Severe COVID-19 initially presenting as mesenteric adenopathy

Noda, Sakura; Ma, Jimmy; Romberg, Erin K.; Hernandez, Rafael E.; Ferguson, Mark

doi:10.1007/s00247-020-04789-9

Cited by 19 publications

(14 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A diffuse mesenteric lymphadenopathy has been reported as presentation of COVID-19 in an adolescent. Although no tissue sample proved that the mesenteric adenopathy was secondary to COVID-19, the child tested positive for SARS-CoV-2 by PCR from sputum, developed chest CT findings and hyperinflammatory response consistent with COVID-19 and other causes of mesenteric lymphadenopathy were ruled out ( 83 ).…”

Section: Sars-cov-2 and Gastrointestinal Tractmentioning

confidence: 99%

SARS-CoV-2 and the Gastrointestinal Tract in Children

et al. 2021

View full text Add to dashboard Cite

Coronavirus disease 2019 (COVID-19), caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is predominantly a respiratory disease. However, its significant impact on the gastrointestinal (GI) system is now well-known. SARS-CoV-2 enters cells via the angiotensin-converting enzyme-2 (ACE-2) receptor, which is abundantly expressed on lung cells, but also on enterocytes. Several etiopathogenetic mechanisms have been postulated to explain the GI involvement in COVID-19, including loss in intestinal absorption, microscopic mucosal inflammation and impaired ACE-2 function, which plays a significant role in maintaining gut homeostasis. In children the GI manifestations include anorexia, nausea, vomiting, diarrhea and abdominal pain, which may represent the earliest presenting symptoms of the disease. However, although rare, a significant GI mucosal inflammation, such as terminal ileitis mimicking an atypical appendicitis, and other GI manifestations have been reported. COVID-19 pandemic has posed a significant challenge in healthcare provision in term of ability in providing safe diagnostic procedures, face-to-face consultations, and offering comprehensive care. For instance, changes in health services have raised the risk of empirical or sub-optimal management of chronic GI disorders such as inflammatory bowel disease (IBD) due to delayed endoscopic and clinical assessment. This review will discuss the acute GI involvement in COVID-19 in children and reflect on challenges and major changes observed in clinical practice during COVID-19 pandemic by sharing both the published literature and personal experience. We also suggest potential strategies for providing optimal gastroenterology care during this unprecedented era.

show abstract

Section: Sars-cov-2 and Gastrointestinal Tractmentioning

confidence: 99%

SARS-CoV-2 and the Gastrointestinal Tract in Children

et al. 2021

View full text Add to dashboard Cite

show abstract

“…This patient has been previously described by case report. 20 A second COVID-positive patient presented with abdominal pain, fever, emesis and hypotension. Abdominal CT demonstrated minimal lymphadenopathy and trace abdominal free fluid, as well as minimal basilar pulmonary ground glass opacities.…”

Section: Resultsmentioning

confidence: 99%

Pediatric radiologic manifestations of COVID-19

et al. 2021

Self Cite

View full text Add to dashboard Cite

Purpose While full description of pediatric COVID-19 manifestations is evolving, children appear to present less frequently, and often display a less severe disease phenotype. There is correspondingly less data regarding pediatric radiologic findings. To describe the imaging findings of pediatric COVID-19, we evaluated the radiologic imaging of the initial patient cohort identified at our institution. Methods In this IRB approved study, all patients at our institution aged 0–21 with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on PCR or immunoglobulin testing were identified. Imaging was reviewed by the co-authors and presence of abnormalities determined by consensus. Pre-existing comorbidities and alternative diagnoses were recorded. Rates of each finding were calculated. Findings were compared to published data following review of the available literature. Results Out of 130 Covid-19 positive patients, 24 patients underwent imaging, including 21 chest radiographs and 4 chest CT scans. Chest x-rays were normal in 33%. Patchy or streaky opacities were the most common radiographic abnormality, each seen in 38% of patients. CT findings included ill-defined or geographic ground glass opacities, dense opacities, septal thickening and crazy paving, and small pleural effusions. Results are similar to those reported in adults. Multiple COVID-19 positive children presented for symptoms due to an additional acute illness, including appendicitis and urinary infection. Conclusions Radiologic findings of COVID-19 in pediatric patients range from normal to severe ARDS type appearance. During this ongoing pandemic, these radiographic signs can be useful for the evaluation of disease status and guiding care, particularly in those with comorbidities. Precis Radiologic findings of COVID-19 in pediatric patients are similar to those seen in adults, and may range from normal to severe ARDS type appearance.

show abstract

“…Bir ergende COVID-19 bağlı yaygın bir mezenterik lenfadenopati bildirilmiştir. Mezenterik adenopatinin COVID-19'a ikincil olduğunu kanıtlayan hiçbir doku örneği olmamasına rağmen, çocukta SARS-CoV-2 için PCR pozitifliği, uyumlu toraks BT bulguları, CO-VID-19 ile uyumlu hiperinflamatuar yanıt ve mezenterik lenfadenopatinin diğer nedenleri dışlanarak tanı konulmuştur (21).…”

Section: çOcuklardaki Sars-cov-2 Enfeksiyonu Sırasında Görülen Gi̇ Klinik Tablolarunclassified

Pediatric COVID-19 and Gastrointestinal System

Salman

Akçam

2021

SDÜ Tıp Fakültesi Dergisi

View full text Add to dashboard Cite

COVID-19 hastalığı daha iyi tanındıkça ilk tarif edildiğinin aksine hastalık sırasında solunum sistemi dışındaki organ tutulumları ile daha fazla oranda seyrettiği anlaşılmıştır. Gastrointestinal sistem, solunum sistemi dışında en fazla tutulan sistemdir. Bu çalışmada bizim deneyimlerimizi de katarak PubMed veri tabanlı İngilizce yayımlanan makaleler taranarak COVID-19 ilişkili gastrointestinal hastalıklar hakkında bir derleme yapmayı amaçladık.

show abstract

Severe COVID-19 initially presenting as mesenteric adenopathy

Cited by 19 publications

References 6 publications

SARS-CoV-2 and the Gastrointestinal Tract in Children

SARS-CoV-2 and the Gastrointestinal Tract in Children

Pediatric radiologic manifestations of COVID-19

Pediatric COVID-19 and Gastrointestinal System

Contact Info

Product

Resources

About