Therap Adv Gastroenterol. 2023 Jun 5;16:17562848231177612.doi: 10.1177/17562848231177612. eCollection 2023.

Anna Röckert Tjernberg ¹, Petter Malmborg ^2 3 4, Karl Mårild ^5 6

Author information

¹Department of Pediatrics, Kalmar County Hospital, Region Kalmar County, Kalmar S-391 85, Sweden.

²Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.

³Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.

⁴Department of Medicine Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden.

⁵Department of Pediatrics, Queen Silvia Children's Hospital, Gothenburg, Sweden.

⁶Department of Pediatrics, Institute of Clinical Science, University of Gothenburg, Gothenburg, Sweden.

Abstract

During the past 3 years, the coronavirus disease 2019 (COVID-19) pandemic has had a great impact on people all over the world. However, it has become evident that disease manifestations and severity differ across age groups. Most children have a milder disease course than adults but possibly more pronounced gastrointestinal (GI) symptoms. Given the child's developing immune system, the impact of COVID-19 on disease development may differ compared to adults. This study reviews the potential bi-directional relationship between COVID-19 and GI diseases in children, focusing on common pediatric conditions such as functional GI disorders (FGID), celiac disease (CeD), and inflammatory bowel disease (IBD). Children with GI diseases, in general, and CeD and IBD, in particular, do not seem to have an increased risk of severe COVID-19, including risks of hospitalization, critical care need, and death. While infections are considered candidate environmental factors in both CeD and IBD pathogenesis, and specific infectious agents are known triggers for FGID, there is still not sufficient evidence to implicate COVID-19 in the development of either of these diseases. However, given the scarcity of data and the possible latency period between environmental triggers and disease development, future investigations in this field are warranted.