Gastrointestinal, hepatic and pancreatic manifestations of COVID-19 in children

Abstract

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a well-established respiratory tract pathogen. Recent studies in adults and children have shown an increasing number of patients reporting gastrointestinal manifestations of SARS-CoV-2 infection such as diarrhoea, nausea, vomiting and abdominal pain. SARS-CoV-2 RNA can be detected in faeces for an extended period, even after respiratory samples have tested negative and patients are asymptomatic. However, faecal-oral transmission has not yet been proven. In this article, the latest evidence on gastrointestinal, hepato-biliary, and pancreatic manifestations in children with coronavirus disease-19 and multisystem inflammatory syndrome will be analysed.

Keywords: Children; Coronavirus-19; Gastrointestinal; Liver; Pancreas.

Fig. 1

Visual summary of gastrointestinal, hepatic, and pancreatic manifestations of SARS-CoV-2 in children. Upper panel: pathogenesis of SARS-CoV-2 infection and mechanisms of damage. Lower panel: clinical manifestations of COVID-19 involving the gastrointestinal tract, the liver, and the pancreas.

Fig. 2

GI involvement in adults with COVID-19 (A) and differences between adult and paediatric COVID-19 related GI, liver, and pancreatic involvement (B).