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新型冠状病毒2型感染中的儿科胃肠道疾病:流行病学及临床意义

Paediatric gastrointestinal disorders in SARS-CoV-2 infection: Epidemiological and clinical implications.

作者信息

Al-Beltagi Mohammed, Saeed Nermin Kamal, Bediwy Adel Salah, El-Sawaf Yasser

机构信息

Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31527, Algharbia, Egypt.

Microbiology Section, Pathology Department, Salmaniya Medical Complex, Manama 12, Bahrain.

出版信息

World J Gastroenterol. 2021 Apr 28;27(16):1716-1727. doi: 10.3748/wjg.v27.i16.1716.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is a threat worldwide for individuals of all ages, including children. Gastrointestinal manifestations could be the initial presenting manifestation in many patients, especially in children. These symptoms are more common in patients with severe disease than in patients with non-severe disease. Approximately 48.1% of patients had a stool sample that was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA. Children typically form 1%-8% of all laboratory-confirmed cases of SARS-CoV-2. Gastrointestinal manifestations of COVID-19 in children are not rare, with a prevalence between 0 and 88%, and a wide variety of presentations, including diarrhoea, vomiting, and abdominal pain, can develop before, with or after the development of respiratory symptoms. Atypical manifestations such as appendicitis or liver injury could also appear, especially in the presence of multisystem inflammatory disease. In this review, we discussed the epidemiology of COVID-19 gastrointestinal diseases in children as well as their implications on the diagnosis, misdiagnosis, prognosis, and faecal-oral transmission route of COVID-19 and the impact of gastrointestinal diseases on the gut microbiome, child nutrition, and disease management.

摘要

2019年冠状病毒病(COVID-19)大流行对包括儿童在内的所有年龄段的个人都是一种全球威胁。胃肠道表现可能是许多患者,尤其是儿童的初始表现。这些症状在重症患者中比非重症患者更常见。约48.1%的患者粪便样本严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒RNA呈阳性。儿童通常占所有实验室确诊的SARS-CoV-2病例的1%-8%。COVID-19在儿童中的胃肠道表现并不罕见,患病率在0%至88%之间,在呼吸道症状出现之前、同时或之后,可能出现包括腹泻、呕吐和腹痛在内的多种表现。还可能出现阑尾炎或肝损伤等非典型表现,尤其是在存在多系统炎症性疾病的情况下。在本综述中,我们讨论了儿童COVID-19胃肠道疾病的流行病学,以及它们对COVID-19的诊断、误诊、预后和粪-口传播途径的影响,以及胃肠道疾病对肠道微生物群、儿童营养和疾病管理的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37e2/8072196/4d06871b870f/WJG-27-1716-g001.jpg

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