Diarrhea as a presenting symptom of coronavirus disease 2019 in children

Document Type : CASE REPORT


1 Department of Pediatrics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran

2 Department of Pediatrics, Faculty of Medicine; Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

3 Massachusetts Eye and Ear Infirmary, Harvard University, Boston, Massachusetts, USA

4 Department of Pediatrics, Endocrinology and Metabolism Population, Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

5 Department of Anesthesiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran


Gastroenteritis is common among children and is usually caused by bacterial, viral, or parasitic gastrointestinal infections. The occurrence of gastroenteritis as the only symptom of coronavirus disease 2019 (COVID-19) is an uncommon condition. We present a 16-month-old girl that has recently been admitted to our hospital with vomiting, diarrhea, and lethargy, who was ultimately diagnosed with COVID-19. This case shows that the clinical manifestations of COVID-19 can be misleading in children.


Ludvigsson JF. Systematic review of COVID-19 in children show milder cases and a better prognosis than adults. Acta Paediatr 2020;109:1088-95.  Back to cited text no. 1
Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 infection in children. N Engl J Med 2020;382:1663-5.  Back to cited text no. 2
Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics 2020;16:16.  Back to cited text no. 3
Karimi A, Rafiei Tabatabaei S, Rajabnejad M, Pourmoghaddas Z, Rahimi H, Armin S, et al. An algorithmic approach to diagnosis and treatment of coronavirus disease 2019 (COVID-19) in children: Iranian expert's consensus statement, Arch Pediatr Infect Dis 2020;8:e102400.  Back to cited text no. 4
Kargar M, Zare M, Najafi A. Molecular epidemiology of rotavirus strains circulating among children with gastroenteritis in Iran. Iran J Pediatr 2012;22:63-9.  Back to cited text no. 5
Sanaei Dashti A, Ghahremani P, Hashempoor T, Karimi A. Molecular epidemiology of enteric adenovirus gastroenteritis in under-five-year-old children in Iran. Gastroenterol Res Pract 2016;2016:2045697.  Back to cited text no. 6
Hong H, Wang Y, Chung HT, Chen CJ. Clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children. Pediatrics & Neonatology 2020:61,:131-132.   Back to cited text no. 7
Qiu H, Wu J, Liang H, Yunling L, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: An observational cohort study. Lancet Infect Dis 2020;20;6,689-96. [Doi: 10.1016/S1473-3099(20)30198-5].  Back to cited text no. 8
Sun D, Li H, Lu XX, Xiao H, Ren J, Zhang FR, et al. Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: A single center's observational study. World J Pediatr 2020:16:251–259  Back to cited text no. 9
Aronoff DM, Neilson EG. Antipyretics: Mechanisms of action and clinical use in fever suppression. Am J Med 2001;111:304-15.  Back to cited text no. 10
Vestjens SM, Spoorenberg SM, Rijkers GT, Grutters JC, van de Garde EM, Meijvis SC, et al. Antipyretic effect of dexamethasone in community-acquired pneumonia. Eur Respir J 2015;46:570-3.  Back to cited text no. 11