COVID-19 Şüphesi Olan Çocuklarda Gastrointestinal Sistem Tutulumu: Türkiye’ den Tek Merkez Deneyimi

Öz

Amaç: Çalışmanın amacı pediyatrik COVİD-19 hastalarının klinik olarak sadece gastrointestinal semptomlar sergileyebileceğine dikkat çekerek, gastrointestinal sistem ile solunum sistemi tutulumu arasındaki ilişkiyi ortaya koymaktır.
Materyal ve Metot: Çalışmaya 1-18 yaş arasında 300 hasta dahil edildi. Hastalar semptomlarına göre; gastrointestinal semptomları, solunum semptomları ve gastrointestinal semptomları ile solunumsal semptomları olanlar şeklinde 3 gruba ayrıldı. PCR testi pozitif hastalar COVID-19 tanısı aldı. PCR negatif saptanan hastaların tanısı klinik semptomlara ve temas öyküsüne göre konuldu. Hastalar demografik özellikler, laboratuvar ve görüntüleme bulguları açısından analiz edildi.
Bulgular: COVID-19 tanısı alan 300 hastanın 29' unda PCR pozitif saptandı. Sadece gastrointestinal semptomları olan 58 hastanın tümünde yakın temas öyküsü vardı, ellisekiz hastanın 24'ünde PCR pozitifliği (%41.3) saptandı. Yedi hastanın ikisinde (%12) görüntüleme bulguları COVID ile uyumluydu, 7 hastanın ikisinde PCR negatifti. Medyan nötrofil lökosit oranı ve CRP gastrointestinal semptomları olan grupta solunum semptomları olan gruba göre daha yüksek bulundu (sırasıyla p = 0.034, p = 0.028).
Sonuç: Solunumsal şikayetler içermeyen, sadece gastrointestinal semptom bulguları olan ve PCR testi negatif saptanan hastalar, olası COVİD-19’un erken solunum tutulumu açısından dikkatle değerlendirilmelidir.

Anahtar Kelimeler

• COVID-19
• çocuk
• gastrointestinal semptom

Gastrointestinal System Involvement in Children suspected for COVID-19: A Single Tertiary Center Experience from Turkey

Abstract

Objective: The aim of our study is to present the association between respiratory system disorders and gastrointestinal system involvement through showing that pediatric COVİD 19 patients can only display gastrointestinal symptoms.
Materials and Methods: Three hundered COVID-19 patients between 1-18 years of age were included into the study. The patients were divided into 3 groups according to symptoms which are classified gastrointestinal, respiratory and gastrointestinal and respiratory groups. Diagnosis of COVID-19 were made by PCR testing. In patients with negative PCR testing, diagnosis was made according to clinical symptoms and contact history. Patients were analyzed in terms of demographic features, laboratory and imaging findings.
Results: There were 300 patients diagnosed with COVID-19. PCR testing was positive in 129 of 300 children. All patients with only gastrointestinal symptoms had close contact history, 24 of 58 patients had PCR positivity (41.3%) and in 7 patients (12%), chest X- Ray findings were compatible with COVID-19. Two of 7 patients had negative PCR testing. Median NRL and CRP was higher in gastrointestinal group than respiratory group (p=0.034, p=0.028 respectively).
Conclusions: Patients with gastrointestinal symptom and negative PCR testing should be evaluated carefully for early respiratory involvement without symptoms.

Keywords

• children
• COVID-19
• gastrointestinal symptom

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