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, From the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, Colorado.
Utpal Bhalala, The Children's Hospital of San Antonio, San Antonio and Baylor College of Medicine, Houston, Texas.Follow
Larisa Strom, Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, Colorado.
Sandeep Tripathi, Department of Pediatrics, OSF Saint Francis Medical Centre/University of Illinois College of Medicine at Peoria, Peoria, Illinois.
John S. Kim, Advocate Aurora HealthFollow
Kristina Michaud, The Children's Hospital of San Antonio, San Antonio and Baylor College of Medicine, Houston, Texas.
Kathleen Chiotos, Division of Critical Care and Anesthesia, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.Follow
Heda R. Dapul, Division of Critical Care Medicine, Department of Pediatrics, NYU Langone Medical Center, New York, New York.Follow
Varsha P. Gharpure, Advocate Aurora HealthFollow
Erica C. Bjornstad, Division of Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.Follow
Julia A. Heneghan, Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota.
Katherine Irby, Division of Critical Care Medicine, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas.
Vicki Montgomery, Division of Critical Care Medicine, Department of Pediatrics, University of Louisville and Norton Children's Hospital, Louisville, Kentucky.
Neha Gupta, Division of Critical Care Medicine, Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma.
Manoj Gupta, Division of Pediatric Cardiology, Department of Pediatrics, Lincoln Hospital, Bronx, New York.
Karen Boman, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Society of Critical Care Medicine, Mount Prospect, Illinois.Follow
Vikas Bansal, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota; and.Follow
Rahul Kashyap, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota; and.
Allan J. Walkey, Division of Pulmonary and Critical Care, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
Vishakha K. Kumar, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Society of Critical Care Medicine, Mount Prospect, Illinois.
Katja M. Gist, From the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, Colorado.

Affiliations

Advocate Children's Hospital

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.

Document Type

Article

PubMed ID

35622434

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