Background: The aim of this study was to identify gastrointestinal (GI) and liver injury presentations in children admitted with COVID-19 infection. Methods: In this retrospective study, we studied all children with suspected symptoms of COVID-19, referred to Amirkola Children’s Hospital. Clinical manifestations of the digestive and respiratory systems and liver function tests were evaluated for all cases. Results: Eighteen children were studied. The most common clinical symptoms were fever, anorexia, weakness, nausea and vomiting, cough, diarrhea, and abdominal pain, respectively. Also, 5/18 (27.8%) and 7/18 (38.9%) of cases had abnormally high alanine aminotransferase (ALT), aspartate aminotransferase (AST), respectively. Additionally, in icteric cases, direct bilirubin was raised. There was no significant relationship between pulmonary lesions and abnormal excess in ALT (P = 0.59) and AST (P = 0.62). Conclusion: The findings showed that there were no severe clinical GI symptoms in children with COVID-19 infection. Besides, children with increased liver enzymes did not have more respiratory involvement than those without a rise in liver enzymes.

Background: One of the main aspects of the treatment in patients with cystic fibrosis (CF) is the effective clearing of airway secretions. Inhaled hypertonic saline (HTS) and mannitol are among drugs used for this purpose. There are two forms of mannitol, including dry-powder and soluble form. We used soluble mannitol in this study. Objectives: The aim of this study was to evaluate the effect of inhaled soluble mannitol on the pulmonary function of patients with CF as well as its comparison with 5% HTS. Methods: This clinical trial study was performed on 30 children with CF ≥ 5 years of age who referred to the CF clinic in Mofid Children's Hospital. Patients were divided into two groups, including soluble mannitol and 5% HTS group. At baseline and two weeks after the treatment, a spirometry test was done and forced expiratory flow in 1 second (FEV1), forced vital capacity (FVC), and Forced expiratory flow between 25% and 75% of forced vital capacity (FEF25-75%) were measured. Results: The mean of FEV1, FVC, and FEF25-75% in the mannitol group before the treatment were 96 ± 30.5%, 99 ± 27%, and 76.3 ± 36.3%, and after the treatment were 100.5 ± 29%, 103.5 ± 23.7%, and 79.9 ± 37.3%, respectively. The difference of FEV1 before and after mannitol was statistically significant (P = 0.031). The mean of FEV1, FVC, and FEF25-75% in 5% HTS group were 96.2 ± 25.5%, 99 ± 19.8% and 77.8 ± 35.6% before the treatment and 95.2 ± 20.1%, 99.3 ± 19.2%, 74.2 ± 29.5% after the treatment. There was no significant difference in 5% HTS group. Conclusions: Inhaled soluble mannitol improved pulmonary function of patients with CF and its effect was better than 5% HTS.