Санаторная реабилитация детей школьного возраста с постковидным астеническим синдромом

Abstract

Aim. To study the effects of sanatory rehabilitation factors for the intensity of asthenic manifestations of post-COVID syndrome in school-aged children. Design. A non-randomized controlled study was conducted. Materials and methods. We examined 60 children aged 8 to 13 years old with asthenic manifestations of post-COVID syndrome; 20 healthy children were used as controls. Rehabilitation was organised at Svetlana health camp (a branch of the Territorial Clinical Hospital, Perm). All children shared their complaints and medical history as well as had their somatic and neurological status checked before and after rehabilitation. The degree of asthenia was determined using the Multidimensional Fatigue Scale; the functional status was evaluated using the functional status scale for post-COVID-19 patients; vegetative manifestations were recorded in a questionnaire and a pattern developed by A. M. Wein. Saliva levels of monocytic chemotactic protein-1 were determined with ELISA. Results. Children with past COVID-19 demonstrated a higher level of asthenia seen on the fatigue sub-scale — 81.22 [50.0; 100.0] points (р = 0.02 vs. controls), together with vegetative disorders; and saliva levels of monocytic chemotactic protein-1 (18.0 [12.5; 29.7] pg/mL) were higher than in controls (16.35 [11.00; 22.60] pg/mL; р = 0.012). After rehabilitation in a health camp, the intensity of asthenia decreased to 87.18 [75.0; 100.0] (р = 0.02), vegetative dysfunction improved, and functional status class changed from 1.74 [1.0; 3.0] to 0.77 [0; 1.0] (р = 0.02); saliva levels of monocytic chemotactic protein-1 increased to 23.1 [13.7; 43.7] pg/mL (p = 0.04). Quantitative changes are associated with improved clinical manifestations of post-COVID syndrome; therefore, elevated levels of this protein are a positive change. Conclusion. Post-COVID syndrome in school-aged children manifested with asthenic and vegetative disorders. Rehabilitation sanatory factors have favourable effect on the clinical manifestations of post-COVID syndrome, as well as the saliva concentration of monocytic chemotactic protein. Keywords: post-Covid syndrome, asthenia, children, monocyte chemotactic protein, rehabilitation.