Coronavirus Infection In Children Research Articles

Безопасность применения двухкомпонентного препарата моноклональных антител к SARS-CoV-2 (тиксагевимаб + цилгавимаб) для доконтактной профилактики новой коронавирусной инфекции у детей с ревматическими заболеваниями

New coronavirus infection (COVID-19) is an acute respiratory disease caused by the SARS-CoV-2 coronavirus. Tixagevimab+cilgavimab has been developed for the prevention and treatment of COVID-19. The purpose of this research was to evaluate the safety of the use of the two-component drug of monoclonal antibodies to SARS-CoV-2 (tixagevimab+cilgavimab) for pre-exposure prophylaxis of the new coronavirus infection in children with rheumatic diseases (RDs). Materials and methods used: a single-center retrospective study with prospective stage had been carried out that included 300 pediatric patients aged 12 to 18 y/o with RDs. The safety of pre-exposure prophylaxis of COVID-19 was assessed based on the dynamics of clinical and laboratory parameters as well as the total indices of RD activity. The effectiveness of pre-exposure prophylaxis was assessed based on recording the incidence of the new coronavirus infection. Safety and effectiveness were assessed after 3, 6, and 9 months after the administration of tixagevimab+cilgavimab drug. Results: no statistically significant increase in RDs activity was registered during 9 months of observation after pre-exposure prophylaxis of COVID-19. On the contrary, in patients with various types of juvenile arthritis, systemic lupus erythematosus and juvenile ankylosing spondylitis during the observation period against the background of antirheumatic therapy, a statistically significant decrease in the activity indices was registered - JADAS71 (p<0.001, p=0.002, p=0.030), SELENA-SLEDAI (p<0.001, p=0.027, p=0.570) and JSpADA (p=0.009, p=0.205, p=1.000), respectively; in patients with juvenile dermapolymyositis, systemic sclerosis and systemic vasculitis - a tendency to decrease in activity indices - DAS (p=0.002, p=0.050, p=0.193), J4S (p=0.840, p=0.720, p=1.000), PVAS (p=0.120, p=0.230, p=1.000 for the new and p=0.360, p=1.000, p=0.860 for the constant attributes), respectively. The new coronavirus infection was suffered by 6/300 (2%) patients within 9 months after pre-exposure prophylaxis. Conclusion: pre-exposure prophylaxis of COVID-19 with the two-component drug of monoclonal antibodies to SARS-CoV-2 (tixagevimab+cilgavimab) may be considered as both effective and safe and can therefore be suggested to pediatric patients with RDs.

