Abstract

Background: COVID-19 is currently a public health emergency around the world. Increasingly more people are being identified with this deadly viral disease. Though children experience a milder disease course, severe and life threatening disease has also been reported. An atypical presentation may delay the diagnosis, isolation, and treatment. The aim of this study was to share our experience of atypical presentation of COVID-19 cases as acute abdomen in children.

Method: We retrospectively reviewed data of all children diagnosed to have COVID 19 in our department between April to June 2020. Epidemiological & clinical data of children presented with acute abdomen were retrieved and placed in Microsoft Excel 2016. The data were then analyzed and literature reviewed.

Result: Total 32 children were diagnosed to have COVID 19 during this period. Six children among them presented with features of acute abdomen, without any respiratory symptom. The diagnostic workout for acute abdomen did not match clinical diagnosis rather RT PCR of nasopharyngeal swab was positive for SARS CoV 2. Four of them were female and 2 were male. Age range was 3 years 10 months to 14 years. Only one patient had radiological evidence of lung injury. All of them improved clinically within 4 days and were discharged from the hospital with advice for home isolation.

Conclusion: The clinical course of COVID 19 is yet to understand completely. A high index of suspicion is required for early diagnosis of children with atypical presentation to reduce further transmission of the disease and to avoid serious complications.

Keywords: COVID-19; Acute abdomen; COVID-19 in Children; Atypical presentation of COVID-19; Diagnosis of COVID-19