In addition, gastrointestinal symptoms are observed more frequently in children with younger age and fever ( 14). GI symptoms are reported to range from 12% to 21% in the pediatric literature with varying frequencies in the United States, Europe and China ( 11– 13). The viral shedding in stool and nasal secretions make children possible facilitators of viral transmission ( 5) and is one of the possible explanations for the prevalence of Gastrointestinal (GI) symptoms in CVOID-19 infected children. Viral fecal shedding for several weeks after diagnosis has been reported ( 10), COVID-19 virus was observed in rectal swabs in eight out of ten children after nasopharyngeal swabs returned negative ( 11). ![]() In addition, liver injury is well described in children with COVID-19 infection. A proportion of affected patients also have digestive manifestations, such as anorexia, nausea, vomiting, diarrhea, and abdominal pain. The typical presentation of COVID-19 includes fever, weakness, nausea, and pulmonary symptoms such as dry cough and dyspnea. The pediatric population display a mild disease and majority (over 90%) have mild, moderate or asymptomatic disease ( 5– 8) Approximately 1% of children develop severe disease requiring admission to intensive care unit ( 9). 2.1%–5% of infected cases are children ( 3, 4). Severe acute respiratory syndrome coronavirus 2 was the cause of a series of cases with severe pneumonia initially reported in Wuhan, China ( 1, 2) declared as COVID-19 by the WHO.
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