Intussusception in an Infant With SARS-CoV-2 Infection: A Case Report and a Review of the Literature

Abstract

Coronavirus disease 2019 (COVID-19) is caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Even if predominantly considered a respiratory pathogen, it could be associated with gastrointestinal involvement, generally in mild forms. Recent reports highlight the association between SARS-CoV-2 and intussusception in infants. A case of intussusception is hereby described in a previously healthy infant in whom the diagnosis of SARS-CoV-2 was made after the analysis of bronchoalveolar lavage and intraoperative specimens following surgical procedures. Accordingly, a review of infant cases with intussusception and SARS-CoV-2 infection is also reported.

Intussusception and COVID-19 in Children: A Systematic Review and Meta-Analysis

“…Subsequently, 103 articles remained, which were analyzed in full text. In total, 34 studies met our inclusion criteria and reported SARS-CoV-2 infection in pediatric patients with ISN and were included for systematic review and meta-analysis [ 4 , 5 , 6 , 7 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. The detailed characteristics of the included studies are shown in Table 1 .…”

“…The detailed characteristics of the included studies are shown in Table 1 . There were 28 case report [ 4 , 6 , 7 , 15 , 16 , 17 , 18 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], 5 cohort [ 20 , 34 , 42 , 43 , 44 ] and 1 case-series [ 5 ] studies. These studies were conducted in United States (n = 9), Italy (n = 4), United Kingdom (n = 3), China (n = 3), India (n = 3), Iran (n = 2), Colombia (n = 2), Jordan (n = 1), Peru (n = 1), Hungary (n = 1), Guatemala (n = 1), Spain (n = 1), Mexico (n = 1), Pakistan (n = 1), and Turkey (n = 1).…”

“…These studies were conducted in United States (n = 9), Italy (n = 4), United Kingdom (n = 3), China (n = 3), India (n = 3), Iran (n = 2), Colombia (n = 2), Jordan (n = 1), Peru (n = 1), Hungary (n = 1), Guatemala (n = 1), Spain (n = 1), Mexico (n = 1), Pakistan (n = 1), and Turkey (n = 1). The majority of the studies were single center [ 4 , 5 , 7 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 43 , 44 ], and only four studies were multicenter [ 6 , 28 , 36 , 42 ]. Among the 34 included studies, 5 cohort studies were assessed using the NOS: 4 studies were found to be moderate-quality studies (i.e., NOS scores between 5 and 7) and 1 study demonstrated a relatively high quality (i.e., NOS scores > 7).…”

“…The median patient age ranged from 1 to 132 months across the studies. Most of the patients were in the 1-12 months age group (n = 32, 50%), p = 0.001 [ 4 , 5 , 6 , 7 , 15 , 16 , 17 , 18 , 20 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 35 , 36 , 38 , 39 , 40 , 41 , 43 ]. There was an increased male predominance in ISN patients diagnosed with SARS-CoV-2 in most of the studies (n = 41, 64.1%, p = 0.000) [ 4 , 7 , 15 , 16 , 17 , 19 , 21 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 33 , 34 , 36 , 37 , 38 , 39 , 40 , 42 ], and the majority of the patients belonged to White (Caucasian) (n = 25, 39.1%), Hispanic (n = 13, 20.3%) and Asian (n = 5, 7.8%) ethnicity, p = 0....…”

Clinical Characteristics of Pediatric Intussusception And Predictors of Surgery And Bowel Resection In Affected Patients

“…The clinical manifestations of intussusception in children are varied and non-speci c [11][12][13] . The classic triad of pediatric intussusception includes vomiting, abdominal pain, and bloody currant jelly stool/palpable abdominal mass; however, this occurs in fewer than half of affected patients 14 .…”