Course Of COVID-19 In Children Research Articles

Features of severe forms of new coronavirus infection (COVID-19) in children

BACKGROUND: The problem of the complicated course of COVID-19 and deaths in children with severe comorbid pathology is relevant. Severe forms of the disease are often the cause of critical conditions and deaths, including decompensated respiratory failure, acute respiratory distress syndrome, septic shock, cardiac, hepatic, renal insufficiency, coagulation disorders, damage to the central nervous system.
 AIM: The aim is to analyze the features of the course of COVID-19 in children who require mandatory hospitalization in specialized hospitals for background pathology, to identify predictors of the development of severe forms of COVID-19 in order to choose the optimal ways of treating this pathology.
 MATERIALS AND METHODS: Under the supervision of the St. Petersburg State Pediatric Medical University in the department for children with new coronavirus infection COVID-19 with intensive care and intensive care wards in the period 2020–2022 with a confirmed diagnosis of “new coronavirus infection” there were 791 patients aged 0 to 17 years. The diagnosis was made on the basis of clinical and epidemiological data, the results of a comprehensive laboratory and instrumental study. The severity of the disease was determined in accordance with the methodological recommendations of the Ministry of Health of the Russian Federation.
 RESULTS: The severe form of COVID-19 was diagnosed in 34 patients out of 791 (4.3%). Adverse outcomes were 1.4%. In 27 out of 34 children (79.4%), new coronavirus infection occurred against the background of severe comorbid pathology. Pneumonia was diagnosed in 91.2% of cases. 88.2% of patients needed oxygen therapy.
 CONCLUSIONS: Severe forms of COVID-19 in children are characterized by high fever with severe intoxication, respiratory tract damage with a significant volume of lung damage (CT-3 and CT-4) with the development of multiple organ failure. Predictors that require mandatory hospitalization in specialized hospitals for background pathology in severe forms of COVID-19 are: primary immunodeficiency conditions, oncohematological pathology with postcytostatic aplasia of hematopoiesis, severe organic lesions of the central nervous system, epilepsy, protein-energy deficiency of 3–4 degrees, bronchopulmonary dysplasia, atypical emolytic uremic syndrome with acute kidney damage. Comprehensive treatment of such patients should be carried out by a multidisciplinary team in a specialized department with extensive diagnostic and therapeutic capabilities.

COVID-19 in Children: Molecular Profile and Pathological Features.

Although the World Health Organization has declared the end of the COVID-19 pandemic, doctors continue to register new cases of the disease among both adults and children. Unfortunately, the course of COVID-19 in children can have a severe form, with death being a potential outcome. The absence of published works discussing the pathological morphology of COVID-19 in children prevents the objective analysis of the disease's pathogenesis, including among the adult population. In this vein, the objective of our study is to identify the morphological features of the lungs' involvement and evaluate virus-host interactions in the case of COVID-19 in patients at a pediatric medical practice. We present the results of the study of the lungs of three children who died due to COVID-19, highlighting the predominant involvement of their respiratory organs at different stages of the disease (5, 21, and 50 days). This article presents data obtained from histopathological and immunohistochemical investigations, taking into account the results of clinical and laboratory indicators and intravital and postmortem SARS-CoV-2 PCR investigations. The common finding of all of the examined COVID-19 cases is the involvement of the endothelium in microcirculation vessels, which are considered to be a primary target of various pathogenic influencing factors. We also discuss both the significance of apoptosis as a result of virus-host interactions and the most likely cause of endothelium cell destruction. The results of this study could be useful for the development of endothelium-protective therapy to prevent the progression of disseminated intravascular coagulation syndrome.

Better COVID-19 Outcomes in Children with Good Asthma Control

Factors associated with COVID-19 presentation in children with asthma are poorly defined. Our study aimed to assess the clinical course of COVID-19 in children with asthma, with particular attention to possible risk factors for severe disease and long-term sequelae in this group of patients. We assessed the occurrence of SARS-CoV-2 infection in children with asthma six months before their regular outpatient visit to the asthma clinic. Characteristics of patients presenting with signs of SARS-CoV-2 upper (URTI) or lower respiratory tract infection (LRTI) were compared. We focused on factors previously associated with COVID-19 severity. Twenty-seven percent of patients (57/210) reported exposure to SARS-CoV-2 infection. In the symptomatic group, 36% (15/42) reported symptoms of LRTI and 64% (27/42) of URTI. Poorer asthma control was observed in patients with LRTI compared to URTI (80% vs. 7%, p < 0.001). In addition, children with poorer asthma control had a higher risk of presenting with SARS-CoV-2 LRTI in a multiple logistic regression analysis. COVID-19 disease course was not associated with regular ICS use and asthma severity. However, patients on regular ICS had better asthma control (p = 0.026). We found no PFT deterioration post-COVID-19 in either group of patients. Our results suggest good asthma control and treatment adherence prior to infection are associated with better COVID-19 outcomes in children with asthma.

