Gastrointestinal and hepatic manifestations among hospitalized COVID-19 children

Abstract Background Gastrointestinal (GI) manifestations have been reported as the most extra-pulmonary manifestations of coronavirus disease 2019 (COVID-19). Recognizing the various manifestations, especially as presenting symptoms of COVID-19 is of great importance. We aimed to investigate the GI...

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Main Authors: Reza Sinaei, Ali Hosseininasab, Parvin Abbaslou, Mazyar Zeinali, Elham Iranmanesh, Roya Sinaei, Keramat Rahmanian
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Pediatrics
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Online Access:https://doi.org/10.1186/s12887-025-05599-4
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author Reza Sinaei
Ali Hosseininasab
Parvin Abbaslou
Mazyar Zeinali
Elham Iranmanesh
Roya Sinaei
Keramat Rahmanian
author_facet Reza Sinaei
Ali Hosseininasab
Parvin Abbaslou
Mazyar Zeinali
Elham Iranmanesh
Roya Sinaei
Keramat Rahmanian
author_sort Reza Sinaei
collection DOAJ
description Abstract Background Gastrointestinal (GI) manifestations have been reported as the most extra-pulmonary manifestations of coronavirus disease 2019 (COVID-19). Recognizing the various manifestations, especially as presenting symptoms of COVID-19 is of great importance. We aimed to investigate the GI and hepatic manifestations of COVID − 19 in children, determining the factors associated with the disease severity and prognosis related to GI symptoms. Methods In this retrospective study, children aged 1-month to 16-years who were admitted to Afzalipour Hospital in Kerman, Iran. for a period of one year (from October 2020 to October 2021) with the diagnosis of COVID-19 were included. The comparison of clinical symptoms and laboratory variables in the appendectomy and non-appendectomy groups were evaluated. Patients’ information was extracted from the patient’s medical record and analyzed in SPSS statistical. software. Results A total of 163 patients (107 boy and 56 girls) with mean age of 4.35 ± 3.86 (range 0.08 to 16) years were included. The most frequent GI symptoms at the time of admission were watery diarrhea (46.6%), vomiting (45.4%), and abdominal pain (32.5%). There was no significant relationship between clinical symptoms and laboratory variables in the appendectomy and non-appendectomy groups, but the severity of COVID-19 was significantly associated with appendicitis (P = 0.03). There was no statistically significant relationship between liver enzyme levels and disease severity and pediatric intensive care unit admission. Conclusions Although most COVID-19 patients present with GI manifestations, we could not determine the relationship between GI and hepatic manifestations and disease severity in this study. Clinical trial number Not applicable.
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spelling doaj-art-72a0c8adc5bd48648579def1ee0f26fd2025-08-20T03:18:34ZengBMCBMC Pediatrics1471-24312025-04-012511910.1186/s12887-025-05599-4Gastrointestinal and hepatic manifestations among hospitalized COVID-19 childrenReza Sinaei0Ali Hosseininasab1Parvin Abbaslou2Mazyar Zeinali3Elham Iranmanesh4Roya Sinaei5Keramat Rahmanian6Department of Pediatrics, School of Medicine, Kerman University of Medical SciencesDepartment of Pediatrics, School of Medicine, Kerman University of Medical SciencesDepartment of Pediatrics, School of Medicine, Kerman University of Medical SciencesDepartment of Pediatrics, School of Medicine, Kerman University of Medical SciencesClinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical SciencesDepartment of Pediatrics, School of Medicine, Kerman University of Medical SciencesClinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical SciencesAbstract Background Gastrointestinal (GI) manifestations have been reported as the most extra-pulmonary manifestations of coronavirus disease 2019 (COVID-19). Recognizing the various manifestations, especially as presenting symptoms of COVID-19 is of great importance. We aimed to investigate the GI and hepatic manifestations of COVID − 19 in children, determining the factors associated with the disease severity and prognosis related to GI symptoms. Methods In this retrospective study, children aged 1-month to 16-years who were admitted to Afzalipour Hospital in Kerman, Iran. for a period of one year (from October 2020 to October 2021) with the diagnosis of COVID-19 were included. The comparison of clinical symptoms and laboratory variables in the appendectomy and non-appendectomy groups were evaluated. Patients’ information was extracted from the patient’s medical record and analyzed in SPSS statistical. software. Results A total of 163 patients (107 boy and 56 girls) with mean age of 4.35 ± 3.86 (range 0.08 to 16) years were included. The most frequent GI symptoms at the time of admission were watery diarrhea (46.6%), vomiting (45.4%), and abdominal pain (32.5%). There was no significant relationship between clinical symptoms and laboratory variables in the appendectomy and non-appendectomy groups, but the severity of COVID-19 was significantly associated with appendicitis (P = 0.03). There was no statistically significant relationship between liver enzyme levels and disease severity and pediatric intensive care unit admission. Conclusions Although most COVID-19 patients present with GI manifestations, we could not determine the relationship between GI and hepatic manifestations and disease severity in this study. Clinical trial number Not applicable.https://doi.org/10.1186/s12887-025-05599-4COVID-19ChildrenGastrointestinalHepaticAppendicitis
spellingShingle Reza Sinaei
Ali Hosseininasab
Parvin Abbaslou
Mazyar Zeinali
Elham Iranmanesh
Roya Sinaei
Keramat Rahmanian
Gastrointestinal and hepatic manifestations among hospitalized COVID-19 children
BMC Pediatrics
COVID-19
Children
Gastrointestinal
Hepatic
Appendicitis
title Gastrointestinal and hepatic manifestations among hospitalized COVID-19 children
title_full Gastrointestinal and hepatic manifestations among hospitalized COVID-19 children
title_fullStr Gastrointestinal and hepatic manifestations among hospitalized COVID-19 children
title_full_unstemmed Gastrointestinal and hepatic manifestations among hospitalized COVID-19 children
title_short Gastrointestinal and hepatic manifestations among hospitalized COVID-19 children
title_sort gastrointestinal and hepatic manifestations among hospitalized covid 19 children
topic COVID-19
Children
Gastrointestinal
Hepatic
Appendicitis
url https://doi.org/10.1186/s12887-025-05599-4
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AT alihosseininasab gastrointestinalandhepaticmanifestationsamonghospitalizedcovid19children
AT parvinabbaslou gastrointestinalandhepaticmanifestationsamonghospitalizedcovid19children
AT mazyarzeinali gastrointestinalandhepaticmanifestationsamonghospitalizedcovid19children
AT elhamiranmanesh gastrointestinalandhepaticmanifestationsamonghospitalizedcovid19children
AT royasinaei gastrointestinalandhepaticmanifestationsamonghospitalizedcovid19children
AT keramatrahmanian gastrointestinalandhepaticmanifestationsamonghospitalizedcovid19children