MICRONUTRIENT STATUS (VITAMINS A AND D) AND ITS EFFECT ON THE SEVERITY OF THE COURSE OF COVID-19 IN CHILDREN

A strong immune response is important during recovery from COVID-19, and its status is infl uenced by several micronutrients. Vitamin D is important in regulating the immune response and protecting against respiratory infections. Vitamin A also has immunomodulatory eff ects, inhibiting viral replication and enhancing immune responses, thereby reducing morbidity and mortality from COVID-19. The aim of research was to study the levels of vitamins A, D, and retinol- binding protein 4 in children with COVID-19, and their associations with the severity of the disease.Material and Methods. 112 children aged 1 month to 18 years with COVID-19 confi rmed by polymerase chain reaction (PCR)in nasal swabs or by a positive serologic test (IgM and IgG or IgM). In all children, vitamin D levels were determined by thecolorimetric enzyme- linked immunosorbent assay (ELISA) using the Monobind test system. Vitamin A and retinol binding protein 4 (RBP4) levels were determined by the colorimetric enzyme- linked immunosorbent assay (ELISA) using the Elabscience test system. Statistical analysis was performed using Stat Plus (its 95 % confi dence interval (95 % CI) was calculated for the mean values, and the Kruskal- Wallis test (H-test) was used as the reliability criterion for checking the equality of the medians of several samples). The level of statistical signifi cance was set at P<0.05). The study was conducted in accordance with the rules of patient safety and ethical principles of scientifi c medical research involving human subjects (2000). The permission to conduct this study was granted by the Bioethics Commission (Protocol No. 73, dated April 3, 2023). The parents (legal representatives) of the patients gave their written consent to the conduct of this study. This study is a fragment of research work «Optimizing the diagnosis of clinical and pathogenetic characteristics of the COVID-19 coronavirus infection in children with comorbid pathology and treatment features» (state registration No. 0123U100064, 2023-2025).Results. The mean age of the children was (7.04±5.75) years (95 % CI 5.96-8.12). According to the severity of the disease,57 children (50.89 %) had a mild course, 43 children (38.39 %) had a moderate course, and 12 children (10.72 %) had a severe course. The concentration of vitamin D in children with mild course of COVID-19 was 30.91 ng/ml, in children with moderate course – 29.10 ng/ml, in children with severe course – 22.42 ng/ml (Р<0.05). The level of vitamin A also varied in children with diff erent severity of the disease: in mild COVID-19 it was 456.10 ng/ml, in moderate – 347.30 ng/ml, and in severe – 242.90 ng/ ml (Р <0.001). At the same time, the level of retinol binding protein 4 was 30.66 ng/ml in mild disease, 33.07 ng/ml in moderate disease and 23.28 ng/ml in severe disease.Conclusions. Children with moderate and severe COVID-19 have signifi cantly lower levels of vitamins A, D, and RBP4compared to uninfected individuals. Vitamin A and RBP4 levels were age-dependent, and vitamin D levels did not show agerelated patterns. Lower levels of vitamins A and D are associated with higher levels of pro-infl ammatory markers – CRP,leukocytes and ESR.

Dynamics of formation of anti- bodies to SARS-CoV-2 after coronavirus infection in children

Objective. To estimate the level of antibodies to SARS-CoV-2-IgM and SARS-CoV-2-IgG in children with COVID-19 in acute period and during 1 year period of follow-up after coronavirus infection. Materials and methods. Blood samples for the presence of IgM and IgG antibodies to SARS-CoV-2 were analyzed in 119 children aged 11.0 [10.1; 11.2] with COVID-19 in the acute period (29.4 % asymptomatic, 51.3 % mild and 19.3 % moderate), and SARS–CoV-2-IgG in the dynamics of the follow-up after 1 (n=55), 6 (n=33) and 12 (n=32) months from the moment of discharge from the hospital in a prospective cohort study. The levels of SARS-CoV-2 surface glycoprotein S, including the receptor-binding domain – RBD were measured at different time by using enzyme-linked immunosorbent assay. Results. The level of IgM positive rate for SARS-CoV-2 was initially negative in 86.6 % of children with COVID-19. The original seroconversion (on admission to the hospital) was 38.7 % and it increased to 96.7 % in 1 month and to 100 % in 12 months of observation. There were no statistically significant differences in IgG persistence depending on the age and course of COVID-19. Conclusions. The new coronavirus infection causes a long-term response of IgG antibodies to SARS-CoV-2 which persists for one year of observation and increases by 12 months after the infection regardless of the severity of COVID-19.

Особенности течения пневмонии, вызванной коронавирусной инфекцией COVID-19, у детей до трех месяцев

COVID-19 infection remains an actual problem in pediatric practice today. Objective. To study the features of the course of this infection in newborns and infants. Patients and methods. A retrospective cohort study included 53 children under the age of 3 months with radiologically confirmed pneumonia. All children were divided into two groups: the main COV (32 children) with confirmed coronavirus infection, and the control NCOV (21 children) without this diagnosis. When analyzing clinical symptoms (runny nose, cough, fever, nausea, vomiting, weakness, lethargy, shortness of breath), it was not possible to establish statistically significant differences. A statistically significant was revealed when comparing the symptom of diarrhea (p = 0.015). Diarrhea could be explained by damage to the dense contacts of enterocytes. Results. Patients in the COV group had leukopenia with a t value of 9.6·109/l at+ normal values of neutrophils and lymphocytes. Lung lesions were not detected at high basophil values, which suggests a protective function of basophils in toddlers. Conclusion. COVID-19 coronavirus infection in children under 3 months has not yet been sufficiently studied and characterized by non-specific symptoms. To date, data on pathogenesis and clinical manifestations in this age group remain contradictory, which requires additional research. Key words: infants, diarrhea, COVID-19, newborns, pneumonia

Analysis and interpretation of Coronavirus infection children's incidence, contributing factors, risks of complications and their relationship.

