{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T22:17:11Z","timestamp":1773613031835,"version":"3.50.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Describe the incidence and associated outcomes of gastrointestinal (GI) manifestations of acute coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in hospitalized children (MIS-C).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Retrospective review of the Viral Infection and Respiratory Illness Universal Study registry, a prospective observational, multicenter international cohort study of hospitalized children with acute COVID-19 or MIS-C from March 2020 to November 2020. The primary outcome measure was critical COVID-19 illness. Multivariable models were performed to assess for associations of GI involvement with the primary composite outcome in the entire cohort and a subpopulation of patients with MIS-C. Secondary outcomes included prolonged hospital length of stay defined as being &gt;75th percentile and mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Of the 789 patients, GI involvement was present in 500 (63.3%). Critical illness occurred in 392 (49.6%), and 18 (2.3%) died. Those with GI involvement were older (median age of 8 yr), and 18.2% had an underlying GI comorbidity. GI symptoms and liver derangements were more common among patients with MIS-C. In the adjusted multivariable models, acute COVID-19 was no associated with the primary or secondary outcomes. Similarly, despite the preponderance of GI involvement in patients with MIS-C, it was also not associated with the primary or secondary outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>GI involvement is common in hospitalized children with acute COVID-19 and MIS-C. GI involvement is not associated with critical illness, hospital length of stay or mortality in acute COVID-19 or MIS-C.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/inf.0000000000003589","type":"journal-article","created":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T17:00:34Z","timestamp":1653670834000},"page":"751-758","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":15,"title":["Gastrointestinal Manifestations in Hospitalized Children With Acute SARS-CoV-2 Infection and Multisystem Inflammatory Condition: An Analysis of the VIRUS COVID-19 Registry"],"prefix":"10.1097","volume":"41","author":[{"given":"Imran A.","family":"Sayed","sequence":"first","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Utpal","family":"Bhalala","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital of San Antonio, San Antonio and Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larisa","family":"Strom","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, OSF Saint Francis Medical Centre\/University of Illinois College of Medicine at Peoria, Peoria, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John S.","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Michaud","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital of San Antonio, San Antonio and Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Chiotos","sequence":"additional","affiliation":[{"name":"Division of Critical Care and Anesthesia, Department of Pediatrics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heda R.","family":"Dapul","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Pediatrics, NYU Langone Medical Center, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varsha P.","family":"Gharpure","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Pediatrics, Advocate Children\u2019s Hospital, Park Ridge, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica C.","family":"Bjornstad","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia A.","family":"Heneghan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Minnesota Masonic Children\u2019s Hospital, Minneapolis, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Irby","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Pediatrics, Arkansas Children\u2019s Hospital, Little Rock, Arkansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicki","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Pediatrics, University of Louisville and Norton Children\u2019s Hospital, Louisville, Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Pediatrics, NYU Langone Medical Center, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manoj","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Lincoln Hospital, Bronx, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Boman","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, Society of Critical Care Medicine, Mount Prospect, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikas","family":"Bansal","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan J.","family":"Walkey","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vishakha K.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, Society of Critical Care Medicine, Mount Prospect, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7427-670X","authenticated-orcid":false,"given":"Katja M.","family":"Gist","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the VIRUS Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.15585\/mmwr.mm6932e2","article-title":"COVID-19-associated multisystem inflammatory syndrome in children - United States, March-July 2020.","volume":"69","author":"Godfred-Cato","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"R2-20250614","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1002\/jgh3.12456","article-title":"Gastrointestinal and hepatic manifestations of COVID-19: a systematic review and meta-analysis.","volume":"5","author":"Dorrell","year":"2020","journal-title":"JGH Open"},{"key":"R3-20250614","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1111\/apt.15731","article-title":"Review article: gastrointestinal features in COVID-19 and the possibility of faecal transmission.","volume":"51","author":"Tian","year":"2020","journal-title":"Aliment Pharmacol Ther"},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1056\/NEJMoa2021756","article-title":"Multisystem inflammatory syndrome in children in New York State.","volume":"383","author":"Dufort","year":"2020","journal-title":"N Engl J Med"},{"key":"R5-20250614","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1016\/j.cgh.2020.09.041","article-title":"Digestive manifestations in patients hospitalized with coronavirus disease 2019.","volume":"19","author":"Elmunzer","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"R6-20250614","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1186\/s12985-015-0448-4","article-title":"Prevalence of gastrointestinal symptoms in patients with influenza, clinical significance, and pathophysiology of human influenza viruses in faecal samples: what do we know?","volume":"12","author":"Minodier","year":"2015","journal-title":"Virol