Infectious Disease Unit, Department of Science Health, Meyer Children's Hospital, University of Florence, Florence, Italy.
Pediatric Clinic, Fondazione IRCCS, Policlinico San Matteo, University of Pavia, Pavia, Italy.
Pediatr Allergy Immunol. 2020 Nov;31 Suppl 26(Suppl 26):92-95. doi: 10.1111/pai.13373.
Gastrointestinal symptoms are common findings in children with SARS-CoV-2 infection. Diarrhea and vomiting have been reported in about 8%-9% of cases, reaching more than 20% in some studies. Children with gastrointestinal involvement appear to be younger than those without, but the severity of the disease seems to be similar between the two groups of subjects. Fecal shedding in children has been reported in 20%-30% of children and has been observed in both those with and those without overt gastrointestinal involvement. Moreover, prolonged fecal elimination, lasting several days after negativization of real-time polymerase chain reaction assay on respiratory swabs, has been reported with variable frequency in children with SARS-CoV-2 infection. These observations raise the question regarding the possibility of oral-fecal transmission and the possible role of children in spreading the infection, particularly when they appear asymptomatic or with gastrointestinal symptoms but with no respiratory involvement, as well as during their convalescent phase.
胃肠道症状是 SARS-CoV-2 感染患儿的常见表现。腹泻和呕吐的报告发生率约为 8%-9%，在一些研究中则高达 20%以上。有胃肠道受累的患儿比无胃肠道受累的患儿年龄更小，但两组患儿的疾病严重程度似乎相似。据报道，儿童粪便中可排出病毒，在有和无明显胃肠道受累的患儿中均有观察到。此外，在 SARS-CoV-2 感染患儿中，有报道称粪便排毒时间延长，在呼吸道拭子实时聚合酶链反应检测转为阴性后可持续数天。这些观察结果提出了关于经口-粪传播的可能性以及儿童在传播感染中的可能作用的问题，尤其是当他们表现为无症状或有胃肠道症状但无呼吸道受累，以及在恢复期时。
