text: Gastrointestinal Perspective of Coronavirus Disease 2019 in Children An Updated Review Gastrointestinal symptoms are common findings in children with severe acute respiratory syndrome coronavirus 2 infection including vomiting diarrhoea abdominal pain and difficulty in feeding although these symptoms tend to be mild The hepato biliary system and the pancreas may also be involved usually with a mild elevation of transaminases and rarely pancreatitis In contrast a late hyper inflammatory phenomenon termed multisystem inflammatory syndrome MIS C is characterized by more frequent gastrointestinal manifestations with greater severity sometimes presenting as peritonitis Gastrointestinal and hepato biliary manifestations are probably related to a loss in enterocyte absorption capability and microscopic mucosal damage caused by a viral infection of intestinal epithelial cells hepatocytes and other cells through the angiotensin conversion enzyme 2 receptor resulting in immune cells activation with subsequent release of inflammatory cytokines Specific conditions such as inflammatory bowel disease IBD and liver transplantation may pose a risk for the more severe presentation of coronavirus disease 2019 COVID 19 but as adult data accumulate paediatric data is still limited The aim of this review is to summarize the current evidence about the effect of COVID 19 on the gastrointestinal system in children with emphasis on the emerging MIS C and specific considerations such as patients with IBD and liver transplant recipients 