medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-217medsovet-8431Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYПостинфекционные гастроинтестинальные расстройства и возможности их коррекцииPost-infection gastrointestinal disorders and treatment optionshttps://orcid.org/0000-0003-2923-1630БехтереваМ. К.BekhterevaM. K.

Бехтерева Мария Константиновна, к.м.н., старший научный сотрудник отдела кишечных инфекций; доцент кафедры инфекционных заболеваний у детей факультета послевузовского и дополнительного профессионального образования

195276, Санкт-Петербург, ул. Профессора Попова, д. 9

194100, Санкт-Петербург, ул. Литовская, д. 2

Mariya K. Bekhtereva, Cand. Sci. (Med.), Associate Professor of the Department of Infectious Diseases in Children, Faculty of Postgraduate and  Additional Professional Education; Senior Researcher of the Department of Intestinal Infections

9, Professor Popov St., St Petersburg, 195276

2, Litovskaya St., St Petersburg, 194100

mkbechtereva@mail.ruhttps://orcid.org/0000-0002-4516-4194БогдановаН. М.BogdanovaN. M.

Богданова Наталья Михайловна, к.м.н., доцент кафедры пропедевтики детских болезней с курсом общего ухода за детьми

194100, Санкт-Петербург, ул. Литовская, д. 2

Natalia M. Bogdanova, Cand. Sci. (Med.), Associate Professor of the Department of Propaedeutics of Childhood Diseases with a course in General Child Care

2, Litovskaya St., St Petersburg, 194100

natasha.bogdanov@mail.ruДетский научно-клинический центр инфекционных болезней; Санкт-Петербургский государственный педиатрический медицинский университетРоссияChildren’s Research and Clinical Center for Infectious Diseases; St Petersburg State Pediatric Medical UniversityRussian FederationСанкт-Петербургский государственный педиатрический медицинский университетРоссияSt Petersburg State Pediatric Medical UniversityRussian Federation20240608202401184–91Copyright © Бехтерева М.К., Богданова Н.М., 20242024Бехтерева М.К., Богданова Н.М.Bekhtereva M.K., Bogdanova N.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8431

Развитие постинфекционной патологии определяется видом возбудителя, генезом повреждения кишечного барьера и преморбидным фоном ребенка. В масштабах последних эпидемиологических событий внимание привлекает вирус SARS-CoV-2, который обладает тропизмом к клеткам желудочно-кишечного тракта, искажает состав и функцию микробиома кишечника. Выделена важность функций кишечных микробов в генезе и исходе инфекции SARS-CoV-2. Доказано, что расстройство микробиоты при новой коронавирусной инфекции отражается не только на длительности и тяжести инфекционного процесса, но и на риске формирования системных заболеваний и злокачественных новообразований. После острой фазы инфекции SARS-CoV-2 может возникнуть постковидный синдром, патофизиология которого до конца не установлена, хотя считается, что основной причиной его появления является диверсификация микробного пейзажа кишечника на фоне прямого воздействия SARS-CoV-2 на ACE2-рецепторы кишечных эпителиоцитов с последующим патоиммунным ответом и нарушением гемостаза. Установившийся постковидный дисбиоз лежит в основе функциональных гастроинтестинальных расстройств с выраженным нарушением в оси «мозг – кишка – микробиота» и разбалансировкой мигрирующего моторного комплекса, что приводит к развитию запора. Постинфекционные запоры дебютирую в течение первых 3 мес. после перенесенной острой инфекции. Главная цель терапии постинфекционного запора – достижение регулярной безболезненной дефекации мягкой консистенции и профилактика калового завала. Многочисленные зарубежные исследования и клинические рекомендации указывают на то, что стимулирующие слабительные эффективны и безопасны при лечении запоров, в том числе в детской практике. Одним из актуальных препаратов данной группы слабительных считается пикосульфат натрия.

The development of post-infectious pathology is determined by the type of pathogen, the genesis of damage to the intestinal barrier and the premorbid background of the child. On the scale of recent epidemiological events, attention is drawn to the SARS-CoV-2 virus, which has tropism for cells of the gastrointestinal tract, distorts the composition and function of the intestinal microbiome. The importance of the functions of intestinal microbes in the genesis and outcome of SARS-CoV-2 infection has been highlighted. It has been proven that a microbiota disorder with a new coronavirus infection affects not only the duration and severity of the infectious process, but also the risk of the formation of systemic diseases and malignant neoplasms. After the acute phase of SARS-CoV-2 infection, post-COVID-19 syndrome may occur, the pathophysiology of which has not yet been fully established. Although it is believed that the main reason for its appearance is the diversification of the intestinal microbial landscape against the background of the direct effect of SARS-CoV-2 on the ACE2 receptors of intestinal epitheliocytes, followed by a pathoimmune response and impaired hemostasis. Established post-COVID-19 dysbiosis underlies functional gastrointestinal disorders with pronounced impairment in the brain-gut-microbiota axis and imbalance of the migrating motor complex, leading to the development of constipation. Post-infectious constipation debut within the first 3 months after an acute infection. The main goal of therapy for post-infectious constipation is to achieve regular painless defecation with soft-consistency stool and prevent feces. Numerous foreign studies and clinical guidelines indicate that stimulating laxatives are effective and safe in the treatment of constipation, include the children’s practice. Sodium picosulfate is considered one of the topical drugs of this group of laxatives.

