Conclusion
In the current SARS-CoV-2 epidemic, all the focus is on the respiratory symptoms of the disease, while recent studies have shown that, gastrointestinal symptoms such as diarrhea are increasing in patients with COVID-19. The number of days from the onset of symptoms to hospitalization is significantly higher in patients with gastrointestinal symptoms compared to patients without gastrointestinal symptoms; as a result complications and prognosis are worse in patients with gastrointestinal symptoms.[7] This fact indicates the need to develop a screening and diagnostic algorithm in dealing with a child with diarrhea in the epidemic SARS-CoV-2. [4]
In any patient with acute and watery diarrhea, with or without vomiting, abdominal pain, fever, or respiratory symptoms, if it has one of the following:
The following steps must be taken:
  1. Preventive precautions should be taken according to the last version of protocol (approach to a child suspected to COVID-19). Patients should be placed in an isolated room, the care giver must wear appropriately mask on face, and avoid direct contact with respiratory and other secretions and should also wash hands with soap and water. [8, 10, 11]
  2. According to the recommended protocol, send CBC, CRP, a sample for SARS-CoV-2 PCR and CXR with or without CT; and also appropriate treatment measures includes supportive care and special treatment should be considered.[8, 11]
  3. Evaluate patient for Multi systemic inflammatory syndrome (MIS-C) criteria in according to the last protocol (approach to a child with MIS-C suspected to COVID-19).[12]
  4. After discharge, the patient should be isolated at home and preventive measures and warning signs should be taught to the patient and remind him that come back to hospital if warning signs develops.