicinával történő helyettesítése javasolt. A halasztható endoszkópos vizsgálatok noninvazív vizsgálómódszerekkel történő átmeneti kiváltása részesítendő előnyben a betegség aktivitásának, a terápia hatékonyságának megítélésére. A gyulladásos bélbetegségben szenvedő gyermekek COVID–19 elleni védőoltása javasolt, jelenleg minden elérhető oltóanyag alkalmazható náluk (az élő ágenst tartalmazó vakcinák ellenjavalltak). Immunmoduláns, szteroid- vagy anti-tumornekrózisfaktor (TNF)-alfa-terápia esetén az oltás lehetséges csökkent hatékonyságával kell számolni. Orv Hetil. 2022; 163(6): 214–221. Summary. The SARS-CoV-2 infection is showing high variety in the disease course, with a constantly increasing incidence among the pediatric population. In this age group, at least one gastrointestinal symptom appears in 18–32% of the cases, showing a significant difference compared to the adult population. The gastrointestinal signs of COVID–19 are not specific, can mimic the symptoms of viral enteritis, inflammatory bowel diseases or acute appendicitis. The multisystem inflammatory syndrome in children (MIS-C) is a rather rare, but serious complication of the pediatric COVID–19 disease: in these cases, the incidence of the gastrointestinal symptoms is increased up to 60–100%, often observed as acute abdomen. Based on recent researches, patients with inflammatory bowel diseases (IBD) are shown to have the same risk in developing COVID–19 infection compared to the normal population: in their medications, the high dose steroid treatment is proved to increase the risk of infection or to make the disease course more serious. The treatment of patients with IBD should be continued without any changes (when the disease is in remission). The use of biologics should be done with special care, with more attention keeping the schedule and the continuity. It is advised to minimise the number of personal visits during the pandemic, they should be substituted with telemedicine. The postponable endoscopic examinations should be temporarily redeemed by non-invasive methods for screening the disease activity and the efficacy of the treatment. The vaccination against COVID–19 is advised in the population with IBD. All vaccines currently available are usable in this patient group (the use of vaccines containing live agents are contraindicated). In the case of patients treated with immunmodulators, steroids or anti-tumor necrosis factor (TNF) alpha, a possible lower efficacy can be expected after the vaccination. Orv Hetil. 2022; 163(6): 214–221.

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“…The ACE2 receptors are a part of the renin angiotensin-aldosterone system that is assumed to play critical roles in controlling the provocative handle. Terminal ileum and the colon are the most affected areas in IBD[ 34 ]. IBD is also correlated with upregulation of inflammatory cytokines and the ACE2 receptors.…”

Section: Covid-19 Induced Ibd: Correlations and Overlapping Of Inflammatory Pathogenesismentioning

confidence: 99%

Transmembrane serine protease 2 and angiotensin-converting enzyme 2 anti-inflammatory receptors for COVID-19/inflammatory bowel diseases treatment

Lashgari¹,

Roudsari²,

Momtaz³

et al. 2021

WJG

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Inflammatory bowel diseases (IBD) refer to a subgroup of chronic, progressive, long-term, and relapsing inflammatory disorders. IBD may spontaneously grow in the colon, and in severe cases may result in tumor lesions such as invasive carcinoma in inflamed regions of the intestine. Recent epidemiological reports indicate that old age and underlying diseases such as IBD contribute to severity and mortality in patients with coronavirus disease 2019 (COVID-19). Currently, the ongoing COVID-19 pandemic caused serious morbidity and mortality worldwide. It has also been shown that the transmembrane serine protease 2 is an essential factor for viral activation and viral engulfment. Generally, viral entry causes a 'cytokine storm' that induces excessive generation of proinflammatory cytokines/chemokines including interleukin (IL)-6, IL-2, IL-7, tumor necrosis factor-α, and interferon-γ. Future research could concentrate on developing inflammatory immunological responses that are efficient to encounter COVID-19. Current analysis elucidates the role of inflammation and immune responses during IBD infection with COVID-19 and provides a list of possible targets for IBD-regulated therapies in particular. Data from clinical, in vitro , and in vivo studies were collected in English from PubMed, Google Scholar, Scopus, and the Cochrane library until May 2021.

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COVID-19 and pediatric inflammatory bowel disease: How to manage it?

Cited by 10 publications

References 27 publications

A COVID-19 e as crianças com doenças crônicas: revisão de escopo

A COVID-19 e as crianças com doenças crônicas: revisão de escopo

A COVID–19-fertőzés gastrointestinalis hatásai gyermekkorban és a gyulladásos bélbeteg gyermekekben

Transmembrane serine protease 2 and angiotensin-converting enzyme 2 anti-inflammatory receptors for COVID-19/inflammatory bowel diseases treatment

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