2023/06/19 by Rhianna Patel, Terry Segal Heller, Terence Stephensen +1 · 1 voice
Medicine · #Hematological disorders and diagnostics #Long-Term Effects of COVID-19 #Respiratory Support and Mechanisms
paper · doi:10.1136/archdischild-2023-rcpch.367
openalex publication_date 2023/06/19 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
<h3>Objectives</h3> Long Covid in children and young people (CYP) describes a range of symptoms persisting 4–12 weeks after an acute COVID-19 infection (Venkatesan 2021). Gastrointestinal (GI) manifestations of long COVID include diarrhoea, nausea, vomiting, abdominal pain, anorexia, constipation and weight loss. Data on the prevalence of these symptoms and the investigations and treatments used in CYP with Long COVID is unexplored, hence clinical guidance remains uncertain. The primary outcome measure of this systematic review is the pooled prevalence of GI manifestations in Long Covid in CYP. Additionally, the investigations and treatments used in CYP will be evaluated in a narrative review. <h3>Methods</h3> In March 2022, we conducted a systematic literature review to evaluate prevalence of GI symptoms in Long COVID and published approach to investigations and treatment in long COVID amongst CYP. Original data from prospective and retrospective studies were retrieved from 9 databases and from unpublished grey literature. Studies not written in English, reporting PIMS-TS/MIS-C patients, Long COVID patients not meeting the NICE guidelines or not reporting CYP were excluded. Overall, 19 studies met the inclusion criteria: 10 cohort studies, 5 case reports and 4 cross sectional studies. <h3>Results</h3> We assessed study quality using the Newcastle-Ottawa scale. 2 studies were classified as having a low risk of bias, 15 moderate and 5 high. Abdominal pain was the most reported GI symptom in CYP with Long COVID (9.03%), followed by nausea (2.85%) and constipation (2.29%). Table 1 demonstrates the meta-analysis of 14 students, calculating the estimated pooled prevalence of GI symptoms in CYP with Long covid was 18% (95% CI 0–63.5%), with the most prevalent manifestation being diarrhoea (5.39%, 95% CI 0–13.8%). The efficacy of investigations and treatments for these complications were described in 5 case reports. Four treatments and 19 investigations were trialed with inconclusive results. <h3>Conclusions</h3> Meta-analysis suggests that GI manifestations are significant symptoms, present in almost a fifth of CYP with Long COVID, but are not highly prevalent in this population. This comprehensive assessment of published investigations and treatments will increase awareness and assist the development of clinical guidelines in this field. However, the evidence base was limited by a paucity of homogenous studies. Considering the debilitating ongoing effects caused by these symptoms on quality of life of CYP, further high-quality prospective studies, including those evaluating treatments and investigations, are urgently needed to optimize management. <h3>Reference</h3> Venkatesan P. ‘NICE guideline on long COVID’, <i>Lancet Respir Med</i> 2021;<b>9</b>:129.