부산대학교 도서관

INTRODUCTION Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a novel strain of human coronavirus, emerged in December 2019 in Wuhan, China (1,2). Named the coronavirus disease-2019 (COVID-19) by the World Health [...]
Objective: The prevalence of gastrointestinal symptoms in coronavirus disease-2019 (COVID-19) has been reported widely. In this study, the prevalence of gastrointestinal system (GIS) involvement in pediatric COVID-19 and its effect on prognosis were investigated. Methods: Children (aged 0-18 years) with acute COVID-19 were included in the study. The patients were grouped according to system involvement: isolated respiratory system (RS), isolated GIS, and combination of both (RS+GIS). These groups were compared in terms of demographic data, clinical characteristics, laboratory and imaging findings, and hospitalization. Results: A total of 223 pediatric patients were included in the study. Of these patients, 19 were asymptomatic, 12 were diagnosed with a multisystem inflammatory syndrome in children, 21 had chronic disorders that may affect disease severity, and 27 had symptoms not related to RS or GIS. The remaining 144 patients were classified according to system involvement: 79 (35.4%), 14 (6.3%), and 51 (22.9%) had isolated RS, isolated GIS, and RS+GIS involvement, respectively. The GIS group was much younger than the RS group (median, 30 and 150 months, respectively, p=0.006). Three patients from the RS group were followed in the intensive care unit (ICU). Moreover, 17 (21.5%) and 4 (7.8%) patients from the RS group had severe-critical respiratory symptoms, in the RS+GIS group had severe-critical respiratory symptoms (p=0.039). Conclusions: Our study showed that GIS involvement in children with COVID-19 is more prevalent than RS involvement in the younger age group. Respiratory symptom severity and ICU admission also decreased with accompanying GIS involvement. GIS involvement was still associated with a milder disease course after adjustment for age. Keywords: Child, COVID-19, gastrointestinal system, SARS-CoV-2, disease severity Amac: Koronavirus hastaligi-2019'da (COVID-19) gastrointestinal semptomlarin prevalansi genis bir degiskenlik icinde bildirilmistir. Bu calismada, pediatrik COVID-19'da gastrointestinal sistem (GIS) tutulumunun prevalansi ve hastaligin prognozuna etkisinin arastirilmasi amaclanmistir. Yontemler: Akut COVID-19 olan 0-18 yas arasi cocuklar calismaya dahil edildi. Hastalar sistem tutulumlarina gore gruplandirildi; izole solunum sistemi (SS), izole GIS ve her ikisinin kombinasyonu (SS+GIS). Bu gruplar demografik veriler, klinik ozellikler, laboratuvar ve goruntuleme bulgulari ve hastaneye yatis acisindan karsilastirildi. Bulgular: Toplam 223 cocuk hasta calismaya dahil edildi. On dokuzu asemptomatik, 12'si cocuklarda multisistem enflamatuvar sendrom tanisi aldi, 21'inde hastalik siddetini etkileyebilecek kronik hastaliklar vardi ve 27'sinde SS veya GIS disi semptomlar mevcuttu. Geriye kalan 144 hasta sistem tutulumuna gore siniflandirildi: 79'unda (%35,4) izole SS tutulumu, 14'unde (%6,3) izole GIS tutulumu, 51'inde (%22,9) ise SS+GIS tutulumu birlikteydi. GIS grubunda olan hastalarin SS grubundakilere gore daha genc oldugu goruldu (sirasiyla ortanca 30 ay ve 150 ay, p=0,006). Tamami SS grubunda olan 3 hasta yogun bakim unitesinde takip edildi. SS grubundaki hastalarin %21,5'inde ciddi kritik solunum semptomlari varken SS+GIS grubunun %7,8'inde ciddi kritik solunum semptomlari vardi (p=0,039). Sonuclar: COVID-19 enfeksiyonu geciren cocuklarda yas azaldikca GIS tutulumunun arttigi goruldu. GIS tutulumunun olmasi solunum semptomlarinin siddetini ve yogun bakima yatisini azalttigi tespit edildi. Yastan bagimsiz olarak da GIS tutulumunun daha hafif seyirli bir hastalik ile iliskili oldugu goruldu. Anahtar kelimeler: Cocuk, COVID-19, gastrointestinal sistem, SARS-CoV-2, hastalik siddeti