J"},{"key":"R7-20250614","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.1016\/S2352-4642(20)30165-6","article-title":"Gastrointestinal features in children with COVID-19: an observation of varied presentation in eight children.","volume":"4","author":"Tullie","year":"2020","journal-title":"Lancet Child Adolesc Health"},{"key":"R8-20250614","doi-asserted-by":"crossref","first-page":"608259","DOI":"10.3389\/fmed.2020.608259","article-title":"Gastrointestinal symptoms associated with unfavorable prognosis of COVID-19 patients: a retrospective study.","volume":"7","author":"Chen","year":"2020","journal-title":"Front Med (Lausanne)"},{"key":"R9-20250614","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/MCG.0000000000001424","article-title":"The prevalence of gastrointestinal symptoms, abnormal liver function, digestive system disease and liver disease in COVID-19 infection: a systematic review and meta-analysis.","volume":"55","author":"Dong","year":"2021","journal-title":"J Clin Gastroenterol"},{"key":"R10-20250614","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1002\/jgh3.12415","article-title":"The prevalence of gastrointestinal symptoms among patients with COVID-19 and the effect on the severity of the disease.","volume":"4","author":"Sulaiman","year":"2020","journal-title":"JGH Open"},{"key":"R11-20250614","doi-asserted-by":"crossref","first-page":"e459","DOI":"10.1097\/INF.0000000000002935","article-title":"COVID-19 gastrointestinal manifestations are independent predictors of PICU admission in hospitalized pediatric patients.","volume":"39","author":"Gonzalez Jimenez","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"R12-20250614","doi-asserted-by":"crossref","first-page":"e0113","DOI":"10.1097\/CCE.0000000000000113","article-title":"The viral infection and respiratory illness universal study (VIRUS): an International Registry of Coronavirus 2019-related critical illness.","volume":"2","author":"Walkey","year":"2020","journal-title":"Crit Care Explor"},{"key":"R13-20250614","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2013a metadata-driven methodology and workflow process for providing translational research informatics support.","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"R14-20250614","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.15585\/mmwr.mm6932e3","article-title":"Hospitalization rates and characteristics of children aged <18 years hospitalized with laboratory-confirmed COVID-19 - COVID-NET, 14 States, March 1-July 25, 2020.","volume":"69","author":"Kim","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"R17-20250614","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1001\/jamapediatrics.2020.1948","article-title":"Characteristics and outcomes of children with coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian Pediatric Intensive Care Units.","volume":"174","author":"Shekerdemian","year":"2020","journal-title":"JAMA Pediatr"},{"key":"R18-20250614","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1001\/jama.2021.2091","article-title":"Characteristics and outcomes of US children and adolescents with multisystem inflammatory syndrome in children (MIS-C) compared with severe acute COVID-19.","volume":"325","author":"Feldstein","year":"2021","journal-title":"JAMA"},{"key":"R19-20250614","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/INF.0000000000002660","article-title":"Coronavirus infections in children including COVID-19: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children.","volume":"39","author":"Zimmermann","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"R20-20250614","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/S2468-1253(20)30126-6","article-title":"Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis.","volume":"5","author":"Mao","year":"2020","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"R21-20250614","doi-asserted-by":"crossref","first-page":"e317","DOI":"10.1097\/INF.0000000000002843","article-title":"Gastrointestinal symptoms in severe COVID-19 children.","volume":"39","author":"Giacomet","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"R22-20250614","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1053\/j.gastro.2020.05.079","article-title":"Gastrointestinal symptoms as a major presentation component of a novel multisystem inflammatory syndrome in children that is related to coronavirus disease 2019: a single center experience of 44 cases.","volume":"159","author":"Miller","year":"2020","journal-title":"Gastroenterology"},{"key":"R23-20250614","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1007\/s00431-021-03993-5","article-title":"Multisystem inflammatory syndrome in children related to COVID-19: a systematic review.","volume":"180","author":"Hoste","year":"2021","journal-title":"Eur J Pediatr"},{"key":"R24-20250614","doi-asserted-by":"crossref","first-page":"121","DOI":"10.21037\/tp-20-188","article-title":"Multisystem inflammatory syndrome in children during the coronavirus disease 2019 (COVID-19) pandemic: a systematic review of published case studies.","volume":"10","author":"Tang","year":"2021","journal-title":"Transl Pediatr"},{"key":"R25-20250614","first-page":"51","article-title":"Multi-system inflammatory syndrome in children & adolescents (MIS-C): a systematic review of clinical features and presentation.","volume":"38","author":"Radia","year":"2021","journal-title":"Paediatr Respir Rev"},{"key":"R26-20250614","doi-asserted-by":"crossref","first-page":"e340","DOI":"10.1097\/INF.0000000000002888","article-title":"A systematic review of multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection.","volume":"39","author":"Kaushik","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"R27-20250614","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1097\/MPG.0000000000002953","article-title":"Features of intestinal disease associated with COVID-related multisystem inflammatory syndrome in children.","volume":"72","author":"Sahn","year":"2021","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"R28-20250614","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1111\/j.1467-842X.2001.tb00294.x","article-title":"How can I deal with missing data in my study?","volume":"25","author":"Bennett","year":"2001","journal-title":"Aust N Z J Public Health"}],"container-title":["Pediatric Infectious Disease Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/INF.0000000000003589","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T00:09:22Z","timestamp":1749946162000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/INF.0000000000003589"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,27]]},"references-count":26,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/inf.0000000000003589","relation":{},"ISSN":["0891-3668"],"issn-type":[{"value":"0891-3668","type":"print"}],"subject":[],"published":{"date-parts":[[2022,5,27]]}}}