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• W4311587119 abstract "To the Editors: SARS-CoV-2 infection typically presents with respiratory symptoms, such as rhinitis, cough and dyspnea.1 Although children affected by SARS-CoV-2 might also present uniquely with vomiting or diarrhea,2 the frequency of SARS-CoV-2 positivity among children presenting with an acute gastroenteritis is currently unknown.3,4 The primary aim of this study was to investigate the frequency of SARS-CoV-2 positivity among children with gastroenteritis. The secondary aims were to compare the frequency of SARS-CoV-2 positivity among children with gastroenteritis, with an acute respiratory disease or without any symptom of infection. At the emergency department (ED) of the Fondazione Ca’ Granda Policlinico, Milan, Italy, children presenting with gastroenteritis or a respiratory disease undergo a nasopharyngeal swab for the detection of SARS-CoV-2 by a molecular test. Children requiring an immediate hospitalization are also tested, regardless of their symptoms.5 For this study, we included all children <18 years of age visiting the ED from December 21, 2020, to March 20, 2022, with gastroenteritis (ie, >3 episodes of vomiting or diarrhea in 24 hours). For each child with gastroenteritis, one child with a respiratory disease (rhinitis, cough or dyspnea) and one child requiring hospitalization for conditions without any symptom of infection (eg, trauma) during the same period were included. These children were matched for age (±6 months) and encounter date (±10 days) with those presenting with gastroenteritis. Subjects with both gastrointestinal and respiratory symptoms or without a SARS-CoV-2 swab test were excluded. Children reporting a close contact with a subject with SARS-CoV-2 in the previous 7 days were also excluded. Information on age, sex, date of encounter and the presence of fever (≥37.5 °C) was retrospectively extracted. Data are given as median and interquartile range or frequency, percentage and 95% confidence interval (CI). The χ2-test was used to compare the frequency of SARS-CoV-2 positivity among the 3 study groups. In the study period, 423 children presented to the ED with acute gastroenteritis. The molecular test for SARS-CoV-2 was not available in 13 children. Therefore, 410 children [3.7 (1.4–8.2) years] with gastroenteritis, 410 with a respiratory disease and 410 hospitalized without any infectious symptom were included (Table 1). Fever was more frequent (P < 0.001) in children with respiratory disease than in those with gastroenteritis. The prevalence of SARS-CoV-2 positivity was similar in children with gastroenteritis and with a respiratory disease [8.0% (5.6%–11%) vs. 6.6% (4.4%–9.4%), respectively; P = 0.5], and lower in those without any infectious symptom [3.2% (1.7%–5.4%); P = 0.004]. Among children with fever, those with gastroenteritis and those with a respiratory disease had a similar frequency of SARS-CoV-2 positivity [8.8% (5.3%–14%) vs. 6.0% (3.5%–9.6); P = 0.3]. TABLE 1. - Characteristics of Children With Acute Gastroenteritis, Respiratory Disease or Without Any Symptom of Infection Admitted to the ED Between December 21, 2020, and March 20, 2022 Gastroenteritis Respiratory Disease No Symptom N 410 410 410 Age, y 3.9 [1.5–8.3] 3.4 [1.4–6.8] 3.9 [1.2–8.7] Male 239 (58) 231 (56) 243 (59) Fever 205 (50) 265 (65)* 0 SARS-CoV-2 positivity 33 (8.0)§ 27 (6.6)‡ 13 (3.2)† Children of the 3 groups are matched for age and encounter date. Data are presented as median and interquartile range or frequency and percentage (%).*P < 0.001 gastroenteritis vs. respiratory disease.‡P = 0.5 gastroenteritis vs. respiratory disease.§P = 0.004 gastroenteritis vs. no symptom.†P = 0.034 respiratory disease vs. no symptom. These data suggest that the frequency of SARS-CoV-2 is similar in cases with acute gastroenteritis and with a respiratory disease. Furthermore, both children with respiratory disease and gastroenteritis are more frequently SARS-CoV-2 positive than children without any symptom of infection. Although data were retrospectively collected in a single center, this study has potential implications for clinicians and health policymakers and helps assessing the pretest probability of SARS-CoV-2 positivity among children in ED." @default.
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• W4311587119 date "2022-10-11" @default.
• W4311587119 modified "2023-09-25" @default.
• W4311587119 title "Frequency of SARS-CoV-2 Positivity Among Children Presenting With Gastroenteritis in Emergency Department" @default.
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• W4311587119 doi "https://doi.org/10.1097/inf.0000000000003733" @default.
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