The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the implementation of restrictive measures led to a dramatic reduction in respiratory syncytial virus (RSV) occurrence together with rare and mild bronchiolitis induced by SARS-CoV-2. We described the respiratory picture of SARS-CoV-2 infection and evaluated the frequency and the severity of SARS-CoV-2 bronchiolitis comparing it with other respiratory viral infections in children less than two years of age. The severity of respiratory involvement was evaluated based on the need for oxygen therapy, intravenous hydration, and the length of hospital stay. A total of 138 children hospitalized for respiratory symptoms were enrolled: 60 with SARS-CoV-2 and 78 with RSV. In the group of SARS-CoV-2-infected children, 13/60 (21%) received a diagnosis of co-infection. Among the enrolled children, 87/138 (63%) received a diagnosis of bronchiolitis. The comparative evaluation showed a higher risk of the need for oxygen therapy and intravenous hydration in children with RSV infection and co-infection compared to children with SARS-CoV-2 infection. In the children with a diagnosis of bronchiolitis, no differences in the main outcomes among the groups were observed. Although children with SARS-CoV-2 infection have less severe respiratory effects than adults, the pediatrician should pay attention to bronchiolitis due to SARS-CoV-2, which could have a severe clinical course in younger children.

INTRODUCTION: Disorders of gut-brain interaction (DGBI) are frequently reported in patients with inflammatory bowel disease (IBD), but pediatric data are scarce. We aimed to determine the prevalence of DGBI-like symptoms in children with quiescent IBD compared with healthy controls (HC), and to evaluate their impact on health-related quality of life, anxiety and symptoms burden. METHODS: This multicenter, prospective, observational study enrolled children aged 10–18 years with biochemically quiescent IBD, with or without endoscopic confirmation of remission from 7 European Society of Pediatric Gastroenterology, Hepatology and Nutrition centers (January 2021–August 2023). Age and sex-matched HC were recruited through primary care pediatricians and screened for subclinical inflammation using fecal calprotectin. DGBI were assessed using Rome IV criteria. Health-related quality of life and psychological burden were evaluated using IMPACT III, PROMIS Anxiety, Visceral Sensitivity Index–Child, and Behavioral Response Questionnaire–Child. RESULTS: A total of 253 children were enrolled (IBD: n = 131; HC: n = 122). The prevalence of DGBI-like symptoms did not differ between IBD and HC (34.4% vs 41.8%, P = 0.30). Functional abdominal pain disorders were present in 24.4% of children with IBD. Children with IBD and DGBI-like symptoms showed significantly lower IMPACT III scores compared with those without DGBI [median 74 (interquartile range 62.5–81) vs 84 (70–90); P = 0.001], with the greatest impairment in IBD symptoms, energy, and social domains. PROMIS Anxiety scores were higher in the DGBI group [31 (20–44) vs 21.5 (16–28); P < 0.001], with a greater proportion exceeding the clinical threshold (>50) (17.8% vs 3.5%; P = 0.008). Female sex was the only independent predictor of DGBI (OR 5.2, 95% CI 1.6–16.1; P = 0.005). DISCUSSION: DGBI-like symptoms are common in children with quiescent IBD and are associated with a substantial psychological and quality-of-life burden.