Severe gastrointestinal symptoms reported in kids with COVID

The retrospective cohort study from Italy followed 685 COVID-positive children under the age of 18 between February 2020 and 2021.
 
Researchers found that 10% experienced severe gastrointestinal (GI) manifestations within 4–6  weeks of infection, including appendicitis, intussusception, pancreatitis, abdominal fluid collection and diffuse adenomesenteritis.
 
Children with abdominal pain, lymphopaenia, multisystem inflammatory syndrome and those between the ages of 5–10 were more likely to experience severe GI manifestations. The presence of severe symptoms was also associated with a higher chance of hospital and ICU admission.
 
This latest research comes as Australia sees its first Omicron surge, with children appearing to be more at risk.
 
Recent data from South Africa’s National Institute for Communicable Diseases shows children under the age of five represent almost 10% of hospital admissions.
 
The UK is seeing a similar trend. Over the past week alone, there has been a 39% increase in hospitalisation rates among children under five.
 
Back on home soil, data predating Omicron from the National Centre for Immunisation Research and Surveillance in June and July suggested transmission at schools and early childhood education and care services was occurring at a rate five times higher than in 2020.
 
Additionally, there are currently 2561 COVID-positive children in Victoria aged 0–9, 570 cases more than the 1991 recorded in the next highest cohort (30–39-year-olds).
 
The Department of Health (DoH) was unable to provide newsGP with national statistics on active COVID cases, as it did not have that information to hand. A spokesperson indicated this is because the number of total active cases the DoH receives from each jurisdiction each day is not disaggregated by age.
 
While there have been no COVID-related deaths in children aged under nine in Australia to date, two children aged between 10 and 19 have died.
 
And with potentially more children set to placed at risk due to Omicron, the Italian study raises renewed concerns around severe disease in children, including life-threatening multisystem inflammatory syndrome, which was first linked to COVID-19 in May 2020.
 
More than 8% of children included in the study had multisystem inflammatory syndrome, defined as fulfilling the CDC criteria.
 
The authors conclude that ‘a high grade of suspicion should be maintained in school-aged children and adolescents as well as all children presenting with abdominal pain, leucopaenia, and elevated inflammatory markers’ to ensure prompt diagnosis, management and prevention of serious complications.
 
The study also serves as a timely reminder of the importance of vaccination.
 
The opening of Australia’s COVID-19 vaccination program for 12-15-year-olds in September 2021 will be extended to all children aged 5–11 from 10 January 2022.
 
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