Objective: COVID-19 patients presenting with gastrointestinal (GI) symptoms occur in both adults and children. To date, however, no large sample size study focusing on gastrointestinal symptoms in pediatric cases has been published. We analyzed COVID-19 infected children in Wuhan who presented with initial GI symptoms to determine the GI characteristics and epidemiological trend of the disease. Design: We retrospectively analyzed 244 children patients confirmed with COVID-19 at Wuhan Children's Hospital from 21 Jan to 20 Mar 2020. Symptomatic cases were divided into two groups according to whether the patients presented with or without GI symptoms on admission. Demographic, epidemiological, symptoms, and laboratory data were compared. We also analyzed the respective trends of case number changes of GI cases and asymptomatic cases. Results: 34 out of 193 symptomatic children had GI symptoms. They had lower median age and weight, a higher rate of fever, a longer length of stay and more hematological and biochemical abnormalities than patients without GI symptoms. There was no significant difference in chest CT findings or stool SARS-CoV-2 test positive percentages between the two groups. The number of patients admitted with GI symptoms showed an overall downward trend with time. At the time of writing, 242 patients were discharged, one died, and one critically ill patient was still in the intensive care unit. Conclusion: COVID-19 infected children with GI symptoms are prone to presenting with more clinical and laboratory abnormalities than patients without GI symptoms. More attention and timely hospital admission are needed for these patients.

中文翻译：

---

有胃肠道症状的COVID-19感染儿童与没有症状的儿童不同吗？武汉市244例小儿临床特点及流行病学趋势的比较研究。

目的：具有胃肠道（GI）症状的COVID-19患者在成人和儿童中均会发生。然而，迄今为止，尚未发表针对儿童病例中胃肠道症状的大样本研究。我们分析了武汉市出现最初GI症状的COVID-19感染儿童，以确定该疾病的GI特征和流行病学趋势。设计：我们回顾分析了2020年1月21日至3月20日在武汉市儿童医院确诊为COVID-19的244例儿童患者。根据入院时有无胃肠道症状的症状患者将其分为两组。比较了人口统计学，流行病学，症状和实验室数据。我们还分析了胃肠道疾病病例和无症状病例的病例数变化的趋势。结果：193名有症状的儿童中有34名患有胃肠道症状。与没有胃肠道症状的患者相比，他们的中位年龄和体重更低，发烧率更高，住院时间更长，血液和生化异常更多。两组之间的胸部CT检查结果或粪便SARS-CoV-2测试阳性百分比没有显着差异。接受胃肠道症状的患者数量随时间呈总体下降趋势。在撰写本文时，有242例患者出院，死亡，1例重症患者仍在重症监护室。结论：与没有GI症状的患者相比，患有GI症状的COVID-19感染的儿童更容易出现临床和实验室异常。这些患者需要更多的关注并及时入院。