Aim: To study and investigate the incidence of Coronavirus infection in children, the course of the disease, the risks of complications and their interrelationships. Materials and Methods: Study included the analysis and observation of children (n=55, aged 14.36±3.62 years) with confirmed Coronerovirus infection, who were observed in the CNE ≪CMCH≫ in Uzhgorod in outpatient conditions. A study of clinical presentations, a clinical and laboratory examination followed by a mathematical analysis of the symptoms data in children with an identified Coronavirus infection and in the dynamics up to week 30 (with survey intervals in 3 weeks) from the diagnosis verification was carried out. Results: A dynamic analysis of the clinical manifestation of symptoms in children with an identified Corona virus infection and within 30 weeks (with survey intervals of 3 weeks) from the beginning of the diagnosis verification was carried out. Complaints from the respiratory system were prevailed. The most long-lasting complaint was observed ≪changes in the sense of taste and smell≫ (from 35(63.6%) to 6(10.9%) up to 18 weeks inclusive. Other complaints ≪Cough, Rhinitis, Shortness of breath, Pain in the chest≫ was observed for 6 weeks. Sore throat, muscular and joint pain were persisted for 3 weeks. Fever was not identified at week 3. Illness with other viral respiratory diseases started at week 9 and was observed until week 30 (from 10(18.2%) to 19(34.5%)) with varying levels. A decrease in cases of IgM identification was observed within 6 weeks (from 55, 100% to 20, 36, 4%). On the 9th week, the presence of IgM was not established. There is also an increase in the number of cases of detection of IgG in patients with a level maximum of 6 weeks. Conclusions: There is a positive effect of the CRP level on the occurrence of symptoms of cough, rhinitis, shortness of breath, chest pain, change in taste and smell, muscle and joint pain (r=0.33-0.55), with the most significant data for the symptom of pain in chest (p=0.00001). Ferritin level interactions mostly had a negative direction (r=-0.35-0.48, p=0.02-0.00001) on the development of symptoms, with the exception of rhinorrhea (r=0.48, p=0.00002) and chest pains (r=0.39, 0.003). According to multiple logistic regression analysis the chance of the symptom of a change in taste and smell increases due to an increasing in the level of Procalcitonin in 1.48 times. The chance of the symptom of shortness of breath increased due to an increasing in the Ferritin level in 1.025 times.

ПОРАЖЕНИЕ ПОЧЕК У ДЕТЕЙ ПРИ НОВОЙ КОРОНАВИРУСНОЙ ИНФЕКЦИИ, ВЫЗВАННОЙ SARS-CoV-2: СИСТЕМАТИЧЕСКИЙ ОБЗОР

This bibliographical review is based on studies published in the PubMed Central® (PMC) database between Mar. 2020 and Dec. 2022 using the keywords as follows: “SARS-CoV-2,” “COVID-19,” “kidney damage” and “children.” Information on clinical criteria, laboratory symptoms, possible pathogenetic response pathways and expected long-term outcomes of kidney damage associated with SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus) infection in children was analyzed. An attempt was made to trace the features of manifestations of the new coronavirus infection depending on previous renal pathology. The polyetiological nature of renal tissue lesion is evident, which is the result of direct effect of SARS-CoV-2 virus on the renin-angiotensin-aldosterone system (RAAS), ischemia, hypercoagulation, cytokine storm, rhabdomyolysis, pulmonary-renal pathogenic reaction etc. Kidney damage in the pediatric population has been found to be more frequent in the severe COVID-19 in children with multisystem inflammatory syndrome (MIS) in the setting of admission at the intensive care unit (ICU). Manifestations range from minor urinary syndrome to the development of acute kidney injury (AKI). A number of consequences and cases of the course of some diseases after coronavirus infection in children as well as clinical and laboratory features of coronavirus infection in patients with previous renal pathology are described. The findings initiated the need for the long-term follow-up of children with COVID-19 both with and without renal insufficiency.

