scholarly journals Limited Additive Diagnostic Impact of Isolated Gastrointestinal Involvement for the Triage of Children with Suspected COVID-19

Children ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 41
Author(s):  
Désirée Caselli ◽  
Claudio Cafagno ◽  
Daniela Loconsole ◽  
Annamaria Giannini ◽  
Francesco Tansella ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
Gastrointestinal Symptoms ◽  
Adult Patients ◽  
Time Interval ◽  
Gastrointestinal Involvement ◽  
Diagnostic Impact ◽  
Children's Hospital ◽  
Optimal Separation ◽  
Gi Symptoms ◽  
Children’S Hospital

The strategy for the selection of patients with a suspected SARS-CoV-2 infection is relevant for the organization of a children’s hospital to provide optimal separation into COVID-19 and non-COVID-19 areas and pathways. We analyzed the proportion of children with COVID-19 presenting with gastrointestinal (GI) symptoms in 137 consecutive patients admitted between January 2020 and August 2021. GI symptoms were present as follows: diarrhea in 35 patients (26%), vomiting in 16 (12%), and both of them in five (3%); the combination of fever, respiratory symptoms, and diarrhea was observed in 16 patients (12%). Of the 676 adult patients with COVID-19 admitted to our hospital in the same time interval, 62 (9.2%) had diarrhea, 30 (4.4%) had vomiting, and 11 (1.6%) had nausea; only one patient, a 38-year-old male, presented with isolated GI symptoms at the diagnosis. Although diarrhea was observed in one quarter of cases, one-half of them had the complete triad of fever, respiratory syndrome, and diarrhea, and only five had isolated diarrhea, of which two were diagnosed with a Campylobacter infection. The occurrence of either respiratory symptoms or gastrointestinal symptoms in our patients was not related to the patient age, while younger children were more likely to have a fever. Of the 137 patients, 73 (53%) could be tested for their serum level of SARS-CoV-2 specific IgG antibodies. The observed titer ranged between 0 (n = 3) and 1729 BAU/mL (median, 425 BAU/mL). Of 137 consecutive patients with COVID-19 admitted to our referral children’s hospital, only three presented with an isolated GI manifestation. It is interesting to note that this finding turned out to be fully in keeping with what was observed on adult patients with COVID-19 in our hospital. The additive diagnostic impact of gastrointestinal involvement for the triage of children with suspected COVID-19 appears limited.

scholarly journals Analysis of Gastrointestinal Symptoms in 281 Cases of Hospitalized Covid 19 Patients, Single-Center Study

2021 ◽  
Author(s):  
Gözde Derviş Hakim ◽  
Şükran Köse ◽  
Pınar Şamlıoğlu ◽  
Cengiz Ceylan ◽  
Mehmet Can Uğur ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Respiratory Symptoms ◽  
Clinical Presentation ◽  
Gastrointestinal Symptoms ◽  
Clinical Analysis ◽  
Clinical Findings ◽  
Gastrointestinal System ◽  
Detailed Review ◽  
Single Center Study ◽  
Gi Symptoms

Objective: Although Covid-19 which has been identified as the disease caused by SARS COV-2 virus mainly affects the respiratory tract, it was observed that many systems were affected. The gastrointestinal system is one of the main systems involved. The aim of this manuscript was to perform epidemiological, virological, and clinical analysis of 59 Covid 19-positive patients with gastrointestinal symptoms. Method: Covid-19 diagnosed patients have been started to be admitted since March, 20, 2020. Epidemiological, demographical, clinical findings, laboratory analyses as well as hospitalization periods and disease progression of the patients presenting gastrointestinal system (GIS) symptoms admitted between March, 31, 2020 and August, 1, 2020. Results: Totally 710 Covid 19-positive patients hospitalized were screened. Among these patients, those with incomplete medical history and deficient data were excluded. The analysis of 281 patients admitted due to Covid-19 diagnosis with complete data since admission revealed that 59 patients presented GIS symptoms at admission. The aforesaid patients were compared with 222 patients admitted due to Covid-19 without GIS symptoms within the same period. GIS symptoms were detected on 59 (59/281) (20.99%) patients admitted due to Covid-19. Detailed review of these patients revealed that 18 (18/59) (30.50%) patients had nausea-vomiting, 10 (10/59) (16.95%) patients had abdominal pain, and 31 (31/59) (52.55%) patients had GIS bleeding. It was observed that vomiting was added into the clinical presentation in 7 of 18 patients. Although there is not any diarrhea symptom alone, total number of cases with diarrhea+abdominal pain, diarrhea+nausea-vomiting, diarrhea+nausea-vomiting+abdominal pain was 17 (17/59) (28.81%) of 59 patients. Conclusion: According to the results of this study, we have found 20.99% gi symptoms in the hospitalizated patients due to Covid 19. Although GIS symptoms are not associated with disease severity, they are important for the identification and spread of the disease, along with respiratory symptoms.

