{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T09:18:32Z","timestamp":1762075112205,"version":"build-2065373602"},"reference-count":108,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T00:00:00Z","timestamp":1668384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Intussusception (ISN) post-COVID-19 infection in children is rare but can occur. SARS-CoV-2 may play a role in the pathogenesis of ISN and trigger immune activation and mesenteric adenitis, which predispose peristaltic activity to \u201ctelescope\u201d a proximal bowel segment into the distal bowel lumen. Objectives: To estimate the prevalence of SARS-CoV-2 infection in ISN children and analyze the demographic parameters, clinical characteristics and treatment outcomes in ISN pediatric patients with COVID-19 illness. Methods: We performed this systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Studies reporting on the incidence of ISN post-SARS-CoV-2 infection in children, published from 1 December 2019 until 1 October 2022, in PROQUEST, MEDLINE, EMBASE, PUBMED, CINAHL, WILEY ONLINE LIBRARY, SCOPUS and NATURE, with a restriction to articles available in the English language, were included. Results: Of the 169 papers that were identified, 34 articles were included in the systematic review and meta-analysis (28 case report, 5 cohort and 1 case-series studies). Studies involving 64 ISN patients with confirmed COVID-19 (all patients were children) were analyzed. The overall pooled proportions of the ISN patients who had PCR-confirmed SARS-CoV-2 infection was 0.06% (95% CI 0.03 to 0.09, n = 1790, four studies, I2 0%, p = 0.64), while 0.07% (95% CI 0.03 to 0.12, n = 1552, three studies, I2 0%, p = 0.47) had success to ISN pneumatic, hydrostatic and surgical reduction treatment and 0.04% (95% CI 0.00 to 0.09, n = 923, two studies, I2 0%, p = 0.97) had failure to ISN pneumatic, hydrostatic and surgical reduction treatment. The median patient age ranged from 1 to 132 months across studies, and most of the patients were in the 1\u201312 month age group (n = 32, 50%), p = 0.001. The majority of the patients were male (n = 41, 64.1%, p = 0.000) and belonged to White (Caucasian) (n = 25, 39.1%), Hispanic (n = 13, 20.3%) and Asian (n = 5, 7.8%) ethnicity, p = 0.000. The reported ISN classifications by location were mostly ileocolic (n = 35, 54.7%), and few children experienced ileo-ileal ISN (n = 4, 6.2%), p = 0.001. The most common symptoms from ISN were vomiting (n = 36, 56.2%), abdominal pain (n = 29, 45.3%), red currant jelly stools (n = 25, 39.1%) and blood in stool (n = 15, 23.4%). Half of the patients never had any medical comorbidities (n = 32, 50%), p = 0.036. The approaches and treatments commonly used to manage ISN included surgical reduction of the ISN (n = 17, 26.6%), pneumatic reduction of the ISN (n = 13, 20.2%), antibiotics (n = 12, 18.7%), hydrostatic reduction of the ISN (n = 11, 17.2%), laparotomy (n = 10, 15.6%), intravenous fluids (n = 8, 12.5%) and surgical resection (n = 5, 7.8%), p = 0.051. ISN was recurrent in two cases only (n = 2, 3.1%). The patients experienced failure to pneumatic (n = 7, 10.9%), hydrostatic (n = 6, 9.4%) and surgical (n = 1, 1.5%) ISN treatment, p = 0.002. The odds ratios of death were significantly higher in patients with a female gender (OR 1.13, 95% CI 0.31\u20130.79, p = 0.045), Asian ethnicity (OR 0.38, 95% CI 0.28\u20130.48, p &lt; 0.001), failure to pneumatic or surgical ISN reduction treatment (OR 0.11, 95% CI 0.05\u20130.21, p = 0.036), admission to ICU (OR 0.71, 95% CI 0.83\u20131.18, p = 0.03), intubation and placement of mechanical ventilation (OR 0.68, 95% CI 0.51\u20131.41, p = 0.01) or suffering from ARDS (OR 0.88, 95% CI 0.93\u20131.88, p = 0.01) compared to those who survived. Conclusion: Children with SARS-CoV-2 infection are at low risk to develop ISN. A female gender, Asian ethnicity, failure to ISN reduction treatment (pneumatic or surgical), admission to ICU, mechanical ventilation and suffering from ARDS were significantly associated with death following ISN in pediatric COVID-19 patients.<\/jats:p>","DOI":"10.3390\/children9111745","type":"journal-article","created":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T02:28:58Z","timestamp":1668479338000},"page":"1745","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Intussusception and COVID-19 in Children: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4552-4513","authenticated-orcid":false,"given":"Saad","family":"Alhumaid","sequence":"first","affiliation":[{"name":"Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zainab","family":"Al Alawi","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulrahman A.","family":"Alnaim","sequence":"additional","affiliation":[{"name":"Department of Pediatric, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed A.","family":"Al Ghamdi","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam 34212, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muneera","family":"Alabdulqader","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Specialty, Pediatric Department, Medical College, King Faisal University, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khalid","family":"Al Noaim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6774-9847","authenticated-orcid":false,"given":"Ali A.","family":"Rabaan","sequence":"additional","affiliation":[{"name":"Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia"},{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"},{"name":"Department of Public Health\/Nutrition, The University of Haripur, Haripur 22620, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koblan M.","family":"Al mutared","sequence":"additional","affiliation":[{"name":"Administration of Pharmaceutical Care, Ministry of Health, Najran 66255, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nourah","family":"Al Dossary","sequence":"additional","affiliation":[{"name":"General Surgery Department, Alomran General Hospital, Ministry of Health, Al-Ahsa 36358, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murtadha","family":"Alsuliman","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hereditary Blood Diseases Centre, Ministry of Health, Al-Ahsa 36422, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yameen Ali","family":"Almatawah","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Infection Control, Pediatric Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Tawffeq","family":"AlOmran","sequence":"additional","affiliation":[{"name":"Division of Infection Control, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Mahmoud","family":"Al HajjiMohammed","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Prince Saud Bin Jalawi Hospital, Ministry of Health, Al-Ahsa 36424, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duaa Riyadh","family":"Alfarhan","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Aljafr General Hospital, Ministry of Health, Al-Ahsa 7110, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hussain Ahmed","family":"Al Suwaiq","sequence":"additional","affiliation":[{"name":"Primary Care Medicine, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36421, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manea M.","family":"Al mutarid","sequence":"additional","affiliation":[{"name":"Nutrition Department, Maternity and Children Hospital, Ministry of Health, Najran 66211, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed Jamal","family":"Alkolib","sequence":"additional","affiliation":[{"name":"Pharmacy Department, New Najran General Hospital, Ministry of Health, Najran 66244, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7623-3343","authenticated-orcid":false,"given":"Ranjan K.","family":"Mohapatra","sequence":"additional","affiliation":[{"name":"Department of Chemistry, Government College of Engineering, Keonjhar 758002, Odisha, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbas","family":"Al Mutair","sequence":"additional","affiliation":[{"name":"Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia"},{"name":"College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia"},{"name":"School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia"},{"name":"Department of Nursing, Prince Sultan Military College, Dharan 34313, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,14]]},"reference":[{"doi-asserted-by":"crossref","unstructured":"Rubenstein, S., Grew, E., Clouser, K., Kwok, A., Veerapandiyan, A., Kornitzer, J., Pecor, K., and Ming, X. 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