детиинфекцияCOVID-19SARS-CoV-2иммунитетмикробиотазапорфункциональные гастроинтестинальные расстройствасиндром избыточного бактериального ростапостковидный синдромслабительные препаратыпикосульфат натрияchildreninfectionCOVID-19SARS-CoV-2immunitymicrobiotaconstipationfunctional gastrointestinal disordersbacterial overgrowth syndromepost-COVID syndromelaxativessodium picosulfateReferencesХалиуллина СВ, Анохин ВА, Поздняк ВА, Раимова ЮА, Хаертынов ХС, Закирова АМ, Мухамердиева ЗТ. Диарейный синдром у детей в период пандемии коронавирусной инфекции. Практическая медицина. 2022;20(5):48–55. https://doi.org/10.32000/2072-1757-2022-5-48-55.Khaliullina SV, Anokhin VA, Pozdnyak VA, Raimova YuA, Khaertynov KhS, Zakirova AM, Mukhamerdieva ZT. Diarrheal syndrome in children during the COVID-19 pandemic. Practical Medicine. 2022;20(5):48–55. (In Russ.) https://doi.org/10.32000/2072-1757-2022-5-48-55.Chen B, Zhu S, Du L, He H, Kim JJ, Dai N. Reduced interstitial cells of Cajal and increased intraepithelial lymphocytes are associated with development of small intestinal bacterial overgrowth in post-infectious IBS mouse model. Scand J Gastroenterol. 2017;52(10):1065–1071. https://doi.org/10.1080/00365521.2017.1342141.Chen B, Zhu S, Du L, He H, Kim JJ, Dai N. Reduced interstitial cells of Cajal and increased intraepithelial lymphocytes are associated with development of small intestinal bacterial overgrowth in post-infectious IBS mouse model. Scand J Gastroenterol. 2017;52(10):1065–1071. https://doi.org/10.1080/00365521.2017.1342141.Горелов АВ. Острые кишечные инфекции у детей. М.: ГЭОТАР-Медиа; 2019. 144 с.Горелов АВ. Острые кишечные инфекции у детей. М.: ГЭОТАР-Медиа; 2019. 144 с.Ермоленко КД, Украинцев СЕ, Гончар НВ, Скрипченко НВ. Отдаленные последствия кампилобактериоза у детей раннего возраста. Вопросы современной педиатрии. 2023;22(6):528–536. https://doi.org/10.15690/vsp.v22i6.2660.Ermolenko KD, Ukraintsev SE, Gonchar NV, Skripchenko NV. Long-term effects of campylobacteriosis in infants. Current Pediatrics. 2023;22(6):528–536. (In Russ.) https://doi.org/10.15690/vsp.v22i6.2660.Al-Beltagi M, Saeed NK, Bediwy AS, El-Sawaf Y. Paediatric gastrointestinal disorders in SARS-CoV-2 infection: Epidemiological and clinical implications. World J Gastroenterol. 2021;27(16):1716–1727. https://doi.org/10.3748/wjg.v27.i16.1716.Al-Beltagi M, Saeed NK, Bediwy AS, El-Sawaf Y. Paediatric gastrointestinal disorders in SARS-CoV-2 infection: Epidemiological and clinical implications. World J Gastroenterol. 2021;27(16):1716–1727. https://doi.org/10.3748/wjg.v27.i16.1716.Lo Vecchio A, Garazzino S, Smarrazzo A, Venturini E, Poeta M, Berlese P et al. Factors Associated With Severe Gastrointestinal Diagnoses in Children With SARS-CoV-2 Infection or Multisystem Inflammatory Syndrome. JAMA Netw Open. 2021;4(12):e2139974. https://doi.org/10.1001/jamanetworkopen.2021.39974.Lo Vecchio A, Garazzino S, Smarrazzo A, Venturini E, Poeta M, Berlese P et al. Factors Associated With Severe Gastrointestinal Diagnoses in Children With SARS-CoV-2 Infection or Multisystem Inflammatory Syndrome. JAMA Netw Open. 2021;4(12):e2139974. https://doi.org/10.1001/jamanetworkopen.2021.39974.De-Madaria E, Capurso G. COVID-19 and acute pancreatitis: examining the causality. Nat Rev Gastroenterol Hepatol. 2021;18(1):3–4. https://doi.org/10.1038/s41575-020-00389-y.De-Madaria E, Capurso G. COVID-19 and acute pancreatitis: examining the causality. Nat Rev Gastroenterol Hepatol. 2021;18(1):3–4. https://doi.org/10.1038/s41575-020-00389-y.Liang W, Feng Z, Rao S, Xiao C, Xue X, Lin Z et al. Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus. Gut. 2020;69(6):1141–1143. https://doi.org/10.1136/gutjnl-2020-320832.Liang W, Feng Z, Rao S, Xiao C, Xue X, Lin Z et al. Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus. Gut. 2020;69(6):1141–1143. https://doi.org/10.1136/gutjnl-2020-320832.Pegoraro F, Trapani S, Indolfi G. Gastrointestinal, hepatic and pancreatic manifestations of COVID-19 in children. Clin Res Hepatol Gastroenterol. 2022;46(4):101818. https://doi.org/10.1016/j.clinre.2021.101818.Pegoraro F, Trapani S, Indolfi G. Gastrointestinal, hepatic and pancreatic manifestations of COVID-19 in children. Clin Res Hepatol Gastroenterol. 2022;46(4):101818. https://doi.org/10.1016/j.clinre.2021.101818.Sansotta N, Norsa L, D’Antiga L. Gastrointestinal coronavirus disease 2019 manifestations in childhood. Curr Opin Clin Nutr Metab Care. 2022;25(3):195–202. https://doi.org/10.1097/MCO.0000000000000825.Sansotta N, Norsa L, D’Antiga L. Gastrointestinal coronavirus disease 2019 manifestations in childhood. Curr Opin Clin Nutr Metab Care. 2022;25(3):195–202. https://doi.org/10.1097/MCO.0000000000000825.Wu Y, Cheng X, Jiang G, Tang H, Ming S, Tang L et al. Altered oral and gut microbiota and its association with SARS-CoV-2 viral load in COVID-19 patients during hospitalization. NPJ Biofilms Microbiomes. 