Gastrointestinal manifestations as the initial presentation of COVID 19 in pediatrics

Abstract

Initial research on SARS-COV 2 (Severe Acute Respiratory Syndrome Coronavirus 2) appeared to demonstrate that children infected with the virus remained asymptomatic or had only mild to moderate conditions. The most common symptoms were fever and cough. However, in a later phase of the pandemic, numerous other aspects of clinical presentation in the pediatric public were observed, especially gastrointestinal conditions. In the present study, patients monitored at the Pediatric Intensive Care Unit of the Hospital Estadual Adão Pereira Nunes from April 17, 2020 until June 17, 2020, who had detectable PCR-RT (Polymerase Chain Reaction -Trasncriptase) or positive serology for COVID 19 (Coronavirus disease 19). This is a hospital unit that is not a reference for COVID 19, and its target audience is trauma victims.The initial symptoms of most hospitalized patients with clinical suspicion were fever and gastrointestinal symptoms, with significant abdominal pain standing out, mimicking acute abdomen. Signs and symptoms that differ from adults, who have respiratory manifestations as a starting point. Based on the recognition of the different clinical presentations of SARS-COV 2 in the pediatric population, an early diagnosis is possible, with better conduction and outcome.

Relação entre sintomas gastrointestinais e infecção por COVID-19 na população pediátrica: revisão de escopo

“…Crianças entre 2 meses e 18 anos. Retrospectivo Souza et al (39) Destacar as manifestações gastrointestinais como apresentação inicial da SARS-CoV-2, através da análise dos pacientes pediátricos acompanhados na unidade de tratamento intensiva pediátrica de um hospital de emergência, com diagnóstico de COVID-19.…”

“…Esta revisão de escopo abrange as manifestações gastrointestinais na população pediátrica advindas da infecção por COVID-19 e o mecanismo pelo qual o vírus é capaz de causar a desordem. A COVID-19 é uma doença sistêmica, a qual vem apresentando na população pediátrica, como sintomatologia inicial, manifestações gastrointestinais (22,37) , o que a diferencia dos adultos que, de modo geral, apresentam alta prevalência de sintomas respiratórios (39) . A média de pacientes pediátricos que evoluíram somente com sintomas gastrointestinais e ausência de sintomas respiratórios é de 33,5% (22,37) .…”

“…A enzima receptora ECA2 tem uma função importante na regulação da homeostase intestinal. Após ocorrer essa influência do vírus sobre as células, as atividades da receptora são interrompidas no trato gastrointestinal, gerando evidentes diferenças em sua expressão e ocasionando as manifestações gastrointestinais (38,39) .…”

Relationship between gastrointestinal symptoms and COVID-19 infection in the pediatric population: a scoping review

“…This scoping review covers gastrointestinal manifestations in the pediatric population resulting from COVID-19 infection and the mechanism by which the virus is capable of causing the disorder. COVID-19 is a systemic disease, which has been presenting gastrointestinal symptoms (22,37) in the pediatric population as initial symptoms, which differentiates it from adults who, in general, have a high prevalence of respiratory symptoms (39) . The average number of pediatric patients who developed only gastrointestinal symptoms and no respiratory symptoms is 33.5% (22,37) .…”

“…Souza et al (39) To highlight gastrointestinal manifestations as the initial presentation of SARS-CoV-2, through the analysis of pediatric patients followed in the pediatric intensive care unit of an emergency hospital, diagnosed with COVID-19.…”