ABSTRACT
INTRODUCTION: The rate of pediatric patients diagnosed with Sars Cov 2 has increased since the early stages of the pandemic. Gastrointestinal symptoms have been demonstrated to be relatively common in pediatric COVID-19 patients as well as severe complications like PIMS syndrome because of the expression of ACE II in different areas of the digestive tract which serves as a receptor for their entry and infection in the body. During the last months of the omicron variant wave, we observed some gastrointestinal conditions in pediatric patients days after the resolution of the Sars Cov 2 acute infection period, sparking our interest to execute further research and analysis. OBJECTIVE(S): Describe the presence of functional gastrointestinal disorders as a post-covid infection sequel METHODS: We performed a descriptive, cross-sectional, observational, retrospective study, were we recollected the clinical and epidemiological data from the medical records of pediatric patients with a history of Sars cov-2 infection confirmed with positive PCR or antigen (sars cov-2) tests at Hospital Angeles Lomas, Mexico City. We included children from 6 months up to 16 years of age, who presented functional gastrointestinal disorders at a minimum 15 days after the infection that fulfilled Rome IV criteria. We evaluated the frequency and proportion of the qualitative variables;we obtained the arithmetic mean and the standard deviation for the quantitative variables with normal distribution RESULTS: We included data from 30 patients with confirmed covid 19 diseases by positive pcr or antigen (sars cov-2) tests, with a mean age 5.327 +/- 3.8 years Min: 7 months Max: 16 years, with a female predominance of 56.7% vs 43% male patients. During the acute infection by covid, 20% presented respiratory symptoms, 13.3% gastrointestinal symptoms, 36.7% only fever, 3.3% dysgeusia and 26.7% were asymptomatic. Adequate nutritional status was detected in 93% of the patients. The mean days the patients presented manifestations was 32 +/- 14 days, at a minimum 15 days, with a maximum of 63 days, being the most frequent functional gastrointestinal disorders: abdominal pain 90%, bloating 76%, vomit and reflux 33%, diarrhea 30%, constipation 26.7%. There was no weight loss in the patients, the appropriate treatment was given for each case. There was no complication in 90% of the patients, 10% presented acute abdominal pain and were transferred to the emergency room, 1 patient was diagnosed with appendicitis and 2 patients with mesenteric lymphadenitis. CONCLUSION Special attention must be paid to toddler and preschooler patients with Sars Cov 2 infection, regardless of the clinical manifestation in acute infections, mild or asymptomatic, functional gastrointestinal disorders may occur in the first 2 months after a positive PCR test. The ileum and the colon are places in which there is a greater expression of the ACE II, so when the enterocytes are invaded by SARS CoV-2, they may produce alterations in absorption and other mechanisms that could be the cause of these consequences. It is of vital importance that all pediatricians are aware of the consequences of the disease to prevent misdiagnosis.
ABSTRACT
Introduction: During the present Sars cov-2 pandemic, pregnant women are considered high-risk group population due to a state of immune compromise. Previous knowledge regarding pregnant women and their newborns is rapidly changing as new covid discoveries are unraveled, paying special attention on newborns evolution during their first days of life. Objectives: To determine impact of Sars Cov2 infection on the expected birth weight of newborns of infected mothers. Methods: It is a descriptive, cross-sectional, observational and retrospective study involving the analysis of clinical records of patients from the infectiology service of the Hospital Español Mexico. The study includes newborns from mothers between the ages of 18 to 48 infected with Sars Cov2, confirmed by a PCR test. The study excludes patients with incomplete records. We evaluated the frequency and proportion of the qualitative variables;we obtained the arithmetic mean and the standard deviation for the quantitative variables with normal distribution. Results: Data included 36 patients from the infectology service between the months of March 2020 to April 2021, with positive PCR for sars cov 2, with a mean age of 34.28 ± 5.86 years, mainly presented the following comorbidities: : obesity in 27.8%, hypothyroidism 11.1%, diabetes 13.9%, gestational hypertension 13.9%. The principal symptoms presented by the mothers were respiratory in 19.4%, gastrointestinal 13.9%, asymptomatic presentation 47.2%. Newborns results were obtained with a mean gestational age of 37.3 ± 2.6, with a male predominance of 52.8%, with a mean birth weight of 2811.1 ± 616.7, height 47.64 ± 3.7. About 16.4% of the patients were premature, only 4 were admitted to the neonatal intensive care unit, due to sepsis, pediatric inflamatory multisystemic syndrome, and an intrauterine growth restriction. All the newborns had a negative PCR test despite the positive PCR of all the mothers Conclusion: Newborns from mothers infected with Sars cov 2, were born with appropriate weight for their gestational age. The immune system of newborn babies protects to have adequate nutrition during the gestational period, however, some presented inflammatory and vascular complications. Special emphasis should be done on maternal metabolic clinical history, such as obesity, metabolic syndrome, and hypothyroidism since these comorbidities can impact negatively in the prognosis of the infected mother and the newborn. It is very important to perform a nutritional screening during prenatal care for an adequate metabolic programming in early life in children.