Introduction
Gastrointestinal symptoms in children with SARS-CoV-2 infection
SARS-CoV-2 and gastrointestinal diseases
SARS-CoV-2 and inflammatory bowel disease
SARS-CoV-2 and chronic liver diseases
SARS-CoV-2 and functional gastrointestinal disorders
Psychological functioning
Pediatric gastrointestinal diseases in the era of SARS-CoV-2 | |
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• Corticosteroids may be used as induction therapy in IBD children, and steroid weaning should be made on an individual basis | |
• Treatment with biologics or other conventional immunomodulators should be started and/or regularly continued in IBD pediatric patients | |
• Patients with autoimmune hepatitis should not reduce or stop the immunosuppressive therapy to avoid acute flares of disease and unnecessary hospital admission | |
• In patients with chronic hepatitis C already on treatment with oral direct-acting antiviral, therapy should be continued | |
• Children and adolescents presenting with chronic diarrhea and abdominal pain and a recent history of gastrointestinal disorders should undergo serological SARS-CoV-2 testing | |
• Antitransglutaminase IgA threshold for biopsy-sparing approach for diagnosis of celiac disease may be reduced to ≥5 times upper limit normal | |
• Psychological assistance services for patients suffering from chronic gastrointestinal diseases and their parents should be ensured |
Digestive endoscopy
Digestive endoscopy in the SARS-CoV-2 era | |
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• Endoscopy must be performed in all urgent cases; elective procedures should be deferred | |
• Endoscopic procedures should not be postponed in cases of new diagnoses of inflammatory bowel disease and the occurrence of severe acute flares or complications | |
• All patients should be tested by naso-pharyngeal swab 24–48 h before endoscopic procedures | |
• Negative pressure rooms should be used for with confirmed SARS-CoV-2 infection | |
• All endoscopy staff members must wear personal protective equipment and frequently wash their hands with alcoholic solutions before and after procedures | |
• Endoscopic room and equipment should be sterilized after each patient’s procedure |