A Survey of Nosocomial Respiratory Viral Infections in a Children's Hospital: Occult Respiratory Infection in Patients Admitted During an Epidemic Season

1991 ◽  
Vol 12 (4) ◽  
pp. 231-238 ◽  
Author(s):  
Paul N. Goldwater ◽  
A. James Martin ◽  
Brownwyn Ryan ◽  
Sylvia Morris ◽  
Jill Thompson ◽  
...  
Keyword(s):  
Respiratory Infection ◽  
Respiratory Symptoms ◽  
Respiratory Virus ◽  
Pediatric Hospital ◽  
Children's Hospital ◽  
Asymptomatic Patients ◽  
Number Of Patients ◽  
Epidemic Period ◽  
Children’S Hospital ◽  
Hospital Acquired

AbstractObjective:To define the extent of shedding of respiratory viruses and Mycoplasma pneumoniae among a population of pediatric patients admitted to the hospital during a winter epidemic period and to identify nosocomial infections within this population.Design:An open, prospective survey of patients admitted to three wards (General Medical, Respiratory Infectious, and Infectious Diseases) of a pediatric hospital during a defined three-month period.Patients:All patients with medical, respiratory, and infectious conditions admitted to three wards of the Adelaide Children's Hospital had nasopharyngeal aspirations performed at the time of admission with the purpose of documenting viral and M pneumoniae shedding. Patients were monitored daily for the development of symptoms of respiratory infection or new symptoms of respiratory disease. Such patients underwent a further nasopharyngeal aspiration for the purpose of diagnosing hospital-acquired infection.Results:Nasopharyngeal aspirations were obtained from 601 patients. Forty-seven percent of asymptomatic patients were positive for a respiratory virus orMpneumoniae, and 61% of patients with respiratory symptoms were also positive. Gastroenteritis patients shed viruses in 66% of cases. Respiratory symptoms were initially overlooked by admitting physicians but subsequently identified in 110 cases, and 46% of these were found to be positive for a respiratory virus or M pneumoniae. There were 18 possible hospital acquired infections among the 293 initially virus-negative patients. Multiple isolates were obtained from a substantial number of patients, especially those with respiratory symptoms.Conclusions:A substantial proportion of all patients admitted to a pediatric hospital during winter represent a potential source of infection, and strict infection control measures should be enacted to limit the spread of these infections.

scholarly journals Renal bone disease in pediatric and young adult patients on hemodialysis in a children's hospital.

1993 ◽  
Vol 3 (12) ◽  
pp. 1938-1946
Author(s):  
R Mathias ◽  
I Salusky ◽  
W Harman ◽  
A Paredes ◽  
J Emans ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Calcium ◽  
Bone Disease ◽  
Adult Patients ◽  
Osteitis Fibrosa ◽  
Assay Method ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Renal Bone Disease ◽  
Serum Pth

Renal bone disease has been well defined in adult patients receiving chronic dialysis and in children on peritoneal dialysis/continuous ambulatory peritoneal dialysis. However, little is known about the histologic features in patients undergoing chronic hemodialysis in a children's hospital center. Twenty one patients, aged 17.5 +/- 1.5 yr, on hemodialysis for 35 +/- 6 months underwent iliac crest bone biopsies and deferoxamine infusion tests. Nineteen of 21 patients were receiving oral calcitriol. The 21 patients were classified by histomorphometry as follows: osteitis fibrosa, 5; mild hyperparathyroidism, 3; normal histology, 3; aplastic, 6; and mixed lesions, 4. Four of 21 patients were surface positive for aluminum, and seven other patients stained positive for iron in bone. Serum parathyroid hormone (PTH) levels correlated directly with the bone formation rate (r = 0.84) and with eroded bone perimeter (r = 0.67). Eight of the nine patients with serum PTH levels above 125 pg/mL had marrow fibrosis. All patients with serum calcium levels < 10.0 mg/dL and serum PTH levels > 125 pg/mL had either osteitis fibrosa or mixed bone lesions--a group of patients that might benefit from aggressive vitamin D therapy. In contrast, an examination of patients with serum calcium levels > 10.0 mg/dL and serum PTH levels < 65 pg/mL correctly identified three out of three patients with aluminum-related bone disease. These findings suggest that measurements of serum intact PTH levels by the immunoradiometric assay method may be valuable in distinguishing high-turnover lesions from normal or low-turnover skeletal lesions in this population.