Clinical case of severe COVID-19 in a child with morbid obesity

The pandemic of coronavirus infection is characterized by a low percentage of complications and severe forms in sick children compared to the adult population. However, there have been described cases of severe clinical course of COVID-19 in children with comorbidities among which is obesity. The aim of this study was to analyze the severe course of a new coronavirus infection paralleled with morbid obesity in a pediatric patient. Materials and methods. All accompanying patient medical documentation was examined. Results and discussion. From the anamnesis of life it is known that the patient was long time complained of intensively increased body weight, on which she repeatedly underwent examinations. In 2018, hypothalamic pubertal syndrome was diagnosed for the first time, for which the patient received hypoglycemic and antihypertensive drugs, hepatoprotectors on an ongoing basis. In the epidemiological anamnesis, the intrafamilial COVID-19 contact with mother was established. The main disease began acutely with a rise in body temperature up to 3939.5C, cough and weakness. During the first week of illness, the patient did not seek medical help and receive self-treatment, but the positive effect was not achieved. Saturation measurement showed low oxygen level (SpO2 71%). In this regard, the patient underwent chest computed tomography, which revealed a bilateral interstitial polysegmental lung lesion with signs of consolidation. After emergency hospitalization, the patient was prescribed empiric antibiotic therapy, anti-inflammatory and antithrombotic treatment, as well as respiratory support. A positive PCR result of a throat and nasal swab for SARS-CoV-2 was obtained in the hospital. Due to a poor response to therapy, the patient was transferred to a respiratory hospital. At the time of hospitalization, the condition was considered severe due to severe respiratory failure and premorbidity. The range of treatments included oxygenotherapy, antibacterial and anticoagulation therapy, as well as surfactant and the nucleoside analogue Remdesivir. During treatment, the clinical picture gained a positive trend, and after 6 days of hospitalization the patient no longer needed respiratory support. According to the results of repeated computed tomography, bilateral interstitial polysegmental pneumonia was diagnosed with damage to the lung tissue up to 95%. The patient remained stable and showed no signs of respiratory failure during the following days of hospitalization. On the 20th day of ilness, the patient was discharged from hospital with full clinical recovery. Conclusion. This clinical case demonstrates the role of premorbid background in aggravating the clinical picture of a new coronavirus infection in a child. Careful study of anamnestic characteristics is necessary in patients of any age, even with an uncomplicated disease course.

Clinical and paraclinical manifestation COVID-19 in different age children

COVID-19 is an infectious disease caused by a new coronavirus first discovered in 2019. The infection has spread rapidly throughout the world and affects people of all ages. Thus, 12.7% of all SARS-CoV-2 patients are children. Purpose - to establish the clinical and paraclinical manifestations of the course of COVID-19 in children, depending on age to predict the severity of the disease’s manifestation. Materials and methods. The 60 children aged from 3 months to 17 years old with laboratory-confirmed SARS-CoV-2 were examined. All patients underwent general clinical, laboratory, and instrumental examinations and received therapy according to Ukrainian National protocol. SARS-CoV-2 infection was confirmed by real-time PCR. Results. Thus, in young children COVID-19 begins acutely (90.0%) with intoxication (75.0%), fever (65.0%), nasal congestion (25.0%), rhinorrhea (20.0%), dry cough (60.0%), increased ESR and C-reactive protein (55.0%). The course of COVID-19 in children 4-6 years is accompanied by acute onset (85.71%), fever (85.71%), pharyngitis (85.71%), lymphopenia (28.56%), and no CT signs of lesions (71.43%). In children 7-12 years old, COVID-19 causes intoxication (88.89%), fever (83.33%), pharyngitis (55.56%), dry cough (77.78%), lymphocytosis (16.67%) with accelerated ESR (38.89%) and pneumonia (38.89%). The course of COVID-19 in children was older than 13 years old characterized by fever (73.33%), pharyngitis (66.67%), dry cough (73.33%), olfactory loss (20.0%), leukopenia (20.0%), ESR acceleration (20.0%), and a decrease in prothrombin (13.33%) without pulmonary lesions (73.33%). Conclusions. These data suggest that the severity and duration of clinical and laboratory manifestations of COVID-19 depend on the child’s age. The course of COVID-19 in children of all age groups is mostly of moderate severity with a favorable prognosis ((56.67%) hospitalized children did not have any complications). Only children from 7 to 12 years old need additional attention due to the severe manifestations of intoxication (88.89%) and the risk of complications with pneumonia (38.89%). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