Persistent symptoms of novel coronavirus infection in children one month after infection

Objective: To explore the persistent symptoms associated with novel coronavirus infection in children and their influencing factors, and to provide a reference basis for the next step of intervention and health education.

Coronavirus infection (COVID-19): clinical case of a severe disease in a newborn

The article presents a single clinical case of a severe coronavirus infection (COVID-19) in a newborn. Clinical and laboratory examination and treatment of the patient were carried out in accordance with the guidelines for the treatment of coronavirus infection in children. On the third day of hospitalization neonatal death occurred due to the development of multiple organ failure despite the medical therapy. An autopsy revealed diffuse alveolar damage (DAD) of the type of adult respiratory distress syndrome (ARDS) accompanied by bilateral polysegmental pneumonia and systemic inflammatory response syndrome.

The use of antibacterial drugs in the treatment of coronavirus infection in children in real outpatient clinic practice

Introduction. In light of the available data on the unjustified use of antibiotics in children with acute respiratory viral infections, the frequency of prescribing antibacterial drugs to children with a new coronavirus infection in real clinical practice is of great practical and scientific interest.The aim of the study was to study the frequency of antibiotic therapy and identify factors that increase the risk of needing antibiotics in children with coronavirus infection at the outpatient stage.Materials and methods. A retrospective cross-sectional study was conducted on the basis of children's polyclinics in Samara from November 2021 to July 2022, which included a survey of parents and an analysis of outpatient records of 100 children who were under outpatient observation and treatment for COVID-19. An analysis was made of the frequency of prescribing antibiotics to them and potential factors predisposing to their prescribing to children with COVID-19. The obtained data were subjected to statistical processing using the IBM SPSS Statistics 25 program and a comparative analysis.Results. The frequency of use of antibiotic therapy according to the results of the study was 11 % and did not exceed the Russian average data (14.3 %). When analyzing the factors influencing the doctor's decision to prescribe an antibiotic to a child with coronavirus infection, the most important were a history of recurrent respiratory infections (children from the FIC group), as well as the presence of concomitant diseases and background conditions in children, primarily chronic bronchopulmonary diseases. and nervous system.Discussion. The prescription of antibiotics for children with a new coronavirus infection at the outpatient stage remains empirical due to the limitations of the use of laboratory and instrumental methods for additional examination of the child, which objectifies the likelihood of a secondary bacterial infection. Despite this, the frequency of antibiotic use according to the results of the study was 11 % and did not exceed the Russian average data (14.3 %), as well as the average frequency of antibiotic use for acute respiratory viral infections in children in the Russian Federation (21.5-23.3 %).

Incidence of the new coronavirus infection in children based on outpatient data in Voronezh

Background. The article analyzes the COVID-19 incidence in children managed in the pediatric outpatient department of the Voronezh City Outpatient Clinic №1, summarizes and systematizes the data on the spread of SARS-CoV-2 in children.
 Aim. To study the COVID-19 incidence in the children of the pediatric outpatient department №2 of the Voronezh City Outpatient Clinic №1 by age group and gender for 20202022.
 Materials and methods. A retrospective epidemiological analysis was carried out at of the pediatric outpatient department №2 of the Voronezh City Outpatient Clinic №1. The incidence of COVID-19 in children in 20202022 was studied on the basis of information from the register of infectious diseases (form 060/y). The study included all laboratory-confirmed cases of COVID-19 infection in children registered in the Voronezh City Outpatient Clinic №1 for 20202022. Patients were divided into groups by age and gender to study the features of the course of the new coronavirus infection.
 Results. There were no gender differences in the structure of COVID-19 incidence in 20202022, according to the data of the pediatric outpatient department №2 of the Voronezh City Outpatient Clinic №1. COVID-19 was reported in all age groups; the lowest rate was in newborns (0.3%), the highest in children 1014 years old (25.7%).
 Conclusion. Six completed epidemic waves were observed in the study period, corresponding to all-Russian statistical data. There were no deaths reported in healthcare organizations for the study period.

