tetano
Editor, Senior Moderator
Pediatr Infect Dis J
. 2022 May 27.
doi: 10.1097/INF.0000000000003589. Online ahead of print.
Gastrointestinal Manifestations in Hospitalized Children With Acute SARS-CoV-2 Infection and Multisystem Inflammatory Condition: An Analysis of the VIRUS COVID-19 Registry
Imran A Sayed[SUP] 1 [/SUP], Utpal Bhalala[SUP] 2 [/SUP], Larisa Strom[SUP] 3 [/SUP], Sandeep Tripathi[SUP] 4 [/SUP], John S Kim[SUP] 1 [/SUP], Kristina Michaud[SUP] 2 [/SUP], Kathleen Chiotos[SUP] 5 [/SUP], Heda R Dapul[SUP] 6 [/SUP], Varsha P Gharpure[SUP] 7 [/SUP], Erica C Bjornstad[SUP] 8 [/SUP], Julia A Heneghan[SUP] 9 [/SUP], Katherine Irby[SUP] 10 [/SUP], Vicki Montgomery[SUP] 11 [/SUP], Neha Gupta[SUP] 12 [/SUP], Manoj Gupta[SUP] 13 [/SUP], Karen Boman[SUP] 14 [/SUP], Vikas Bansal[SUP] 15 [/SUP], Rahul Kashyap[SUP] 15 [/SUP], Allan J Walkey[SUP] 16 [/SUP], Vishakha K Kumar[SUP] 14 [/SUP], Katja M Gist[SUP] 1 [/SUP], VIRUS Investigators
Affiliations
Abstract
Background: Describe the incidence and associated outcomes of gastrointestinal (GI) manifestations of acute coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in hospitalized children (MIS-C).
Methods: Retrospective review of the Viral Infection and Respiratory Illness Universal Study registry, a prospective observational, multicenter international cohort study of hospitalized children with acute COVID-19 or MIS-C from March 2020 to November 2020. The primary outcome measure was critical COVID-19 illness. Multivariable models were performed to assess for associations of GI involvement with the primary composite outcome in the entire cohort and a subpopulation of patients with MIS-C. Secondary outcomes included prolonged hospital length of stay defined as being >75th percentile and mortality.
Results: Of the 789 patients, GI involvement was present in 500 (63.3%). Critical illness occurred in 392 (49.6%), and 18 (2.3%) died. Those with GI involvement were older (median age of 8 yr), and 18.2% had an underlying GI comorbidity. GI symptoms and liver derangements were more common among patients with MIS-C. In the adjusted multivariable models, acute COVID-19 was no associated with the primary or secondary outcomes. Similarly, despite the preponderance of GI involvement in patients with MIS-C, it was also not associated with the primary or secondary outcomes.
Conclusions: GI involvement is common in hospitalized children with acute COVID-19 and MIS-C. GI involvement is not associated with critical illness, hospital length of stay or mortality in acute COVID-19 or MIS-C.
. 2022 May 27.
doi: 10.1097/INF.0000000000003589. Online ahead of print.
Gastrointestinal Manifestations in Hospitalized Children With Acute SARS-CoV-2 Infection and Multisystem Inflammatory Condition: An Analysis of the VIRUS COVID-19 Registry
Imran A Sayed[SUP] 1 [/SUP], Utpal Bhalala[SUP] 2 [/SUP], Larisa Strom[SUP] 3 [/SUP], Sandeep Tripathi[SUP] 4 [/SUP], John S Kim[SUP] 1 [/SUP], Kristina Michaud[SUP] 2 [/SUP], Kathleen Chiotos[SUP] 5 [/SUP], Heda R Dapul[SUP] 6 [/SUP], Varsha P Gharpure[SUP] 7 [/SUP], Erica C Bjornstad[SUP] 8 [/SUP], Julia A Heneghan[SUP] 9 [/SUP], Katherine Irby[SUP] 10 [/SUP], Vicki Montgomery[SUP] 11 [/SUP], Neha Gupta[SUP] 12 [/SUP], Manoj Gupta[SUP] 13 [/SUP], Karen Boman[SUP] 14 [/SUP], Vikas Bansal[SUP] 15 [/SUP], Rahul Kashyap[SUP] 15 [/SUP], Allan J Walkey[SUP] 16 [/SUP], Vishakha K Kumar[SUP] 14 [/SUP], Katja M Gist[SUP] 1 [/SUP], VIRUS Investigators
Affiliations
- PMID: 35622434
- DOI: 10.1097/INF.0000000000003589
Abstract
Background: Describe the incidence and associated outcomes of gastrointestinal (GI) manifestations of acute coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in hospitalized children (MIS-C).
Methods: Retrospective review of the Viral Infection and Respiratory Illness Universal Study registry, a prospective observational, multicenter international cohort study of hospitalized children with acute COVID-19 or MIS-C from March 2020 to November 2020. The primary outcome measure was critical COVID-19 illness. Multivariable models were performed to assess for associations of GI involvement with the primary composite outcome in the entire cohort and a subpopulation of patients with MIS-C. Secondary outcomes included prolonged hospital length of stay defined as being >75th percentile and mortality.
Results: Of the 789 patients, GI involvement was present in 500 (63.3%). Critical illness occurred in 392 (49.6%), and 18 (2.3%) died. Those with GI involvement were older (median age of 8 yr), and 18.2% had an underlying GI comorbidity. GI symptoms and liver derangements were more common among patients with MIS-C. In the adjusted multivariable models, acute COVID-19 was no associated with the primary or secondary outcomes. Similarly, despite the preponderance of GI involvement in patients with MIS-C, it was also not associated with the primary or secondary outcomes.
Conclusions: GI involvement is common in hospitalized children with acute COVID-19 and MIS-C. GI involvement is not associated with critical illness, hospital length of stay or mortality in acute COVID-19 or MIS-C.