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Pediatric Gastrointestinal Outcomes During the Post-Acute Phase of COVID-19
27 Pages Posted: 8 May 2024
More...Abstract
Background: The impact of COVID-19 on gastrointestinal (GI) outcomes in children during the post-acute and chronic phases of the disease is not well understood.
Methods: We conducted a retrospective cohort study across twenty-nine healthcare institutions from March 2020 to September 2023, including 413,455 pediatric patients with confirmed SARS-CoV-2 infection and 1,163,478 controls without infection. Infection was confirmed via polymerase chain reaction (PCR), serology, antigen tests, or clinical diagnosis of COVID-19 and related conditions. We examined the incidence of predefined GI symptoms and disorders during the post-acute (28 to 179 days post-infection) and chronic (180 to 729 days post-infection) phases. The adjusted risk ratios (aRRs) were calculated using stratified Poisson regression, with stratification based on propensity scores.
Results: Our cohort comprised 1,576,933 patients, with females representing 48.0% of the sample. The analysis revealed that children with SARS-CoV-2 infection had an increased risk of developing at least one GI symptom or disorder in both the post-acute (8.64% vs. 6.85%; aRR 1.25, 95% CI 1.24-1.27) and chronic phases (12.60% vs. 9.47%; aRR 1.28, 95% CI 1.26-1.30) compared to uninfected peers. Specifically, the risk of abdominal pain was higher in COVID-19 positive patients during the post-acute phase (2.54% vs. 2.06%; aRR 1.14, 95% CI 1.11-1.17) and chronic phase (4.57% vs. 3.40%; aRR 1.24, 95% CI 1.22-1.27).
Interpretation: Children with a history of SARS-CoV-2 infection are at an increased risk of GI symptoms and disorders during the post-acute and chronic phases of COVID-19. This highlights the need for ongoing monitoring and management of GI outcomes in this population.
Funding: This research was funded in part by the National Institutes of Health (NIH) Agreement OTA OT2HL161847-01 as part of the Researching COVID to Enhance Recovery (RECOVER) Research Initiative.
Declaration of Interest: Dr. Becich reports PCORnet funding as MPI for the PaTH Clinical Research Network. All other authors have no conflicts of interest to report.
Ethical Approval: This study was approved by the University of Pennsylvania’s institutional review board (No. 851604), with a waiver of informed consent.
Keywords: COVID-19, Gastrointestinal outcomes, Children, Post-acute phase
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