КЛИНИЧЕСКИЙ СЛУЧАЙ СОЧЕТАННОГО ТУБЕРКУЛЕЗА И ПАТОЛОГИИ СЕРДЕЧНО – СОСУДИСТОЙ СИСТЕМЫ У РЕБЕНКА 3 ЛЕТ

The spread of a new coronavirus infection (COVID-19) forces the whole world to change the conditions for the detection and treatment of other diseases, including tuberculosis. A new coronavirus infection in children with respiratory tuberculosis and latent tuberculosis infection proceeds generally without complications, varying from asymptomatic to moderate. In children, there were also no aggravating factors of the course of COVID-19. This article describes a clinical case of tuberculosis in a 3-year-old child with the debut manifestation of changes in the cardiovascular system after a new coronavirus infection. From the anamnesis of the disease: the girl was sent to the hospital from the children's tuberculosis dispensary, about a tube contact with her father. Contact with a father with tuberculosis, the father was diagnosed with Fibrotic-cavernous pulmonary tuberculosis, was in the first group of dispensary registration, a bacterium separator with multidrug resistance. After a full examination, not only local tuberculosis was detected in the patient, but also pathology of the cardiovascular system, as well as immunoglobulins G were detected during PCR examination, which indicated an asymptomatic course of a new coronavirus infection in the child. The diagnosis was "Primary tuberculosis complex S3 of the right lung in the infiltration phase. Cardiomegaly of the 2nd degree. Insufficiency of the tricuspid valve of the I degree. Expansion of the cavities of the right atrium, right ventricle, trunk of the pulmonary artery. Additional trabeculae in the cavity of the left ventricle. Pulmonary hypertension 0-1 degrees". Thus, we associate the debut of the pathology of the cardiovascular system against the background of the tuberculosis process with a mild coronavirus infection. Each new observation is of interest for understanding the relationship of pathogenesis, clinical features and therapy in this comorbidity.

ANALYSIS OF COVID-19 IMPACT ON THE STATE OF HEALTH AND CARDIOVASCULAR FUNCTION OF CHILDREN 7-9 YEARS OLD

Influenza and acute respiratory viral infections pose significant challenges in paediatrics, given their high prevalence among children and the potential for severe and complicated cases, particularly in young age groups. Over the past 20 years, there have been three coronavirus epidemics that have caused a substantial number of severe cases, high mortality rates, and global transmission. This review aims to provide a comparative analysis of clinical and epidemiological features of coronavirus infections in children, drawing from the examples of SARS and MERS, and offers essential approaches and recommendations for the diagnosis and treatment of COVID-19. The review covers the etiology, epidemiology, laboratory diagnosis, clinical presentation, and treatment of severe acute respiratory syndrome. It also provides a brief historical overview of the epidemiology, diagnosis, and treatment of this disease. Unlike other respiratory viral infections, COVID-19 can result in persistent symptoms following the acute phase, known as post-infection COVID-19 syndrome, which can last for weeks or even months. The long-term effects of COVID-19 in children are not yet fully understood, and further research is needed to explore its true prevalence, pathogenesis, and lasting impacts. The management of paediatric post-infection COVID-19 syndrome requires a multidisciplinary approach, international collaboration, and consensus to ensure early detection and effective treatment in children.
 The article presents current scientific insights into the factors contributing to the development of a prolonged post-COVID period, including chronic systemic inflammation, endothelial dysfunction, coagulation disorders, autoimmune reactions, and other immunological changes. The COVID-19 outbreak serves as a reminder of the ongoing threat posed by infectious diseases caused by pathogenic viruses, highlighting the need for global cooperation and preparedness to effectively mitigate their spread.