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.

A clinical case of the new coronavirus infection with cardiac involvement in a child

The ongoing pandemic of the new coronavirus infection allows us to discover new information concerning the clinical course of the disease. Despite the rarer registration and mild course of COVID-19 in children, we get new data on more severe manifestations in the form of damage to various organs including cardiovascular system. SARS-CoV-2 can lead to myocarditis development, arrhythmia, heart failure, etc.According to an infectious diseases hospital in Omsk, heart changes were recorded in 5.8% of hospitalized children with COVID-19. The article presents a clinical case of the new coronavirus infection in a child of 15 years old who was on treatment in the infection diseases hospital of Budgetary Healthcare Institution of Omsk Oblast City Children's Clinical Hospital №3 of Omsk. The diagnosis was confirmed by examining nasopharyngeal smears for evidence of RNA SARS-CoV-2 by PCR. The course of infection in this patient is characterized by myocarditis development following medium severity disease without comorbid pathology.

The effect of morbid obesity on the outcome of COVID-19 in a child

Numerous works of domestic and foreign colleagues have proved that obesity is an independent risk factor for severe COVID-19 among patients of all age groups. Of particular interest is the study of the effect of overweight on the course of a new coronavirus infection in children and adolescents.Objective. Demonstration of a clinical case of fatal outcome of COVID-19 in a patient with morbid obesity; analysis and generalization of current data on the effect of obesity on the course of a new coronavirus infection in pediatric patients.The article presents a general understanding of the pathogenetic relationship between the two pathologies, as well as a case of a fatal outcome of a new coronavirus infection in a 9-year-old 4-month-old girl with morbid obesity (BMI — 39 kg/m2, SDS BMI +4.98σ). Emphasis is placed on the lack of parallelism between the results of the procalcitonin test and the development of the septic process.Conclusion. Studies of domestic and foreign colleagues, as well as the clinical case we have cited, confirm that morbid obesity is a risk factor for the adverse course of COVID-19 in children.

Features of the course of COVID-19 in children undergoing outpatient treatment

Objective: to study the clinical and epidemiological features of the course of a new coronavirus infection in children of different ages undergoing outpatient treatment.The study participants were 812 children with COVID-19 aged from 1 month to 17 years, who were on outpatient treatment in the children's polyclinic of the city of Kirov from July to December 2021. The average age of patients with COVID-19 was 5.9 ± 1.1 years. Among the sick young children there were 28%, adolescents — 16%. In 76% of cases, contact with patients with a new coronavirus infection was detected, mainly in the family, as well as in educational institutions. In 70% of cases, an early request for medical help was registered — in the first three days of illness. In most cases (89%), a mild severity of the disease was established with the development of subfebrile fever and pharyngitis. Rhinitis phenomena were recorded in 20% of cases. 7% of children complained of a dry cough. Lung tissue lesion (RG1) was detected in 5% of patients, gastrointestinal tract — 5%. In adolescents, the phenomena of rhinitis, pharyngitis, dry cough were less common than in other age groups. Recombinant interferon alpha-2b and umifenovir were used for etiotropic therapy. All children recovered within 7—10 days from the onset of the disease.

Толерантність до фізичного навантаження та її зміни у дітей, які перенесли COVID-19 (огляд літератури, власні дані)

Purpose - to summarize data from the literature and own experience regarding the course of COVID-19 in children; to determine changes in tolerance to physical activity in children who have experienced COVID-19. The issue of long-term consequences of the transferred COVID-19 is increasingly being raise in connection with the pandemic of COVID-19. The problem of changes in the functional state of the body, health and improving the quality of life of children who have infected COVID-19 is relevant. To analyze these parameters, it is advisable to use the assessment of tolerance to physical activity. Tolerance to physical activity is a total indicator of the body’s physiological capabilities, which allows you to assess the processes of oxygen consumption by the myocardium and myocardial reserves, which are important in the overall adaptation of the body. The «gold standard» of assessing tolerance to physical activity is the determination of the maximum VO2, and other indicators, the control of which in dynamics will allow the development of medical and rehabilitation measures aimed at the elimination of post-COVID symptoms. The authors declared no conflict of interest.