2021;7(1):61. https://doi.org/10.1038/s41522-021-00232-5.Wu Y, Cheng X, Jiang G, Tang H, Ming S, Tang L et al. Altered oral and gut microbiota and its association with SARS-CoV-2 viral load in COVID-19 patients during hospitalization. NPJ Biofilms Microbiomes. 2021;7(1):61. https://doi.org/10.1038/s41522-021-00232-5.Shen Y, Yu F, Zhang D, Zou Q, Xie M, Chen X et al. Dynamic Alterations in the Respiratory Tract Microbiota of Patients with COVID-19 and its Association with Microbiota in the Gut. Adv Sci (Weinh). 2022;9(27):e2200956. https://doi.org/10.1002/advs.202200956.Shen Y, Yu F, Zhang D, Zou Q, Xie M, Chen X et al. Dynamic Alterations in the Respiratory Tract Microbiota of Patients with COVID-19 and its Association with Microbiota in the Gut. Adv Sci (Weinh). 2022;9(27):e2200956. https://doi.org/10.1002/advs.202200956.Long B, Carius BM, Chavez S, Liang SY, Brady WJ, Koyfman A, Gottlieb M. Clinical update on COVID-19 for the emergency clinician: Presentation and evaluation. Am J Emerg Med. 2022;54:46–57. https://doi.org/10.1016/j.ajem.2022.01.028.Long B, Carius BM, Chavez S, Liang SY, Brady WJ, Koyfman A, Gottlieb M. Clinical update on COVID-19 for the emergency clinician: Presentation and evaluation. Am J Emerg Med. 2022;54:46–57. https://doi.org/10.1016/j.ajem.2022.01.028.Elmunzer BJ, Spitzer RL, Foster LD, Merchant AA, Howard EF, Patel VA et al. Digestive Manifestations in Patients Hospitalized With Coronavirus Disease 2019. Clin Gastroenterol Hepatol. 2021;19(7):1355–1365.e4. https://doi.org/10.1016/j.cgh.2020.09.041.Elmunzer BJ, Spitzer RL, Foster LD, Merchant AA, Howard EF, Patel VA et al. Digestive Manifestations in Patients Hospitalized With Coronavirus Disease 2019. Clin Gastroenterol Hepatol. 2021;19(7):1355–1365.e4. https://doi.org/10.1016/j.cgh.2020.09.041.Carvalho A, Alqusairi R, Adams A, Paul M, Kothari N, Peters S, DeBenedet AT. SARS-CoV-2 Gastrointestinal Infection Causing Hemorrhagic Colitis: Implications for Detection and Transmission of COVID-19 Disease. Am J Gastroenterol. 2020;115(6):942–946. https://doi.org/10.14309/ajg.0000000000000667.Carvalho A, Alqusairi R, Adams A, Paul M, Kothari N, Peters S, DeBenedet AT. SARS-CoV-2 Gastrointestinal Infection Causing Hemorrhagic Colitis: Implications for Detection and Transmission of COVID-19 Disease. Am J Gastroenterol. 2020;115(6):942–946. https://doi.org/10.14309/ajg.0000000000000667.Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–1069. https://doi.org/10.1001/jama.2020.1585.Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–1069. https://doi.org/10.1001/jama.2020.1585.Sun YK, Wang C, Lin PQ, Hu L, Ye J, Gao ZG et al. Severe pediatric COVID-19: a review from the clinical and immunopathophysiological perspectives. World J Pediatr. 2024;20(4):307–324. https://doi.org/10.1007/s12519-023-00790-y.Sun YK, Wang C, Lin PQ, Hu L, Ye J, Gao ZG et al. Severe pediatric COVID-19: a review from the clinical and immunopathophysiological perspectives. World J Pediatr. 2024;20(4):307–324. https://doi.org/10.1007/s12519-023-00790-y.Ahlawat S, Asha, Sharma KK. Immunological co-ordination between gut and lungs in SARS-CoV-2 infection. Virus Res. 2020;286:198103. https://doi.org/10.1016/j.virusres.2020.198103.Ahlawat S, Asha, Sharma KK. Immunological co-ordination between gut and lungs in SARS-CoV-2 infection. Virus Res. 2020;286:198103. https://doi.org/10.1016/j.virusres.2020.198103.Waterfield T, Watson C, Moore R, Ferris K, Tonry C, Watt A et al. Seroprevalence of SARS-CoV-2 antibodies in children: a prospective multicentre cohort study. Arch Dis Child. 2021;106(7):680–686. https://doi.org/10.1136/archdischild-2020-320558.Waterfield T, Watson C, Moore R, Ferris K, Tonry C, Watt A et al. Seroprevalence of SARS-CoV-2 antibodies in children: a prospective multicentre cohort study. Arch Dis Child. 2021;106(7):680–686. https://doi.org/10.1136/archdischild-2020-320558.Puoti MG, Rybak A, Kiparissi F, Gaynor E, Borrelli O. SARS-CoV-2 and the Gastrointestinal Tract in Children. Front Pediatr. 2021;9:617980. https://doi.org/10.3389/fped.2021.617980.Puoti MG, Rybak A, Kiparissi F, Gaynor E, Borrelli O. SARS-CoV-2 and the Gastrointestinal Tract in Children. Front Pediatr. 2021;9:617980. https://doi.org/10.3389/fped.2021.617980.Shahein AR, Young H, Dalabih A. Phlegmonous Ileocolitis as a Presentation of Post SARS-CoV-2 (COVID-19) Multisystem Inflammatory Syndrome in Children. JPGN Rep. 2020;2(1):e040. https://doi.org/10.1097/PG9.0000000000000040.Shahein AR, Young H, Dalabih A. Phlegmonous Ileocolitis as a Presentation of Post SARS-CoV-2 (COVID-19) Multisystem Inflammatory Syndrome in Children. JPGN Rep. 2020;2(1):e040. https://doi.org/10.1097/PG9.0000000000000040.Noda S, Ma J, Romberg EK, Hernandez RE, Ferguson MR. Severe COVID-19 initially presenting as mesenteric adenopathy. Pediatr Radiol. 