New coronavirus infection in pediatric practice: clinical and epidemiological features of COVID-19 in the city of Smolensk

The aim of the study was to study the clinical and epidemiological features of the new COVID-19 coronavirus infection in children hospitalized in the infectious department. Material and methods . 249 case histories of patients from 0 to 18 years of age who are on inpatient treatment at «Clinical Hospital N1» in Smolensk for the period from April 2020 to July 2022 were studied by the continuous sampling method. Verification of a new coronavirus infection was carried out by examining smears from the nasopharynx and oropharynx for the presence of SARS-CoV-2 by real-time PCR. Results . The prevalence of patients from 1 to 3 (19.3%, 49.1%) and from 6—15 (15.8%, 50.5%) years was revealed both in 2020 and in 2021 and the first half of 2022. No significant differences in gender were found. The largest number of cases in 2020 was registered in April (16%) and November (14%), in 2021 — in December (18%) and November (16%). The prevailing severity in both 2020 and 2021, 2022 was the average severity (63% , 72%, 93%, respectively). The main syndromes of COVID-19 have been identified: intoxication syndrome, respiratory catarrhal syndrome, bronchopulmonary, intestinal. Bilateral pneumonia was most often detected (47% in 2020 , 44% in 2021, 62% in 2022), right-sided pneumonia (33% in 2020, 30% in 2021, 31% in 2022 ), and left-sided pneumonia (20%, 26% and 7%, respectively). The main comorbid pathologies are noted, and cases of somatic diseases first registered against the background of COVID-19 are described.

One of the possibilities of optimizing the therapy of a new coronavirus infection in children with the inclusion of an extract from marshmallow root, chamomile flowers, horsetail grass, walnut leaves, yarrow grass, oak bark and dandelion grass: prospective open comparative cohort study

Background. The issue of acute respiratory infections in children remains one of the most urgent. Therefore, in the pandemic due to the new coronavirus SARS-CoV-2, the search for effective treatment regimens for this disease is necessary.
 Aim. To compare the change of clinical symptoms, terms of virus elimination and disease-related economic cost as well as utilization of outpatient healthcare services in children with new coronavirus infection using the herbal medicine Tonsilgon N, oral solution, added to standard therapy.
 Materials and methods. A prospective open comparative cohort study of the effectiveness of coronavirus infection treatment in children using the standard of care alone and the standard of care with Tonsilgon N was conducted. Group 1 children (n=720) received the standard therapy for COVID-19 and Tonsilgon N oral solution for 10 days, and group 2 patients (n=670) only received the standard therapy for COVID-19. Treatment efficacy was evaluated according to the change of clinical symptoms in the observed patients, the results of SARS-CoV-2 coronavirus RNA detection in nasopharyngeal smears by polymerase chain reaction, the utilization of healthcare services, temporary disability of parents, the economic cost of the disease.
 Results. Studied patients of both groups had a typical clinical presentation of mild to moderate severity new coronavirus infection. Fatigue (96.599.7%) and sore throat (93.893.9%) were the most frequent symptoms. Posterior pharynx hyperemia was noted slightly less frequently. Low-grade fever was noted in 85.786.6% of the patients, equally often in patients of both groups. The significant therapeutic effect of the herbal medicine containing extract of marshmallow root, chamomile flowers, horsetail herb, walnut leaf, yarrow herb, oak bark, and dandelion herb includes reducing the time of sore throat relief in 93.2% of main group patients. After 10 days of treatment, sore throat persisted only in 6.8% of group 1 and 68.1% of group 2 patients (p=0.0001). These results indicate that Tonsilgon combined with standard of care is a promising way to improve the quality of life of children with the new coronavirus infection. The addition of Tonsilgon in therapy for new coronavirus infection in children shortens the time of acute inflammation resolution and reduces the duration of inflammatory intoxication. The therapy of new coronavirus infection under the provisional guidelines leads to a reduction in the time for clinical recovery and virus elimination in children and adolescents (p=0.0001) and a decrease in the utilization of outpatient healthcare services are observed: 3/4 of Group 1 patients and 1/2 of Group 2 patients (p=0.0001) applied for medical help twice during the observation period, 14.6% of Group 1 patients and 29.1% of Group 2 parents applied for medical help more than 3 times (p=0.0001). Thus, the direct and indirect economic costs of the disease decreased. The lower economic cost for parents of children in Group 1 was due to less need for medication and a lower reduction in family income due to temporary disability compared to those for parents in Group 2 (p=0.0001). No treatment-related adverse events was reported.
 Conclusion. The above data indicate that Tonsilgon therapy is an affordable way to optimize the treatment of new coronavirus infection in children.