Взаємозв’язок вітамін D-статусу, генотипів за поліморфізмом rs2228570 вітамін D-рецептора та саплементації холекальциферолом у дітей шкільного віку, які хворіли на COVID-19

Purpose - to study the features of vitamin D status and the effect of vitamin D3 supplementation on 25(OH)D in the serum of school-age children with COVID-19, taking into account the genotype of the rs2228570 polymorphism of the vitamin D receptor (VDR) gene. Materials and methods. The pilot, prospective, open-label study included 36 schoolchildren aged 9-16 who experienced asymptomatic (12 children) and mild / moderate (24 children) COVID-19. In all children were studied the content of 25(OH)D in blood serum and its dynamics under the influence of supplementation of 1000 IU per day for 12 weeks, taking into account the genotypes and frequency of distribution of alleles of the rs2228570 polymorphism of the VDR gene (26 children). Results. Children with asymptomatic COVID-19 were characterized by normal values of 25(OH)D (32.682.12 ng/ml). Children who underwent mild / moderate COVID-19 were probably more (41.7%) likely to have a state of hypovitaminosis vitamin D (27.362.12 ng/ml) and fewer children (58.3%) with an optimal level of 25(OH)D than children with asymptomatic disease. In 80.7% of the examined children, the genotype was determined by the rs2228570 polymorphism of the VDR gene, which includes the G allele with greater transcriptional activity of the VDR receptor. Supplementation of 1000 IU of cholecalciferol per day, regardless of 25(OH)D status and genotype for this polymorphism probably increased the supply of vitamin D in examined children with a tendency to increase 25(OH)D in children with genotype by polymorphism rs2228570 VDR gene, which includes allele G. Conclusions. Vitamin D deficiency can be considered as a risk factor for the symptomatic course of COVID-19 in children, which requires monitoring and correction of vitamin D status, the effectiveness of which can be determined by the genotype of the rs2228570 polymorphism of the VDR gene. Further studies of the role of vitamin D / VDR complex in the development and severity of COVID-19 in children will significantly expand the understanding of the pathogenetic relationship, to suggest and predict the effectiveness of personalized vitamin D supplementation regimens. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Порівняльна характеристика третьої хвилі коронавірусної хвороби в дітей з попередніми спалахами захворюваності

Purpose - to compare the clinical and epidemiological characteristics of coronavirus infection (COVID-19) in inpatients during the third wave of the disease with previous outbreaks, to study the course of COVID-19 in children depending on the predicted variant of the virus and timely prevention of possible disease. Materials and methods. 861 case histories of children who were hospitalized at the Kyiv City Children’s Clinical Infectious Diseases Hospital (Kyiv, Ukraine) were analyzed for coronavirus disease during three outbreaks of the disease. During the observation of the pandemic, the following periods were identified: 1st wave - from June to November 2020 (340 cases); 2nd wave - from February to May 2021 (190 cases); 3d - August - December 2021 (331 cases) and divided children by age into five categories: from birth to 1 month, 1-12 months, 1-5 years, 6-10 years and over 10 years. For calculations and statistical analysis, a statistical package was used using descriptive statistics methods, namely: logistic regression models were built, with the definition of Chi-square criterion, odds ratio (OR), probable interval (95% CI) and ROC-curve multifactor model with the definition of the area under the curve (AUC). The median (M), interquartile interval (IQR, 1st-3rd quartile) was also determined in the work. Fisher’s test, Mann-Whitney test and Kruskal-Wallis test were used. Results. In the analysis of the observation of the dependence of coronavirus infection in children on the period of morbidity, using the method of logistic regression models, interrelated factors were identified: D-dimer (decreased (p=0.05) indicator for 3 waves, OR=7.47 (95% CI: 0,56-1)); radiological changes (decreased risk (p=0.005) during 3 waves, OR=1.66 (95% CI: 0.0009-2.86)) and procalcitonin (increased risk of elevated procalcitonin levels (p=0.07) during 3 waves, OR=4.27 (95% CI: 0.41-4.5)). Conclusions. The third wave of COVID-19 was characterized by a more severe course and a higher incidence of complicated cases (p<0.001). Among hospitalized pediatric patients, the proportion of patients with concomitant pathology progressively increased (p=0.0005). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local ethics committee of all participating institutions. No conflict of interests was declared by the authors. Key words: coronavirus infection, COVID-19, children, incidence wave, complications.

