PhD Scientific Days 2024

Health Sciences III.

Viral infection associated pediatric gastrointestinal disturbances in the context of the COVID-19 pandemic

Text of the abstract

Introduction: While chronic abdominal complaints pose a diagnostic challenge often attributed to functional disorders, the early detection of conditions such as celiac disease and inflammatory bowel diseases holds significant importance. In the history of children's complaints, we often hear about a preceding viral infection; however, examining this relationship is not simple.

Aims: We assessed the prevalence of gastrointestinal complaints among children post-COVID-19 and delineated both the organic origins of these symptoms and the prevalence of newly diagnosed celiac disease cases.

Methods: For our study conducted at the Long COVID clinic of the Pediatric Center, Semmelweis University, Bókay Unit, we enrolled children who underwent celiac screening between July 7, 2021, and July 6, 2022, following a confirmed COVID-19 infection. We analyzed gastrointestinal symptoms during and after the acute infection and conducted further investigations to distinguish between functional and organic gastrointestinal disorders.

Results: One hundred ninety-four children met our inclusion criteria. One hundred fourteen (58.8%) exhibited at least one persistent gastrointestinal symptom during examination (mean time since acute COVID testing = 207 days; SD = 130 days). At this time, 33.5% had loss of appetite, 32.5% abdominal pain, 26.8% nausea or vomiting, 16.5% diarrhea. Weight loss was observed in 14.9%, constipation in 11.9%, and difficulty swallowing in 4.1%. Further investigations revealed inflammatory bowel disease in two cases, lactose malabsorption in two cases, reflux in two other children, and cyclic vomiting syndrome in one child. However, functional disorders were suggested for the majority of children. The overall prevalence of celiac disease was 5.7%, with six newly diagnosed children (3.1%).

Conclusions: Differentiating between organic and functional etiologies of symptoms is essential, necessitating a multidisciplinary approach for comprehensive patient care. Furthermore, our study highlights a potentially elevated prevalence of celiac disease among children with a history of COVID-19, prompting further investigation into this association.

Funding: Supported by the ÚNKP-23-3-II-SE-4 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.