2021;51(1):140–143. https://doi.org/10.1007/s00247-020-04789-9.Noda S, Ma J, Romberg EK, Hernandez RE, Ferguson MR. Severe COVID-19 initially presenting as mesenteric adenopathy. Pediatr Radiol. 2021;51(1):140–143. https://doi.org/10.1007/s00247-020-04789-9.Effenberger M, Grabherr F, Mayr L, Schwaerzler J, Nairz M, Seifert M et al. Faecal calprotectin indicates intestinal inflammation in COVID-19. Gut. 2020;69(8):1543–1544. https://doi.org/10.1136/gutjnl-2020-321388.Effenberger M, Grabherr F, Mayr L, Schwaerzler J, Nairz M, Seifert M et al. Faecal calprotectin indicates intestinal inflammation in COVID-19. Gut. 2020;69(8):1543–1544. https://doi.org/10.1136/gutjnl-2020-321388.Rohani P, Karimi A, Tabatabaie SR, Khalili M, Sayyari A. Protein losing enteropathy and pneumatosis intestinalis in a child with COVID 19 infection. J Pediatr Surg Case Rep. 2021;64:101667. https://doi.org/10.1016/j.epsc.2020.101667.Rohani P, Karimi A, Tabatabaie SR, Khalili M, Sayyari A. Protein losing enteropathy and pneumatosis intestinalis in a child with COVID 19 infection. J Pediatr Surg Case Rep. 2021;64:101667. https://doi.org/10.1016/j.epsc.2020.101667.Авдеев СН, Адамян ЛВ, Алексеева ЕИ, Багненко СФ, Баранов АА, Баранова НН и др. Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19): временные методические рекомендации. Версия 18 (26.10.2023). Режим доступа: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/064/610/original/ВМР_COVID-19_V18.pdf.Авдеев СН, Адамян ЛВ, Алексеева ЕИ, Багненко СФ, Баранов АА, Баранова НН и др. Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19): временные методические рекомендации. Версия 18 (26.10.2023). Режим доступа: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/064/610/original/ВМР_COVID-19_V18.pdf.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(17):1663–1665. https://doi.org/10.1056/NEJMc2005073.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(17):1663–1665. https://doi.org/10.1056/NEJMc2005073.Yelin D, Margalit I, Yahav D, Runold M, Bruchfeld J. Long COVID-19 – it’s not over until? Clin Microbiol Infect. 2021;27(4):506–508. https://doi.org/10.1016/j.cmi.2020.12.001.Yelin D, Margalit I, Yahav D, Runold M, Bruchfeld J. Long COVID-19 – it’s not over until? Clin Microbiol Infect. 2021;27(4):506–508. https://doi.org/10.1016/j.cmi.2020.12.001.Röckert Tjernberg A, Malmborg P, Mårild K. Coronavirus disease 2019 and gastrointestinal disorders in children. Therap Adv Gastroenterol. 2023;16:17562848231177612. https://doi.org/10.1177/17562848231177612.Röckert Tjernberg A, Malmborg P, Mårild K. Coronavirus disease 2019 and gastrointestinal disorders in children. Therap Adv Gastroenterol. 2023;16:17562848231177612. https://doi.org/10.1177/17562848231177612.Buonsenso D, Munblit D, Pazukhina E, Ricchiuto A, Sinatti D, Zona M et al. Post-COVID Condition in Adults and Children Living in the Same Household in Italy: A Prospective Cohort Study Using the ISARIC Global Follow-Up Protocol. Front Pediatr. 2022;10:834875. https://doi.org/10.3389/fped.2022.834875.Buonsenso D, Munblit D, Pazukhina E, Ricchiuto A, Sinatti D, Zona M et al. PostCOVID Condition in Adults and Children Living in the Same Household in Italy: A Prospective Cohort Study Using the ISARIC Global Follow-Up Protocol. Front Pediatr. 2022;10:834875. https://doi.org/10.3389/fped.2022.834875.Minotti C, McKenzie C, Dewandel I, Bekker C, Sturniolo G, Doni D et al. How does post COVID differ from other post-viral conditions in childhood and adolescence (0–20 years old)? A systematic review. eClinicalMedicine. 2024;68:102436. https://doi.org/10.1016/j.eclinm.2024.102436.Minotti C, McKenzie C, Dewandel I, Bekker C, Sturniolo G, Doni D et al. How does post COVID differ from other post-viral conditions in childhood and adolescence (0–20 years old)? A systematic review. eClinicalMedicine. 2024;68:102436. https://doi.org/10.1016/j.eclinm.2024.102436.Mariani F, Rainaldi S, Dall’Ara G, De Rose C, Morello R, Buonsenso D. Persisting Gastrointestinal Symptoms in Children with SARS-CoV-2: Temporal Evolution over 18 Months and Possible Role of Lactoferrin. Children (Basel). 2024;11(1):105. https://doi.org/10.3390/children11010105.Mariani F, Rainaldi S, Dall’Ara G, De Rose C, Morello R, Buonsenso D. Persisting Gastrointestinal Symptoms in Children with SARS-CoV-2: Temporal Evolution over 18 Months and Possible Role of Lactoferrin. Children (Basel). 2024;11(1):105. https://doi.org/10.3390/children11010105.