Prevalence of Anosmia in 10.157 Pediatric COVID-19 Cases: Multicenter Study from Turkey.

Introduction:COVID-19-related anosmia is a remarkable and disease-specific finding. With this multicenter cohort study, we aimed to determine the prevalence of anosmia in pediatric cases with COVID-19 from Turkey and make an objective assessment with a smell awareness questionnaire.Material and Methods:This multicenter prospective cohort study was conducted with pediatric infection clinics in 37 centers in 19 different cities of Turkey between October 2020 and March 2021. The symptoms of 10.157 COVID-19 cases 10–18 years old were examined. Age, gender, other accompanying symptoms, and clinical severity of the disease of cases with anosmia and ageusia included in the study were recorded. The cases were interviewed for the smell awareness questionnaire at admission and one month after the illness.Results:Anosmia was present in 12.5% (1.266/10.157) of COVID-19 cases 10-18 years of age. The complete records of 1053 patients followed during the study period were analyzed. The most common symptoms accompanying symptoms with anosmia were ageusia in 885 (84%) cases, fatigue in 534 cases (50.7%), and cough in 466 cases (44.3%). Anosmia was recorded as the only symptom in 84 (8%) of the cases. One month later, it was determined that anosmia persisted in 88 (8.4%) cases. In the smell awareness questionnaire, the score at admission was higher than the score one month later (P < 0.001).Discussion:With this study, we have provided the examination of a large case series across Turkey. Anosmia and ageusia are specific symptoms seen in cases of COVID-19. With the detection of these symptoms, it should be aimed to isolate COVID-19 cases in the early period and reduce the spread of the infection. Such studies are important because the course of COVID-19 in children differs from adults and there is limited data on the prevalence of anosmia.

The Role of Children and Young People in the Transmission of SARS-CoV-2.

The Role of Children and Young People in the Transmission of SARS-CoV-2.

COVID-19 disease characteristics in different pediatric age groups.

Little is known about the COVID-19 disease characteristics and differences between different pediatric age groups. This study aimed to investigate the disease characteristics according to age groups. We conducted a retrospective, single-center study of pediatric COVID-19 in a tertiary care hospital in Turkey. The patients were divided into three groups: 15 days-24 months old (Group 1), 25-144 months old (Group 2), and 145-210 months old (Group 3) according to age. A total of 139 pediatric patients with COVID-19 were examined. Twenty-nine patients (20.9%) were in Group 1, 52 (37.4%) were in Group 2, 58 (41.7%) were in Group 3. Thirty-nine patients (28.1%) were hospitalized. The most common symptoms were cough (55.4%) and fever (51.8%). The median chest X-ray (CXR) score of hospitalized patients was 1 (min 0-max 7), and the median CXR score of outpatients was 1 (min 0-max 6). Fever was significantly more frequent in Group 1, and chest pain was more frequent in Group 3. Group 1 had significantly higher WBC, lymphocyte, thrombocyte counts, AST, LDH, D-dimer, and Troponin T levels but lower hemoglobin, total protein, and albumin levels. The treatment included antibiotics, oseltamivir, hydroxychloroquine, and supportive therapy. Only one patient (0.7%) received non-invasive mechanical ventilatory support. As we know the clinical course of COVID-19 in children is less severe than in adults. We also found significant differences in both clinical and laboratory findings between different pediatric age groups which supports the theory that disease pathogenesis is highly variable according to age.

