Turkish Archives of Pediatrics
Original Article

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


Department of Pediatrics, Division of Pediatric Infectious Diseases, Selçuk University, Faculty of Medicine, Konya, Turkey


Department of Pediatrics, Division of Pediatric Gastroenterology, Selçuk University, Faculty of Medicine, Konya, Turkey


Department of Medical Microbiology, Selçuk University, Faculty of Medicine, Konya, Turkey


Department of Biostatistics, Selçuk University, Faculty of Medicine, Konya, Turkey

Turk Arch Pediatr 2022; 57: 413-420
DOI: 10.5152/TurkArchPediatr.2022.22011
Read: 198 Downloads: 65 Published: 01 July 2022

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 accord- ing 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.

Cite this article as: Alkan G, Emiroğlu M, Tüter Öz SK, Emiroğlu HH, Türk Dağı H, Körez MK. Gastrointestinal and liver manifestations in children with COVID-19 and their relationship to clinical course. Turk Arch Pediatr. 2022;57(4):413-420

EISSN 2757-6256