Covid, “symptom-like peritonitis in small children”

“In very young children, under the age of 4, Sars-Cov-2 infection can present itself as a similar peritonitis, which often requires surgery. It is an important symptom that pediatric surgeons need to know because, clinically , the disease can present, exclusively, with acute pain similar to appendicitis “. Claudio Spinelli, professor of pediatric surgery at the University of Pisa, director of the pediatric surgery section of the university hospital of the Tuscan city, explains this to Salute, inviting “not to be alarmed about the risks of infection in the pediatric range” but also “not to neglect the question which, however, exists, particularly in this phase of the epidemic in which the English variant, with its greater contagiousness than the initial virus, is increasingly widespread”.

With Covid “children – explains Spinelli – have both medical and surgical problems. And sometimes they can even be serious. The English variant enters the cell and attaches more easily to the Ace2 receptors. They are receptors that children have in much lower number than adults. But the fact that this virus has an extremely high infectious capacity, despite the smaller number of these receptors, means that the little ones are still infected more easily than in the first period. In the hospital, in fact, we had more hospitalizations “.

In general “we have many asymptomatic or slightly symptomatic children, about 75% of the infected. We have, however, seen severe forms in the youngest, with less than 2 years. And we have had cases with localization in the intestine, with clinical symptoms similar to appendiceal in reality they are linked to severe vasculitis, which can cause massive ischemia affecting the small intestine or colon or intra-abdominal abscesses. Unfortunately, these children must be operated on and intestinal resections must be made. And sometimes, albeit rarely, these cases have had an inauspicious outcome “.

On the subject there are already “studies in progress, some published”, recalls Spinelli, stressing that children are still the population least affected by the virus. In the pediatric age group, “children aged 14 to 19 are the ones who contract the virus the most, with 150 cases per 100 thousand. An incidence that drops sharply between the ages of 3 and 5 with 120 cases per 100 thousand. Between 0 -3 years we arrive at 100 cases out of 100 thousand. These are smaller numbers than the rest of the population, but still important and we must keep them in mind because we often tend to underestimate them “.


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