COVID-19 coronavirus infection in children: Clinical presentation, diagnosis, vaccination, and treatment

In late 2019, a new subtype of coronavirus named Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19 SARS-CoV-2) rapidly spread around the world, causing a global pandemic. Initially, the proportion of confirmed cases among children was relatively small, and it was believed that children were rarely infected. Subsequent observations have shown that in children and adolescents, the infection is either asymptomatic or paucisymptomatic, and therefore the true incidence is underestimated due to the lack of testing. The article systematizes the results of studies on the prevalence, diagnosis, clinical features, vaccination, and treatment of children with a new coronavirus infection COVID-19 SARS-CoV-2. The SARS-CoV-2 positivity rate throughout the peak of the pandemic in children was low compared to adults. Children are not only less likely to become infected with the virus, but they also endure the infection more easily than adults. The mortality rate in children with COVID-19 was <0.5%. In most children, infection is either asymptomatic or paucisymptomatic. Vaccination of children and adolescents is recommended mainly to achieve herd immunity in all age groups. However, there are no convincing data on the duration of the immune response, the level of the required protective antibody titer, as well as on the long-term side effects of vaccination due to the insufficient follow-up period and the uncertainty of the immune response criteria. As information is accumulated on the viral load of children and adolescents, their role in the transmission of the virus, diagnostic approaches in this age group are optimized. The effectiveness of the treatment was tested on patients admitted to the hospital, and recommendations for treatment were developed. Currently, global research efforts are focused on the protection of particularly vulnerable children, the prospects for total childhood vaccination, its effectiveness and safety.

Клинический случай комбинированного постковидного синдрома у ребенка

Despite the fact that the new coronavirus infection in children proceeds much milder than in adults, the pediatric practice is facing a problem associated with the general concept of «post-COVID conditions», including Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 and a complex of disease processes with various manifestations, united by the concept of postacute consequences of treatment or hospitalization for SARS-CoV-2 infection (PASC). The article describes a clinical case of combined post-COVID syndrome, in the form of a MIS-C and the subsequent development of PASC in the form of long-term recurrent urticarial rash elements in a 10-year-old child, simulating reactions similar to serum sickness and chronic urticaria.