Wilms tumor outcome and biology in adolescent and young adult patients at Ann and Robert H. Lurie Children's Hospital of Chicago.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. e21016-e21016
Author(s):  
Christine Higham ◽  
Yasmin C. Gosiengfiao ◽  
David Otto Walterhouse ◽  
Elaine Morgan ◽  
Jennifer Reichek ◽  
...  
Keyword(s):  
Young Adult ◽  
Wilms Tumor ◽  
Adult Patients ◽  
Adolescent And Young Adult ◽  
Children's Hospital ◽  
Children’S Hospital

Mo1964 Efficacy and Safety of Endoscopic Studies in 207 Pediatric and Young Adult Patients: A Japanese Single Children's Hospital Experience

2012 ◽  
Vol 142 (5) ◽  
pp. S-709
Author(s):  
Kie Nakao ◽  
Kouji Kawamoto ◽  
Yuri Etani ◽  
Yoshiko Nakayama ◽  
Akio Kubota ◽  
...  
Keyword(s):  
Young Adult ◽  
Adult Patients ◽  
Efficacy And Safety ◽  
Children's Hospital ◽  
Hospital Experience ◽  
Children’S Hospital

scholarly journals 452. Familial Cluster of COVID-19 Cases Associated with High Prevalence of Anosmia, Ageusia, and Gastrointestinal Symptoms

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S293-S293
Author(s):  
Bethany E Ho ◽  
Andrea P Ho ◽  
Michaela A Ho ◽  
Elizabeth C Ho
Keyword(s):  
Disease Transmission ◽  
Respiratory Symptoms ◽  
Index Case ◽  
Gastrointestinal Symptoms ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Familial Cluster ◽  
Gi Symptoms ◽  
High Prevalence ◽  
Polymerase Chain

Abstract Background Patients with COVID-19 most commonly report respiratory symptoms, with a minority reporting gastrointestinal (GI) symptoms in currently available reports. Additionally, little is known about the symptoms of anosmia/hyposmia, ageusia, and dysgeusia anecdotally seen in COVID-19 patients, which may be considered both GI and sensory/neurological manifestations of infection. Methods We interviewed 7 patients via oral inquiries and a questionnaire, collecting data on subject symptoms and their durations. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to confirm 2 of these cases. Results We report a familial cluster of 7 COVID-19 cases, 5 of whom reported sensory symptoms of anosmia/hyposmia (5/7), ageusia/hypogeusia (5/7), and/or dysgeusia (3/7). All 7 cases reported GI involvement with one or more symptom of: nausea (5/7), diarrhea (4/7), abdominal pain (3/7), anorexia (3/7), and emesis (2/7). Figure 1. Timeline of Symptoms and Exposure to Index Case in Familial COVID-19 Cluster Conclusion This frequency of GI symptoms is high relative to currently available epidemiological reports, which also infrequently report on sensory symptoms. The mechanistic underpinnings of GI and sensory symptoms in COVID-19 warrant close consideration and analysis, especially as it relates to reducing disease transmission. COVID-19 exhibits wide variation in duration, severity, and progression of symptoms, even within a familial cluster. Disclosures All Authors: No reported disclosures

scholarly journals Clinical Case Series of Gastrointestinal Symptoms in Patients With Novel Coronavirus 2019 Infection

2021 ◽  
Author(s):  
Hamideh Abbaspour Kasgari ◽  
Amir Mohammad Shabani ◽  
Hafez Fakheri ◽  
Parnian Mohammadzadeh
Keyword(s):  
Respiratory Symptoms ◽  
Acute Phase Proteins ◽  
Severe Disease ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Stable Condition ◽  
Signs And Symptoms ◽  
Case Series Study ◽  
Gi Symptoms ◽  
Loss Of Appetite

Background: Various digestive symptoms have been frequently reported in a significant portion of patients infected with the virus since the outbreak of Coronavirus Disease 2019 (COVID-19). Most patients with COVID-19 have a fever accompanied by respiratory signs and symptoms, such as cough and dyspnea. We present 36 cases with a chief complaint of Gastrointestinal (GI) symptoms along with respiratory symptoms. In this study, we aimed at investigating the prevalence and outcomes of COVID-19 patients with digestive symptoms. Methods: A variety of observed GI symptoms included nausea and vomiting (72.2%), diarrhea (25%), abdominal pain (19.4%), loss of appetite (14%), and anosmia (14%). The most nonGI symptoms were dyspnea (66.7%), fever (66.7%), dry cough (58.3%), myalgia (52.4%), and others. Six patients (16.6%) were critically ill, 7 (19.4%) were in stable condition, and 23 patients (64%) showed moderate symptoms. Among the patients, 7 (19.5%) needed critical care and were admitted to ICU. Leucopenia, lymphopenia, and elevated acute-phase proteins were other features observed in these patients. The most common antiviral regimen was hydroxychloroquine and oseltamivir. Finally, 32 patients (89%) were discharged, and 4 (11%) died. Conclusion: This case series study highlights that patients with COVID-19 are prone to GI symptoms along with fever and respiratory symptoms. Patients may even present with digestive symptoms and without any respiratory symptoms. Hence, clinicians should pay more attention to these patients and help diagnose COVID-19 earlier to start prompt treatment before the occurrence of severe disease.