Иванова ОН. Постковидный синдром у детей. Международный научно-исследовательский журнал. 2021;(9):35–39. https://doi.org/10.23670/IRJ.2021.9.111.040.Ivanova ON. Post-COVID syndrome in children. International Research Journal. 2021;(9):35–39. (In Russ.) https://doi.org/10.23670/IRJ.2021.9.111.040.Налетов АВ, Свистунова НА, Мацынина НИ, Сердюкова ДА. Функциональные гастроинтестинальные расстройства у детей школьного возраста, перенесших COVID-19. Forcipe. 2022;5(S2):370. Режим доступа: https://ojs3.gpmu.org/index.php/forcipe/article/view/4569.Naletov AV, Svistunova NA, Matsynina NI, Serdyukova DA. Functional gastrointestinal disorders in school-age children who had COVID-19. Forcipe. 2022;5(S2):370. (In Russ.) Available at: https://ojs3.gpmu.org/index.php/forcipe/article/view/4569.Raveendran AV, Jayadevan R, Sashidharan S. Long COVID: An overview. Diabetes Metab Syndr. 2021;15(3):869–875. https://doi.org/10.1016/j.dsx.2021.04.007.Raveendran AV, Jayadevan R, Sashidharan S. Long COVID: An overview. Diabetes Metab Syndr. 2021;15(3):869–875. https://doi.org/10.1016/j.dsx.2021.04.007.Parzen-Johnson S, Katz BZ. Navigating the Spectrum of Two Pediatric COVID-19 Complications: Multi-System Inflammatory Syndrome in Children and Post-Acute Sequelae of SARS-CoV-2 Infection. J Clin Med. 2024;13(4):1147. https://doi.org/10.3390/jcm13041147.Parzen-Johnson S, Katz BZ. Navigating the Spectrum of Two Pediatric COVID-19 Complications: Multi-System Inflammatory Syndrome in Children and Post-Acute Sequelae of SARS-CoV-2 Infection. J Clin Med. 2024;13(4):1147. https://doi.org/10.3390/jcm13041147.Jin B, Singh R, Ha SE, Zogg H, Park PJ, Ro S. Pathophysiological mechanisms underlying gastrointestinal symptoms in patients with COVID-19. World J Gastroenterol. 2021;27(19):2341–2352. https://doi.org/10.3748/wjg.v27.i19.2341.Jin B, Singh R, Ha SE, Zogg H, Park PJ, Ro S. Pathophysiological mechanisms underlying gastrointestinal symptoms in patients with COVID-19. World J Gastroenterol. 2021;27(19):2341–2352. https://doi.org/10.3748/wjg.v27.i19.2341.Berenguera A, Jacques-Aviñó C, Medina-Perucha L, Puente D. Long term consequences of COVID-19. Eur J Intern Med. 2021;92:34–35. https://doi.org/10.1016/j.ejim.2021.08.022.Berenguera A, Jacques-Aviñó C, Medina-Perucha L, Puente D. Long term consequences of COVID-19. Eur J Intern Med. 2021;92:34–35. https://doi.org/10.1016/j.ejim.2021.08.022.Taribagil P, Creer D, Tahir H. ‘Long COVID’ syndrome. BMJ Case Rep. 2021;14(4):e241485. https://doi.org/10.1136/bcr-2020-241485.Taribagil P, Creer D, Tahir H. ‘Long COVID’ syndrome. BMJ Case Rep. 2021;14(4):e241485. https://doi.org/10.1136/bcr-2020-241485.Гриневич ВБ, Лазебник ЛБ, Кравчук ЮА, Радченко ВГ, Ткаченко ЕИ, Першко АМ и др. Поражения органов пищеварения при постковидном синдроме. Клинические рекомендации. Экспериментальная и клиническая гастроэнтерология. 2022;(12):4–68. https://doi.org/10.31146/16828658-ecg-208-12-4-68.Grinevich VB, Lazebnik LB, Kravchuk YuA, Radchenko VG, Tkachenko EI, Pershko AM et al. Gastrointestinal disorders in post-COVID syndrome. Clinical guidelines. Experimental and Clinical Gastroenterology. 2022;(12):4–68. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-208-12-4-68.Полунина АВ, Новикова ВП, Блинов АЕ, Варламова ОН, Белова АА, Балашов АЛ и др. Динамика уровня зонулина в стуле при инфекции COVID-19 и в постковидный период у детей. Инфекционные болезни. 2022;20(3):35–40. https://doi.org/10.20953/1729-9225-2022-3-35-40.Polunina AV, Novikova VP, Blinov AE, Varlamova ON, Belova AA, Balashov AL et al. Dynamics of fecal zonulin levels in COVID-19 and in the post-covid period in children. Infectious Diseases. 2022;20(3):35–40. (In Russ.) https://doi.org/10.20953/1729-9225-2022-3-35-40.Новикова ВП, Полунина АВ, Баннова СЛ, Балашов АЛ, Дудурич ВВ, Данилов ЛГ и др. Состояние желудочно-кишечного тракта у детей при новой коронавирусной инфекции и в постковидный период. Роль синбиотика в коррекции клинических симптомов, кишечной микробиоты и проницаемости кишечной стенки. РМЖ. Мать и дитя. 2023;6(3):283–289. https://doi.org/10.32364/2618-8430-2023-6-3-10.Novikova VP, Polunina AV, Bannova SL, Balashov AL, Dudurich VV, Danilov LG et al. Gastrointestinal tract in children with novel coronavirus infection and post-COVID-19 syndrome. The role of synbiotics for improving clinical symptoms, gut microbiota, and intestinal permeability. Russian Journal of Woman and Child Health. 2023;6(3):283–289. (In Russ.) https://doi.org/10.32364/2618-8430-2023-6-3-10.Budden KF, Gellatly SL, Wood DL, Cooper MA, Morrison M, Hugenholtz P, Hansbro PM. Emerging pathogenic links between microbiota and the gutlung axis. Nat Rev Microbiol. 