ПРОГНОСТИЧЕСКИЕ ПРЕДИКТОРЫ ТЯЖЕСТИ ТЕЧЕНИЯ КОРОНАВИРУСНОЙ ИНФЕКЦИИ У ДЕТЕЙ ДОШКОЛЬНОГО ВОЗРАСТА

As for adults, the prognostic predictive factors have been established, including some cytokines, associated with the diagnosis, pathogenesis, and severity of the coronavirus infection (COVID-19). However, predictors for the severity of the course of coronavirus infection in children are not well understood. In addition, there is no information on the cytokine profile in preschool children with COVID-19 as yet. The purpose of the research was to create a predictive model based on a comprehensive analysis of cytokine levels, which would then allow predicting the severity of the course of coronavirus infection in preschool children. Materials and methods used: 21 children (47.6% (10/21) boys and 52.4% (11/21) girls) aged 4.0 [3.0; 4.0] y/o with confirmed coronavirus infection (main group) vs. 25 children (44% (11/25) boys and 56% (14/25) girls) of health group I aged 3.0 [2.9; 3.7] y/o (the control group). Depending on the severity of COVID-19, patients of the main group were divided into subgroups: SG1 of 7 children with asymptomatic COVID-19; SG2 of 7 patients with a mild form; and SG3 of 7 cases of moderate form of the disease. In all children, the presence of SARS-CoV-2 in nasopharyngeal and oropharyngeal swabs was detected by PCR. The concentration of cytokines in blood serum was assessed by the flow fluorometry. Results: in children with COVID-19 at the time of admission to the hospital, the serum concentration of IL-1β, IL-2, IL-4, IL-6, IL-8, IP-10, MCP-1, IFN-γ, and TGF-β1 was statistically significantly higher than in the control group (p<0.05). Thus, based on a comprehensive analysis of the levels of IL-1β, IL-2, IL-6, IL-8, IL-12p70, IP-10, and TGF-β1 at the time of admission to the hospital, the prognostic model was developed allowing predicting the severity of COVID-19 in preschool children (Se=1.0 [95% CI 0.99-1.00], Sp=0.98 [95% CI 0.96-0.99], ROC-AUC=1.0 [95% CI 0.99-1.00], p<0.001; R2=0.93). Conclusion: the results of a comprehensive analysis allow us to consider the indicators of IL-1β, IL-2, IL-6, IL-8, IL-12p70, IP-10, and TGF-β1 as predictors for coronavirus infection severity in preschool children.

Features of COVID-19 in children

The novel SARS-CoV-2 coronavirus infection is predominantly asymptomatic or presenting few symptoms in children, and life-threatening complications are rare. In most cases, symptoms of ARVI are observed, such as fever, cough, myalgia, or weakness, which are milder than in adult patients. In addition, most laboratory and radiographic findings in children with COVID-19 are nonspecific. However, some children may develop prolonged forms of COVID-19, as well as long-term symptoms (post-COVID syndrome) after the illness, which significantly affect the quality of life. There are different data regarding the prevalence and duration of long-term effects of a new coronavirus infection in children. The most common symptoms following COVID-19 in children/teens are fatigue, lack of concentration, and muscle pain. The review presents the latest literature data on the duration and course of COVID-19 in children. It should be remembered that long-term symptoms could affect the physical, social, and psychological well-being of children and adolescents in the future.

Features of clinical manifestations, diagnosis, treatment and prevention of COVID-19 coronavirus infection in children

Worldwide spread of COVID-19 coronavirus infection SARS-CoV-2 also affected the child population. Now, a sufficient number of studies have been described in adult patients, and only limited data are available with an analysis of the clinical course of the disease in pediatric patients infected with SARS-CoV-2. Currently, SARS-CoV-2 has spread around the world as a variant of omicron. The article is a lecture on the features of the clinical picture, diagnosis, treatment, and prevention of coronavirus infection in children, taking into account the latest domestic and foreign articles.
 The purpose of the lecture is to improve the knowledge of family doctors and pediatricians in the study of clinical features, course, diagnosis, therapy, prevention, and long-term consequences of a coronavirus infection. The lecture presents the etiology and epidemiology of coronavirus infection. The clinical picture of the omicron strain is described. The assessment of the clinical picture of the disease is presented based on the working criteria of the severity of the disease. The diagnosis of coronavirus infection is presented in detail. The algorithm for treating children with coronavirus infection is presented according to the latest recommendations of the Ministry of Health of the Russian Federation. The emphasis is on prevention and elimination of dehydration. Vaccine prophylaxis during the pandemic is considered.

Особенности клинического течения новой коронавирусной инфекции у детей

Особенности клинического течения новой коронавирусной инфекции у детей