Sudden food aversion in toddlers can be clue to COVID-19

In toddlers, one clue to a diagnosis of COVID-19 may be a sudden complete or nearly complete avoidance of solid foods due to alterations in the child’s sense of smell and taste, doctors in California suggest.

In a report published on Tuesday in Pediatrics, they describe two small children, both younger than 18 months, who suddenly developed an aversion to solid food around the time they were diagnosed with COVID-19. When they did eat, they gagged or spit up the food immediately afterward.

One toddler also became acutely sensitive to the smell of any fragrant products at the same time as the food aversion, another sign of an impaired sense of smell. Six to eight months after diagnosis, both toddlers had started to tolerate some solid food, but neither had fully resumed their baseline intake.

“This delayed and variable clinical course in our patients is consistent with recent studies in adults” showing that COVID-19-related problems with smell and taste “can wax and wane, and one-third of patients may have persistent symptoms,” the doctors said.

They said they hope to see more data from other pediatricians to add to their findings. But based on their limited data, they said food aversion in young, preverbal children “should be a trigger to test for the presence of SARS-CoV-2 infection.”

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