S.V. KHALIULLINA¹, V.A. ANOKHIN¹, V.A. POZDNYAK¹, YU.A. RAIMOVA¹, KH.S. KHAERTYNOV¹, A.M. ZAKIROVA¹, Z.T. MUKHAMERDIEVA²

¹Kazan State Medical University, Kazan

²Republic Clinical Infectious Hospital named after Prof. A.F. Agafonov, Kazan

Contact details:

Khaliullina S.V. — MD, Associate Professor of the Department of Children’s Infections

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-917-860-92-46, e-mail: svekhal@mail.ru

Diarrheal syndrome in COVID-19 is registered in 12–30% of patients. It is known to be associated with the severity and prognosis of the disease.

The purpose is to describe the clinical features of mono- and mixed infections in children with gastrointestinal lesions during the COVID-19 pandemic.

Material and methods. An observational retrospective study was conducted on the basis of Kazan Republican Clinical Hospital, which included observation of 160 children hospitalized with an infectious disease clinic that included gastrointestinal lesions. To confirm the COVID-19 diagnosis, standard methods were used (PCR, ICA, ELISA), for acute intestinal infection — bacteriological examination, determination of antigens in feces by LFIA.

As part of statistical data processing (https://medstatistic.ru/calculators.html), we calculated the median, interquartile range, relative frequency (proportion), significance of differences between groups (Mann — Whitney test, chi-square, Fisher), the presence of a relationship between signs (rank correlation by Spearman).

Results. Monoinfection was diagnosed in 50.6% of patients (81/160), in combination with rota- and noroviruses — in 39.4% (63/160), with bacterial pathogens — in 3.1% (5/160) of patients. Severe forms of the disease were not identified, signs of respiratory failure were observed in 1.9% (3/160) of patients. The gastritis variant of the gastrointestinal tract lesion was more often recorded with monoinfection (p < 0.05), gastroenteritis prevailed in combination with rotavirus infection (55.9%, 33/59). Interestingly, in the same groups, the proportion of children with colitis syndrome was high (23.5%, 19/81 and 40.7%, 24/59, respectively).

Conclusion. Pediatric patients with the «diarrheal variant» of COVID-19 are the children, mostly younger one y. o. or older than seven y. o., with acute, but not «rapid» development of clinical symptoms, not requiring emergency hospitalization, who carry the infection in a mild or moderate form. Among the «intestinal» symptoms, gastritis or enteritis predominate, a short period of diarrhea, less pronounced than with classic AII (in frequency and duration) vomiting syndrome.

Key words: COVID-19, infectious diarrhea, children.

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