Gastrointestinal and Liver Manifestations in Children with COVID-19 and Their Relationship to Clinical Course

Objective: Coronavirus disease 2019 is a major health problem in all age groups. Although most clinical symptoms are respiratory, gastrointestinal symptoms are often reported. This is a major concern for children and has limited research coverage. In this study, we evaluated the frequencies of gastrointestinal symptoms and liver biochemical findings in children with coronavirus disease 2019 and their relationship with clinical course and length of hospital stay. Materials and Methods: Demographic data, clinical, and laboratory findings of children with Coronavirus disease 2019 who were followed up by the Department of Pediatric Infectious Diseases between March 2020 and August 2020 were recorded. They were classified according to age groups as <5 years, 5-10 years, and >10 years. Laboratory findings were analyzed according to age groups. Demographic, clinical, and laboratory findings were compared in both situations, the presence of gastrointestinal symptoms and the presence of elevated liver enzymes. It was considered statistically significant if it was <.05. Results: A total of 294 patients (median age 10 years [14 days to 18 years]) were enrolled in this study. Although fever is the most common symptom of coronavirus disease 2019, 15.6% of patients presented with acute gastroenteritis. Most patients with liver involvement (n = 130, 44.2%) were under 5 years of age (n = 74, 56.9%, P <.001). The patterns of abnormal liver test results were cholestatic (71.5%), hepatocellular (18.4%), and mixed (10%) types. Severe or mas-sive elevation of aminotransferase or liver failure was not observed. No statistically significant difference was noted in outcomes, including length of stay, for patients with gastrointestinal symptoms (P =.178) or liver involvement (P =.146). Conclusion: The presence of gastrointestinal symptoms or elevated liver enzymes does not affect the course of the disease in children with coronavirus disease 2019.