Intussusception in a child with COVID-19 in the USA

Abstract

COVID-19, caused by the novel coronavirus strain SARS-CoV-2 that emerged in late 2019, has resulted in a global pandemic. COVID-19 was initially believed to occur less frequently in children with relatively mild disease. However, severe disease and varied presentations have been reported in infected children, one of such being intussusception. There have only been three reported cases of intussusception in the pediatric population infected with COVID-19. In this paper, we will discuss the management and treatment of a novel fourth case of COVID-19-associated intussusception. This case is the first reported in the USA and suggests that COVID-19 may be implicated in the development of intussusception. Pediatricians should consider the possibility of intussusception when a child with COVID-19 presents with abdominal pain.

Intussusception and SARS-CoV-2 infection

“…The mortality rate in intussusception is reported to be less than 1% [ 7 ]; it's striking that in this group of cases, 1 of 8 has died, this patient was the first reported and was associated with Multisithemic Inflammatory Syndrome caused by COVID-19.…”

“…Although the pathogenesis of intussusception related to the SARS-CoV-2 is not fully understood, it can be inferred that it involves alteration in peristaltic intestinal movement that allows intussusception [ 7 ]. Diagnostic imaging studies have identified data of ileocolitis and mesenteric lymphadenitis in adult tomography [ 8 ]; in pediatrics, there are 2 studies that report thickening of the wall of the small intestine and colon [ 9 ], which may be consistent with local inflammation.…”

“… Moazzam et alKarachi, Pakistan (3) Martínez-Castaño et al España [ 11 ]. Makrinioti et al Londres UK [ 5 ] Bazuaye-Ekwuyasi et al Galveston, USA [ 7 ]. Mercado et al Saltillo, México Caso 1 Mercado et al Saltillo, México Caso 2 Age 10 months 8 months 4 months 6 months 10 months 9 months 8 months 7 months Gender Female Male Male Male Female Male Male Female Respiratory symptoms No No 1 week before No 2 weeks before 4 days before No 1 week before Symptom evolution Initially intussusceptions symtoms, then SARS-CoV-2 positive test Initially intussusceptions symptoms, then SARS-CoV-2 positive test Initially intussusceptions symptoms, then SARS-CoV-2 positive test Initially intussusceptions symptoms, then SARS-CoV-2 positive test Not specified Initially SARS- CoV-2 positive test, then intussusceptions symptoms Initially SARS- CoV-2 positive test, then intussusceptions symptoms Initially intussusceptions symptoms, then SARS-CoV-2 positive test Fever Detected upon arrival at the hospital 2 days before No No No 1 day before 2 days before Detected upon arrival at the hospital Initial labs Not relevant …”

Intususcepción en niño con COVID-19

“…Después del caso pediátrico de intususcepción intestinal y COVID-10 documentado en Wuhan, China, [1] fue descrito otro caso en Inglaterra, pero complicdo con necrosis de íleon proximal, insuficiencia multiorgánica y coagulación intravascular diseminada, que causaron su muerte. [2]. El primer caso publicado en EEUU sobre intususcepción y COVID-19 ocurrió en octubre 2020.…”

“…El primer caso publicado en EEUU sobre intususcepción y COVID-19 ocurrió en octubre 2020. [2] Los síntomas gastrointestinales en COVID-19 son raros y se han limitado principalmente a diarrea o vómitos. Una revisión de 452 pacientes en 23 estudios reveló que la diarrea (6,6%) y los vómitos (5,8%) eran mucho menos frecuentes que la fiebre (43,1%) o la tos (43,4%).…”