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. KumarKatja M. Gist

Research output: Contribution to journalArticlepeer-review

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 languageEnglish (US)
Pages (from-to)751-758
Number of pages8
JournalPediatric Infectious Disease Journal
Volume41
Issue number9
DOIs
StatePublished - Sep 1 2022

Bibliographical note

Funding Information:
The registry is funded in part by the Gordon and Betty Moore Foundation, and Janssen Research & Development, LLC.

Funding Information:
U.B. is currently funded by National Institute of Health (Site Principal Investigator for Stress Hydrocortisone in Pediatric Septic Shock—R01HD096901), The Children’s Hospital of Philadelphia (Site Principal Investigator for Pediatric Resuscitation Quality Collaborative-PediResQ), Voelcker Pilot Grant (PI for project on prearrest electrocardiographic changes), The Children’s Hospital of San Antonio Endowed Chair Funds for ancillary projects related to Society of Critical Care Medicine VIRUS (COVID-19) Registry and Society of Critical Care Medicine VIRUS electronic medical record automation pilot. The other authors have no conflicts of interest to disclose.

Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.

Keywords

  • coronavirus disease 2019
  • critical illness
  • gastrointestinal
  • pediatric

PubMed: MeSH publication types

  • Journal Article
  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

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