2017;15(1):55–63. https://doi.org/10.1038/nrmicro.2016.142.Budden KF, Gellatly SL, Wood DL, Cooper MA, Morrison M, Hugenholtz P, Hansbro PM. Emerging pathogenic links between microbiota and the gutlung axis. Nat Rev Microbiol. 2017;15(1):55–63. https://doi.org/10.1038/nrmicro.2016.142.Benvari S, Mahmoudi S, Mohammadi M. Gastrointestinal viral shedding in children with SARS-CoV-2: a systematic review and meta-analysis. World J Pediatr. 2022;18(9):582–588. https://doi.org/10.1007/s12519-022-00553-1.Benvari S, Mahmoudi S, Mohammadi M. Gastrointestinal viral shedding in children with SARS-CoV-2: a systematic review and meta-analysis. World J Pediatr. 2022;18(9):582–588. https://doi.org/10.1007/s12519-022-00553-1.Yan D, Zhang X, Chen C, Jiang D, Liu X, Zhou Y et al. Characteristics of Viral Shedding Time in SARS-CoV-2 Infections: A Systematic Review and Meta-Analysis. Front Public Health. 2021;9:652842. https://doi.org/10.3389/fpubh.2021.652842.Yan D, Zhang X, Chen C, Jiang D, Liu X, Zhou Y et al. Characteristics of Viral Shedding Time in SARS-CoV-2 Infections: A Systematic Review and Meta-Analysis. Front Public Health. 2021;9:652842. https://doi.org/10.3389/fpubh.2021.652842.Liu F, Ye S, Zhu X, He X, Wang S, Li Y et al. Gastrointestinal disturbance and effect of fecal microbiota transplantation in discharged COVID-19 patients. J Med Case Rep. 2021;15(1):60. https://doi.org/10.1186/s13256-020-02583-7.Liu F, Ye S, Zhu X, He X, Wang S, Li Y et al. Gastrointestinal disturbance and effect of fecal microbiota transplantation in discharged COVID-19 patients. J Med Case Rep. 2021;15(1):60. https://doi.org/10.1186/s13256-020-02583-7.Lv W, He J, Shao J, Chen Y, Xia L, Zhang L. Causal relationships between short-chain fatty acids and L-isoleucine biosynthesis and susceptibility and severity of COVID-19: Evidence from Mendelian randomization. J Infect. 2023;87(1):e16–e18. https://doi.org/10.1016/j.jinf.2023.04.022.Lv W, He J, Shao J, Chen Y, Xia L, Zhang L. Causal relationships between short-chain fatty acids and L-isoleucine biosynthesis and susceptibility and severity of COVID-19: Evidence from Mendelian randomization. J Infect. 2023;87(1):e16–e18. https://doi.org/10.1016/j.jinf.2023.04.022.Su Q, Lau RI, Liu Q, Chan FKL, Ng SC. Post-acute COVID-19 syndrome and gut dysbiosis linger beyond 1 year after SARS-CoV-2 clearance. Gut. 2023;72(6):1230–1232. https://doi.org/10.1136/gutjnl-2022-328319.Su Q, Lau RI, Liu Q, Chan FKL, Ng SC. Post-acute COVID-19 syndrome and gut dysbiosis linger beyond 1 year after SARS-CoV-2 clearance. Gut. 2023;72(6):1230–1232. https://doi.org/10.1136/gutjnl-2022-328319.Cui GY, Rao BC, Zeng ZH, Wang XM, Ren T, Wang HY et al. Characterization of oral and gut microbiome and plasma metabolomics in COVID-19 patients after 1-year follow-up. Mil Med Res. 2022;9(1):32. https://doi.org/10.1186/s40779-022-00387-y.Cui GY, Rao BC, Zeng ZH, Wang XM, Ren T, Wang HY et al. Characterization of oral and gut microbiome and plasma metabolomics in COVID-19 patients after 1-year follow-up. Mil Med Res. 2022;9(1):32. https://doi.org/10.1186/s40779-022-00387-y.Drossman DA. Presidential address: Gastrointestinal illness and the biopsychosocial model. Psychosom Med. 1998;60(3):258–267. https://doi.org/10.1097/00006842-199805000-00007.Drossman DA. Presidential address: Gastrointestinal illness and the biopsychosocial model. Psychosom Med. 1998;60(3):258–267. https://doi.org/10.1097/00006842-199805000-00007.Drossman DA. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016;150(6):P1262–1279.E2. https://doi.org/10.1053/j.gastro.2016.02.032.Drossman DA. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016;150(6):P1262–1279.E2. https://doi.org/10.1053/j.gastro.2016.02.032.Бельмер СВ, Волынец ГВ, Горелов АВ, Гурова ММ, Звягин АА, Корниенко ЕА и др. Функциональные расстройства органов пищеварения у детей. Рекомендации Общества детских гастроэнтерологов, гепатологов и нутрициологов. Редакция от 02.04.2020 г. М.; 2021. 64 с. Режим доступа: https://www.gastroscan.ru/literature/pdf/belmer---erdes-2021.pdf.Бельмер СВ, Волынец ГВ, Горелов АВ, Гурова ММ, Звягин АА, Корниенко ЕА и др. Функциональные расстройства органов пищеварения у детей. Рекомендации Общества детских гастроэнтерологов, гепатологов и нутрициологов. Редакция от 02.04.2020 г. М.; 2021. 64 с. Режим доступа: https://www.gastroscan.ru/literature/pdf/belmer---erdes-2021.pdf.Ghannoum MA, Ford M, Bonomo RA, Gamal A, McCormick TS. A Microbiome-Driven Approach to Combating Depression During the COVID-19 Pandemic. Front Nutr. 2021;8:672390. https://doi.org/10.3389/fnut.2021.672390.Ghannoum MA, Ford M, Bonomo RA, Gamal A, McCormick TS. A Microbiome-Driven Approach to Combating Depression During the COVID-19 Pandemic. Front Nutr. 2021;8:672390. https://doi.org/10.3389/fnut.2021.672390.Nakov R, Dimitrova-Yurukova D, Snegarova V, Nakov V, Fox M, Heinrich H. Increased prevalence of gastrointestinal symptoms and disorders of gutbrain interaction during the COVID-19 pandemic: An internet-based survey. Neurogastroenterol Motil. 