COVID-19 News: SARS-CoV-2 Infected Children Show Persisting Gastrointestinal Symptoms Over 18 Months. Lactoferrin Helps
Nikhil Prasad Fact checked by:Thailand Medical News Team Jan 17, 2024 10 months, 5 days, 5 hours, 47 minutes ago
COVID-19 News: As doctors and infected individuals deal with the persistent challenges posed by the COVID-19 pandemic, emerging research sheds light on the long-term consequences of SARS-CoV-2 infection, particularly in children. A recent study conducted by Fondazione Policlinico Universitario A. Gemelli IRCCS-Italy and Università Cattolica del Sacro Cuore explores the temporal evolution of gastrointestinal (GI) symptoms in children infected with SARS-CoV-2, extending the investigation to an 18-month follow-up. Furthermore, the study which is covered in this
COVID-19 News report, delves into the potential therapeutic role of lactoferrin in alleviating persisting GI symptoms.
Lactoferrin Helps Children With Persisting COVID-19 Induced
Gastrointestinal Symptoms
Thailand
Medical News has previously covered studies showing that lactoferrin could be used as an adjuvant in COVID-19 treatment protocols.
https://www.thailandmedical.news/news/numerous-studies-are-showing-that-lactoferrin-can-be-used-as-an-adjuvant-in-covid-19-treatment-protocols
https://www.thailandmedical.news/news/breaking-scientists-find-that-the-otc-drug-diphenhydramine-when-paired-with-lactoferrin-could-be-a-new-therapeutic-for-covid-19
Understanding Long COVID in Children
Long COVID, or post-COVID condition (PCC), is recognized as a prolonged aftermath of SARS-CoV-2 infection, affecting both adults and children. Approximately 40% of patients experience at least one symptom of long COVID after an acute infection. In the pediatric population, around one-quarter of children continue to exhibit long COVID symptoms even a year after the initial infection. The heterogeneity of long COVID encompasses various clinical manifestations, impacting multiple organ systems, including respiratory, cardiovascular, neurocognitive, musculoskeletal, and gastrointestinal.
GI System as a Target for SARS-CoV-2
Among the various systems affected by SARS-CoV-2, the GI system stands out as a specific target, with symptoms reported across the entire spectrum of infection, from acute to post-COVID complications. The pathophysiology of acute and chronic GI symptoms in children remains unclear, with potential mechanisms including persistent viral presence in the gut, local inflammation, subcellular damage, immunity-triggered inflammation, and alterations in the microbiota. Additionally, GI inflammation may contribute to dysautonomia and postural orthostatic tachycardia syndrome (POTS).
Research Gap in Pediatric Long COVID
Despite significant progress in understanding long COVID in adults, research on pediatric long COVID has lagged behind. The temporal evolution of GI symptoms in children, especially over an extended period, remains unexplored. Moreover, the optimal management of chronic GI symptoms in children with long COVID remains uncertain. However, considering potential pathogenetic mechanisms, certain strategies such as probiotics and lactoferrin have been proposed as therapeutic possibilities.
Study Overview and Population
The retrospective study conducted by the Italian researchers involved 1224 pediatric patients, with 47.7% females. Among the participants, 19.8% were vaccinated, and 11.5% had comorbidities. The study aimed to investigate the temporal evolution of GI symptoms in children with SARS-CoV-2 from acute infection to an 18-month follow-up. Additionally, the study explored the role of lactoferrin in improving GI symptoms in comparison to untreated children.
Results and Temporal Evolution of GI Symptoms
During acute infection, 14.1% of the children presented with GI symptoms, with a subsequent decrease over the follow-up periods: 4.4% at three months, 1.9% at six months, 3.3% at twelve months, and 2.3% at eighteen months. Children treated with oral lactoferrin for three months showed a trend toward less persisting GI symptoms at six months compared to untreated children, although this difference was not statistically significant (25% vs. 33.3%, p = 0.73).
Discussion and Potential Role of Lactoferrin
The study marks a pioneering effort in investigating the long-term evolution of GI symptoms in children with SARS-CoV-2 and exploring the potential efficacy of lactoferrin in managing these symptoms. Lactoferrin, known for its antimicrobial, anti-inflammatory, antioxidant, and immunomodulating properties, has been considered a potential therapeutic option for COVID-19 and long COVID.
Lactoferrin's immunomodulatory effects, including its impact on innate and acquired immunity, as well as its ability to enhance immunity against viral and bacterial diseases, make it a compelling candidate for investigation. Additionally, lactoferrin's effects on plasminogen, vital for fibrin clot degradation and other processes implicated in long COVID, provide a multifaceted rationale for its potential efficacy.
Furthermore, lactoferrin's impact on the gut microbiome, promoting the elimination of pathogenic bacteria and enhancing beneficial ones, underscores its relevance in addressing gut dysbiosis associated with long COVID. Studies in pediatric patients have demonstrated lactoferrin's safety and efficacy in modulating gut microbiota.
Conclusion and Future Directions
The study reveals the relatively common occurrence of GI symptoms in children during acute SARS-CoV-2 infection, persisting for up to 12–18 months in a non-negligible proportion. The preliminary observation suggests a potential trend toward faster improvement of persisting GI symptoms in children with long COVID treated with lactoferrin.
While acknowledging the limitations of the retrospective design and the need for a placebo-controlled randomized trial, the study provides a foundation for future research. The call for larger prospective trials, especially in children with long COVID characterized by GI symptoms, is essential to determine the therapeutic role of lactoferrin and explore its potential as a preventative therapeutic approach. As the world continues to grapple with the aftermath of the COVID-19 pandemic, such research endeavors pave the way for effective management strategies, improving the quality of life for children affected by long COVID.
The study findings were published in the peer reviewed journal: Children.
https://www.mdpi.com/2227-9067/11/1/105
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