Gastrointestinal diseases such as celiac disease, functional gastrointestinal disorders (FGIDs), inflammatory bowel disease (IBDs) and acute or chronic diarrhea are quite frequent in the pediatric population . The approach, the diagnosis and management can be changed in the 2019 coronavirus disease (COVID-19) pandemic era . This review has focused on: i) the current understanding of digestive involvement in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected children and adolescents and the clinical implications of COVID-19 for pediatric gastroenterologists, ii) the impact of COVID-19 on the clinical approach to patients with pre-existing or onset diseases, including diagnosis and treatment, and iii) the role and limited access to the instrumental diagnosis such as digestive endoscopy . To date, it is unclear if immunosuppression in patients with IBD and chronic liver disease represents a risk factor for adverse outcomes . Scheduled outpatient follow-up visits may be postponed, especially in patients in remission . Conversely, telemedicine services are strongly recommended . The introduction of new therapeutic regimens should be made on an individual basis, discussing the benefits and risks with each patient . Furthermore, psychological care in all children with chronic disease and their parents should be ensured . All non-urgent and elective endoscopic procedures may be postponed as they must be considered at high risk of viral transmission . Finally, until SARS-CoV-2 vaccination is not available, strict adherence to standard social distancing protocols and the use of personal protective equipment should continue to be recommended.
Index: ACE2, COVID-19, Digestive endoscopy, Functional gastrointestinal disorders, Gastrointestinal symptoms, Inflammatory bowel disease, Liver disease, Pediatrics