Comparison of symptoms of influenza A with abacavir-associated hypersensitivity reaction

2003 ◽  
Vol 14 (7) ◽  
pp. 478-481 ◽  
Author(s):  
Philip Keiser ◽  
Naiel Nassar ◽  
Daniel Skiest ◽  
Charla Andrews ◽  
Beena Yazdani ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Hypersensitivity Reaction ◽  
Odds Ratio ◽  
Influenza A ◽  
Respiratory Symptoms ◽  
Respiratory Infections ◽  
Gastrointestinal Symptoms ◽  
Gi Symptoms ◽  
Viral Respiratory Infections ◽  
Viral Respiratory

Differentiation between abacavir hypersensitivity and viral respiratory infections is problematic. Fifteen cases of abacavir hypersensitivity were matched to 30 controls with culture proven influenza A with no abacavir exposure. Rash was associated with hypersensitivity (odds ratio [OR] = 13.1, P = 0.02) as was the presence of nausea (OR = 30, P < 0.001), vomiting (OR = 17.1, P = 0.001) or diarrhoea (OR = 22, P < 0.001). The number of gastrointestinal symptoms was also predictive of hypersensitivity reaction ( P < 0.001). Respiratory symptoms (cough, sore throat, or dyspnoea) were not associated with abacavir hypersensitivity (OR = 0.08, P = 0.001). Multivariate analysis confirmed the following associations for abacavir hypersensitivity: the number of gastrointestinal symptoms (OR = 8.6, P = 0.0032), cough (OR = 0.039, P = 0.02) and rash (OR = 16.9, P = 0.07). Abacavir hypersensitivity is strongly associated with gastrointestinal (GI) symptoms. Cough without GI symptoms is associated with influenza.

scholarly journals Virus discharge and initial gastrointestinal involvement are negatively associated with circulating lymphocyte count in COVID-19

2020 ◽  
Author(s):  
Wei Chen ◽  
Kenneth I. Zheng ◽  
Saiduo Liu ◽  
Chongyong Xu ◽  
Chao Xing ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Lymphocyte Count ◽  
Respiratory Symptoms ◽  
Gastrointestinal Symptoms ◽  
Gastrointestinal Involvement ◽  
Negatively Associated ◽  
Qrt Pcr ◽  
Medical University ◽  
Positive Results

Abstract Background: It’s reported SARS-CoV-2 could transmit via gastrointestinal tract, with or without pulmonary symptoms. However, as far as we know, there is no convenient marker to predict the virus discharge in stool and initial gastrointestinal involvement of COVID-19.Aims: We aimed to investigate the biomarker predicting virus discharge in stool and initial gastrointestinal involvement of COVID-19, which may assist the clinicians to better combat and prevent COVID-19.Methods: The patients complained of initial gastrointestinal involvement, including vomiting, diarrhea, with or without respiratory symptoms, attending the Sixth People’s Hospital of Wenzhou, and the Second Affiliated Hospital of Wenzhou Medical University, were screened by qRT-PCR for SARS-CoV-2. The Confirmed COVID-19 patients without contaminated ingestion were all enrolled to investigate the association between circulating lymphocyte count and virus discharge, initial gastrointestinal involvement.Results: 76 COVID-19 patients were finally enrolled in this study (mean age 44.5, male 44.7%), with 24 (31.5%) complained of initial gastrointestinal symptoms. Significantly lower circulating lymphocyte count was found in the patients with positive results of qRT-PCR on stool (p = 0.012). Furthermore, when the circulating lymphocyte count increased from bottom tertile to the 2nd and 3rd tertiles, the risk of initial gastrointestinal involvement decreased by nearly 75% (OR = 0.25, 95% CI: 0.07, 0.98, p = 0.047), 83% (OR = 0.17, 95% CI: 0.05, 0.63, p = 0.008), adjusted for possible confounders.Conclusions: The circulating lymphocyte count is negatively associated with virus discharge in stool in COVID-19 patients, and the risk of initial gastrointestinal involvement also.

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