2022;34(2):e14197. https://doi.org/10.1111/nmo.14197.Nakov R, Dimitrova-Yurukova D, Snegarova V, Nakov V, Fox M, Heinrich H. Increased prevalence of gastrointestinal symptoms and disorders of gutbrain interaction during the COVID-19 pandemic: An internet-based survey. Neurogastroenterol Motil. 2022;34(2):e14197. https://doi.org/10.1111/nmo.14197.Hashimoto K. Detrimental effects of COVID-19 in the brain and therapeutic options for long COVID: The role of Epstein-Barr virus and the gut-brain axis. Mol Psychiatry. 2023;28(12):4968–4976. https://doi.org/10.1038/s41380-023-02161-5.Hashimoto K. Detrimental effects of COVID-19 in the brain and therapeutic options for long COVID: The role of Epstein-Barr virus and the gut-brain axis. Mol Psychiatry. 2023;28(12):4968–4976. https://doi.org/10.1038/s41380-023-02161-5.Liu Q, Mak JWY, Su Q, Yeoh YK, Lui GC, Ng SSS et al. Gut microbiota dynamics in a prospective cohort of patients with post-acute COVID-19 syndrome. Gut. 2022;71(3):544–552. https://doi.org/10.1136/gutjnl-2021-325989.Liu Q, Mak JWY, Su Q, Yeoh YK, Lui GC, Ng SSS et al. Gut microbiota dynamics in a prospective cohort of patients with post-acute COVID-19 syndrome. Gut. 2022;71(3):544–552. https://doi.org/10.1136/gutjnl-2021-325989.Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A, Villapol S. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 2021;11(1):16144. https://doi.org/10.1038/s41598-021-95565-8.Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A, Villapol S. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 2021;11(1):16144. https://doi.org/10.1038/s41598-021-95565-8.Cho YK, Lee J, Paik CN. Prevalence, risk factors, and treatment of small intestinal bacterial overgrowth in children. Clin Exp Pediatr. 2023;66(9):377–383. https://doi.org/10.3345/cep.2022.00969.Cho YK, Lee J, Paik CN. Prevalence, risk factors, and treatment of small intestinal bacterial overgrowth in children. Clin Exp Pediatr. 2023;66(9):377–383. https://doi.org/10.3345/cep.2022.00969.Avelar Rodriguez D, Ryan PM, Toro Monjaraz EM, Ramirez Mayans JA, Quigley EM. Small Intestinal Bacterial Overgrowth in Children: A State-OfThe-Art Review. Front Pediatr. 2019;7:363. https://doi.org/10.3389/fped.2019.00363.Avelar Rodriguez D, Ryan PM, Toro Monjaraz EM, Ramirez Mayans JA, Quigley EM. Small Intestinal Bacterial Overgrowth in Children: A State-OfThe-Art Review. Front Pediatr. 2019;7:363. https://doi.org/10.3389/fped.2019.00363.Takakura W, Pimentel M. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome – An Update. Front Psychiatry. 2020;11:664. https://doi.org/10.3389/fpsyt.2020.00664.Takakura W, Pimentel M. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome – An Update. Front Psychiatry. 2020;11:664. https://doi.org/10.3389/fpsyt.2020.00664.Quigley EMM, Murray JA, Pimentel M. AGA Clinical Practice Update on Small Intestinal Bacterial Overgrowth: Expert Review. Gastroenterology. 2020;159(4):1526–1532. https://doi.org/10.1053/j.gastro.2020.06.090.Quigley EMM, Murray JA, Pimentel M. AGA Clinical Practice Update on Small Intestinal Bacterial Overgrowth: Expert Review. Gastroenterology. 2020;159(4):1526–1532. https://doi.org/10.1053/j.gastro.2020.06.090.Rana SV, Bhardwaj SB. Small intestinal bacterial overgrowth. Scand J Gastroenterol. 2008;43(9):1030–1037. https://doi.org/10.1080/00365520801947074.Rana SV, Bhardwaj SB. Small intestinal bacterial overgrowth. Scand J Gastroenterol. 2008;43(9):1030–1037. https://doi.org/10.1080/00365520801947074.Lee J, Paik CN, Kim DB, Lee JM, Kim YJ, Choi SK, Cho YJ. Role of Glucose Breath Test for Small Intestinal Bacterial Overgrowth in Children and Adolescents With Functional Abdominal Pain Disorders in Korea. J Neurogastroenterol Motil. 2022;28(1):78–85. https://doi.org/10.5056/jnm20231.Lee J, Paik CN, Kim DB, Lee JM, Kim YJ, Choi SK, Cho YJ. Role of Glucose Breath Test for Small Intestinal Bacterial Overgrowth in Children and Adolescents With Functional Abdominal Pain Disorders in Korea. J Neurogastroenterol Motil. 2022;28(1):78–85. https://doi.org/10.5056/jnm20231.Soares AC, Lederman HM, Fagundes-Neto U, de Morais MB. Breath methane associated with slow colonic transit time in children with chronic constipation. J Clin Gastroenterol. 2005;39(6):512–515. https://doi.org/10.1097/01.mcg.0000165665.94777.bd.Soares AC, Lederman HM, Fagundes-Neto U, de Morais MB. Breath methane associated with slow colonic transit time in children with chronic constipation. J Clin Gastroenterol. 