Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria, 98124, Messina, Italy.
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
Ital J Pediatr. 2021 Mar 24;47(1):71. doi: 10.1186/s13052-021-01020-9.
Gastrointestinal diseases such as celiac disease, functional gastrointestinal disorders (FGIDs), inflammatory bowel disease (IBDs) and acute or chronic diarrhea are quite frequent in the pediatric population. The approach, the diagnosis and management can be changed in the 2019 coronavirus disease (COVID-19) pandemic era. This review has focused on: i) the current understanding of digestive involvement in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected children and adolescents and the clinical implications of COVID-19 for pediatric gastroenterologists, ii) the impact of COVID-19 on the clinical approach to patients with pre-existing or onset diseases, including diagnosis and treatment, and iii) the role and limited access to the instrumental diagnosis such as digestive endoscopy. To date, it is unclear if immunosuppression in patients with IBD and chronic liver disease represents a risk factor for adverse outcomes. Scheduled outpatient follow-up visits may be postponed, especially in patients in remission. Conversely, telemedicine services are strongly recommended. The introduction of new therapeutic regimens should be made on an individual basis, discussing the benefits and risks with each patient. Furthermore, psychological care in all children with chronic disease and their parents should be ensured. All non-urgent and elective endoscopic procedures may be postponed as they must be considered at high risk of viral transmission. Finally, until SARS-CoV-2 vaccination is not available, strict adherence to standard social distancing protocols and the use of personal protective equipment should continue to be recommended.
胃肠道疾病，如乳糜泻、功能性胃肠疾病（FGIDs）、炎症性肠病（IBD）和急性或慢性腹泻，在儿科人群中相当常见。在 2019 年冠状病毒病（COVID-19）大流行时代，其治疗方法、诊断和管理可能会发生变化。这篇综述主要关注：i）严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染儿童和青少年的消化受累的当前认识，以及 COVID-19 对儿科胃肠病学家的临床意义，ii）COVID-19 对患有先前存在或发病疾病的患者的临床处理方法的影响，包括诊断和治疗，以及 iii）仪器诊断（如消化道内镜）的作用和有限的应用。迄今为止，尚不清楚 IBD 和慢性肝病患者的免疫抑制是否代表不良预后的危险因素。计划中的门诊随访可能会推迟，尤其是在缓解期的患者。相反，强烈建议使用远程医疗服务。应根据个体情况制定新的治疗方案，与每位患者讨论其益处和风险。此外，应确保所有患有慢性疾病的儿童及其父母都能得到心理关怀。所有非紧急和选择性的内镜检查程序都可能被推迟，因为它们被认为是高病毒传播风险的。最后，在 SARS-CoV-2 疫苗不可用之前，应继续建议严格遵守标准的社会隔离协议和使用个人防护设备。
