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      Gastroenteritis is Less Severe But is More Often Associated With Systemic Inflammation in SARS-CoV-2-positive Than in SARS-CoV-2-Negative Children

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          Abstract

          This study aims to characterize the clinical and metabolic features of acute gastroenteritis in children with and without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A multicenter case–control study was conducted in 2022 including 200 children. Clinical data and laboratory tests were analyzed. Children with SARS-CoV-2 presented less frequently hyponatremia and metabolic acidosis, but more often systemic inflammation as compared with children without SARS-CoV-2.

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          European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014.

          Alfredo Guarino, Shai Ashkenazi, Dominique Gendrel … (2014)
          These guidelines update and extend evidence-based indications for the management of children with acute gastroenteritis in Europe. The guideline development group formulated questions, identified data, and formulated recommendations. The latter were graded with the Muir Gray system and, in parallel, with the Grading of Recommendations, Assessment, Development and Evaluations system. Gastroenteritis severity is linked to etiology, and rotavirus is the most severe infectious agent and is frequently associated with dehydration. Dehydration reflects severity and should be monitored by established score systems. Investigations are generally not needed. Oral rehydration with hypoosmolar solution is the major treatment and should start as soon as possible. Breast-feeding should not be interrupted. Regular feeding should continue with no dietary changes including milk. Data suggest that in the hospital setting, in non-breast-fed infants and young children, lactose-free feeds can be considered in the management of gastroenteritis. Active therapy may reduce the duration and severity of diarrhea. Effective interventions include administration of specific probiotics such as Lactobacillus GG or Saccharomyces boulardii, diosmectite or racecadotril. Anti-infectious drugs should be given in exceptional cases. Ondansetron is effective against vomiting, but its routine use requires safety clearance given the warning about severe cardiac effects. Hospitalization should generally be reserved for children requiring enteral/parenteral rehydration; most cases may be managed in an outpatients setting. Enteral rehydration is superior to intravenous rehydration. Ultrarapid schemes of intravenous rehydration are not superior to standard schemes and may be associated with higher readmission rates. Acute gastroenteritis is best managed using a few simple, well-defined medical interventions.
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            Clinical characteristics, activity levels and mental health problems in children with long coronavirus disease: a survey of 510 children

            Danilo Buonsenso, Ferran Pujol, Daniel Munblit … (2022)
            Background: Whether long coronavirus disease pertains to children as well is not yet clear. Methods: The authors performed a survey in children suffering from persistent symptoms since initial infection. A total of 510 children infected between January 2020 and January 2021 were included. Results: Symptoms such as fatigue, headache, muscle and joint pain, rashes and heart palpitations and issues such as lack of concentration and short-term memory problems were particularly frequent and confirm previous observations, suggesting that they may characterize this condition. Conclusion: A better comprehension of long coronavirus disease is urgently needed.
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              Frequency of Children vs Adults Carrying Severe Acute Respiratory Syndrome Coronavirus 2 Asymptomatically

              Gregorio Milani, Ilaria Bottino, Alessia Rocchi … (2020)
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                Author and article information

                Contributors
                Gregorio P. Milani
                Paola Marchisio
                Carlo Agostoni
                Chiara Maria Corso
                Alfredo Guarino
                Marco Poeta
                Francesco Proli
                Alessandra Drosi
                Rosa Morello
                Andrea Lo Vecchio
                Journal
                Journal ID (nlm-ta): Pediatr Infect Dis J
                Journal ID (iso-abbrev): Pediatr Infect Dis J
                Journal ID (publisher-id): INF
                Title: The Pediatric Infectious Disease Journal
                Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )
                ISSN (Print): 0891-3668
                ISSN (Electronic): 1532-0987
                Publication date (Electronic): 14 June 2023
                Publication date (Print): September 2023
                Volume: 42
                Issue: 9
                Pages: e320-e322
                Affiliations
                From the [* ]Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
                [† ]Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy
                [‡ ]Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
                [§ ]Istituto di Igiene, Global Health Research Institute, Università Cattolica del Sacro Cuore, Rome, Italy
                []Department of Translational Medical Sciences, Section of Pediatrics. University of Naples Federico II, Naples, Italy.
                Author notes
                Address for correspondence: Danilo Buonsenso, PhD, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy. E-mail: danilobuonsenso@ 123456gmail.com .
                Author information
                https://orcid.org/0000-0001-8567-2639
                Article
                Accession ID: 00012
                DOI: 10.1097/INF.0000000000004001
                PMC ID: 10417221
                PubMed ID: 37314203
                SO-VID: 6d26a07a-4908-4f80-9f2a-2ef457082d62
                Copyright © Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
                License:

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date accepted : 31 May 2023
                Categories
                Subject: COVID Reports
                Custom metadata
                STATUS ONLINE-ONLY
                OPEN-ACCESS TRUE
                SDC T

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