2005;39(6):512–515. https://doi.org/10.1097/01.mcg.0000165665.94777.bd.Van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol. 2006;101(10):2401–2409. https://doi.org/10.1111/j.1572-0241.2006.00771.x.Van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol. 2006;101(10):2401–2409. https://doi.org/10.1111/j.1572-0241.2006.00771.x.Богданова НМ. Функциональный запор у детей раннего возраста: причины развития, критерии диагностики и тактика ведения. Медицинский совет. 2018;(17):150–155. https://doi.org/10.21518/2079-701X-2018-17-150-155.Bogdanova NM. Functional constipation in young children: causes, diagnostic criteria and therapeutic strategies. Meditsinskiy Sovet. 2018;(17):150–155. (In Russ.) https://doi.org/10.21518/2079-701X-2018-17-150-155.Корниенко ЕА, Типикина МЮ. Роль воспалительных и микробиологических изменений в патогенезе функциональных расстройств кишечника у детей. Вопросы детской диетологии. 2012;10(3):76–78. Режим доступа: https://www.phdynasty.ru/katalog/zhurnaly/voprosy-detskoy-dietologii/2012/tom-10-nomer-3/9345.Kornienko EA, Tipikina MYu. The role of inflammatory and microbiological changes in the pathogenesis of functional intestinal disorders in children. Pediatric Nutrition. 2012;10(3):76–78. (In Russ.) Available at: https://www.phdynasty.ru/katalog/zhurnaly/voprosy-detskoy-dietologii/2012/tom-10-nomer-3/9345.Ермоленко КД. Структура функциональной патологии органов пищеварения у детей после вирусных кишечных инфекций. Гастроэнтерология Санкт-Петербурга. 2017;(1):59–63. Режим доступа: http://gastroforum.ru/wp-content/uploads/2017/05/№1-2017.pdf.Ermolenko KD. Structure of functional disorders of the digestive system in children, after viral intestinal infections. Gastroenterology of St Petersburg. 2017;(1):53–57. (In Russ.) Available at: http://gastroforum.ru/wp-content/uploads/2017/05/№1-2017.pdf.Алешин ДВ, Ачкасов СИ, Баранская ЕК, Ивашкин ВТ, Куликова НД, Лапина ТЛ и др. Запор: клинические рекомендации. М.; 2021. 32 c. Режим доступа: https://cr.minzdrav.gov.ru/recomend/274_2.Алешин ДВ, Ачкасов СИ, Баранская ЕК, Ивашкин ВТ, Куликова НД, Лапина ТЛ и др. Запор: клинические рекомендации. М.; 2021. 32 c. Режим доступа: https://cr.minzdrav.gov.ru/recomend/274_2.Bosshard W, Dreher R, Schnegg JF, Büla CJ. The treatment of chronic constipation in elderly people: an update. Drugs Aging. 2004;21(14):911–930. https://doi.org/10.2165/00002512-200421140-00002.Bosshard W, Dreher R, Schnegg JF, Büla CJ. The treatment of chronic constipation in elderly people: an update. Drugs Aging. 2004;21(14):911–930. https://doi.org/10.2165/00002512-200421140-00002.Ивашкин ВТ, Маев ИВ, Шептулин АА, Трухманов АС, Полуэктова ЕА, Баранская ЕК и др. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению взрослых пациентов с хроническим запором. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2017;27(3):75–83. Режим доступа: https://www.gastro-j.ru/jour/article/view/160.Ivashkin VT, Maev IV, Sheptulin AA, Trukhmanov AS, Poluektova EA, Baranskaya EK et al. Diagnostics and treatment of chronic constipation in adults: clinical guidelines of the Russian gastroenterological association. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2017;27(3):75–83. (In Russ.) Available at: https://www.gastro-j.ru/jour/article/view/160.Bharucha AE, Pemberton JH, Locke GR 3rd. American Gastroenterological Association technical review on constipation. Gastroenterology. 2013;144(1):218–238. https://doi.org/10.1053/j.gastro.2012.10.028.Bharucha AE, Pemberton JH, Locke GR 3rd. American Gastroenterological Association technical review on constipation. Gastroenterology. 2013;144(1):218–238. https://doi.org/10.1053/j.gastro.2012.10.028.Дроздов ВН, Карноух КИ, Сереброва СЮ, Комиссаренко ИА, Стародубцев АК. Возможности применения натрия пикосульфата в фармакотерапии запоров при функциональных расстройствах кишечника. Медицинский совет. 2019;(3):92–97. https://doi.org/10.21518/2079-701X-2019-3-92-97.Drozdov VN, Karnoukh KI, Serebrova SYu, Komissarenko IA, Starodubtsev AK. Possibilities of sodium picosulfate application in constipation pharmacotherapy in functional intestinal disorders. Meditsinskiy Sovet. 2019;(3):92–97. (In Russ.) https://doi.org/10.21518/2079-701X-2019-3-92-97.Яблокова ЕА, Горелов АВ, Сичинава ИВ. Запоры у детей: диагностика и лечение. РМЖ. 2014;(20):1452–1458. Режим доступа: https://www.rmj.ru/articles/gastroenterologiya/Zapory_u_detey_diagnostika_i_lechenie/.Yablokova EA, Gorelov AV, Sichinava IV. Constipation in children: diagnosis and treatment. RMJ. 2014;(20):1452–1458. (In Russ.) Available at: https://www.rmj.ru/articles/gastroenterologiya/Zapory_u_detey_diagnostika_i_lechenie/.

The authors declare that there are no conflicts of interest present.