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:
- A history of contact with a known or suspected case of COVID-19
patient.
- A history of traveling to infected areas or presence in crowded
places.
- Unexplained sign and symptoms of other organ involvement such as
respiratory or cerebral system.
- Lymphopenia, impaired liver function tests or increased inflammatory
markers in lab tests.
The following steps must be taken:
- 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]
- 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]
- 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]
- 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.