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

    Research output: Contribution to journal › Article

    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.

    Original languageAmerican English
    JournalThe Pediatric infectious disease journal
    DOIs
    StatusPublished - Sep 1 2022

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