COVID-19 and gastrointestinal injury: a brief systematic review and data from Bulgaria

In December 2019, a new Coronavirus (SARS-CoV-2) emerged in China, causing the pandemic disease COVID-19. The clinical presentation is variable, but the predominant symptoms are those of the upper respiratory tract.

AIM

The aim of the current study is to describe the incidence and type of the gastrointestinal injury (GI) in COVID-19, as well as their prognostic value.

MATERIALS AND METHODS

We conducted a coincidental search on this topic in PubMed, Web of Science and EMBASE. We also followed a group of 31 Bulgarian COVID-19 patients throughout the course of their disease and analyzed their symptoms (catarrhal and other) and outcome.

RESULTS

The publications concerning our survey followed a total of 1509 COVID-19 patients. In the Bulgarian cohort, only 14 from the 31 patients were laboratory-confirmed COVID-19 cases. Approximately 1/3 of the infected individuals presented with GI. In some patients this was the first, or only, symptom of the disease. It was also indicative of a more severe disease course.

CONCLUSION

GI may be an important symptom and prognostic factor in COVID-19. Therefore, patients with acute gastrointestinal symptoms must be actively tested for SARS-CoV-2.

Investigation of Salmonella enteritidis outbreak in four kindergartens

In June 2018, in the city of Sofia, Bulgaria, 40 children from four different kindergartens suffered from salmonellosis caused by S. enteritidis. They were reported to have consumed food prepared and delivered by a private catering service. The patients had fever, diarrhea, and some had vomiting and abdominal pain. Sixteen of them were treated in hospital, and the other 24 received home treatment. Some of the outpatients received antibiotic treatment despite WHO recommendations. All 40 isolates were positive for O: D, H: gm and H: m, and were confirmed to be Salmonella enteritidis, respectively. Using conventional and molecular methods, such as serotyping, Multiplex-PCR and PFGE, it was confirmed that the strains were epidemiologically related. Based on molecular genetic methods, we established that the epidemic outbreak had a common origin: contaminated food delivered by a private catering service, which was consumed at all four kindergartens.

[Parental information about the basic causes for dental-jaw deformities]

A total of 610 parents of children from pediatric institutions have been questioned in connection with their information about some of the basic causes of dental-jaw deformities and about their information sources. The results obtained reveal that the parents carefully observe in their children and detect almost always their harmful habits as sucking and oral breathing. What they lack is proper information and motivation to timely cope with those causes as well as to ask for the aid of the stomatologist when necessary. According to the parents, the most important is the role of the stomatologist and the mass media for their information. It is necessary, however, a more active use of those means as well as of the other health and educational workers associated with the rearing and education of the children so as to achieve a more effective health educational activity.