Features of electrocardiogram in school-age children with COVID-19

Introduction. Currently, there is an increase in the incidence and an increase in the severity of the course of COVID-19 in children. The tropism of the SARS-CoV-2 virus to the cardiovascular system has been established, while post-COVID syndrome with various manifestations is recorded in 25% of recovered adolescents. The purpose of the work was to identify the features of the electrocardiogram (ECG) pattern in children hospitalized with a diagnosis of COVID-19. Results. Significant changes in the conductivity and activity of the left heart myocardium were found in COVID-19 patients with pneumonia and respiratory failure. Pronounced changes in ECG indices were found in children of senior school age who were admitted for treatment 2.4 times more often than other children. Proarrhythmogenic ECG indices in children were detected in severe COVID-19 - with community-acquired pneumonia (ΔQTc, QTcmin) and respiratory failure (TpTe/QTmax). These ECG changes, combined with the trend in inflammation markers (an increase in the C-reactive protein level and a decrease in the number of lymphocytes) in children with a moderate course of COVID-19 may be a sign of the involvement of the myocardium in an infectious inflammatory process. This suggests that the effect on the myocardium is exerted by systemic inflammation and not by the hemodynamic overload of the right heart, which is expected in pulmonary pathology. Conclusion. The obtained data indicate the need for dynamic ECG monitoring during the acute stage of the disease and rehabilitation of children who suffered from COVID-19.

Features of the course of covid -19 in children of southern ukraine (experience of the winter season 2021-2022)

Introduction. The infection caused by the SARS-CoV-2 virus can have different clinical manifestations, affect both the respiratory system and other organ systems, and the course can vary from asymptomatic or mild to severe, requiring hospitalization. The diversity of clinical manifestations of the disease, the peculiarities of the course of the disease in different age periods force doctors to be attentive to any symptoms in patients, both those related to the respiratory system and atypical complaints. Any new information about the peculiarities of the course of the coronavirus infection, age differences, "masks" of the disease, typical and atypical clinical manifestations is important. Purpose of research. The purpose of the study was to study and analyze the clinical features of the course of the disease COVID-19 in children in the winter season of 2021-22. Materials and methods. Retrospective analysis of the disease histories of children with a severe course of COVID-19 was carried out. Results. School-age children predominated among those hospitalized, which emphasizes the epidemiological significance of this particular age category in implementation of timely quarantine measures in educational institutions. Among the clinical manifestations, both typical signs of damage to the respiratory system and symptoms of damage from the gastrointestinal tract were registered. A characteristic feature of the course of COVID-19 in the specified winter season of 2021-22. a mixed infection with rotavirus and influenza was registered, which was not observed during the previous wave of the disease. Conclusions. The identified features of the course of COVID-19 in children will help to improve algorithms for providing assistance topatients of different age categories and predict the course of the disease.

COVID-19 та постковідний синдром у дітей з бронхіальною астмою

Abstract. The aim of the study. to determine the features of the course of COVID-19 in children with bronchial asthma and the frequency of the development of post-covid syndrome. Materials and methods. According to the results of the study, 23.3 % of children had COVID-19 without symptoms. 30 children with asthma who suffered from COVID-19 were included in the study. The diagnosis of COVID-19 was confirmed by a PCR test or a rapid Ag test for COVID-19. The age of the children was from 5 to 17 years, the average age was (10.31 ± 0.74) years. Results and their discussion. According to the results of the study, 23.3 % of children had COVID-19 without symptoms. In 76.7 % of children, the course of COVID-19 was mild and was manifested by cough in 66.6 %, fever in 56.6 %, and gastrointestinal symptoms in 16.7 % of children. The need to use short-acting β2 -agonists was noted in 10.0 % of patients. Post-covid syndrome was noted in 13.3 % of children. Conclusion. COVD-19 in children with asthma had a mild or asymptomatic course. None of the children had an exacerbation of asthma or the need for correction of the basic treatment, regardless of the severity of the course of the disease.

Особенности течения раннего послеоперационного периода у детей с гастроинтестинальным синдромом на фоне инфекции COVID-19

Objective. To study the features of the development and course of gastrointestinal syndrome against the background of COVID-19 in preschool-aged children hospitalized in the Pediatric Surgery Department with acute abdominal pain. Patients and methods. The study was performed on the basis of the Departments of Pediatric Surgery, Anesthesiology and Resuscitation at Smolensk Regional Clinical Hospital between September 1, 2021, and December 30, 2021. Using continuous sampling, we analyzed clinical data of 29 children aged 4 to 7 years with acute abdominal pain against the background of COVID-19. The course of COVID-19 in children who were discharged from the Pediatric Surgery Department after exclusion of acute surgical pathology was studied in dynamics. Results. The disease manifested itself as an acute diffuse abdominal pain and hyperthermia in 100% of children; 65% of children had vomiting, and 56.25% of them had diarrhea. Seven (24%) children required diagnostic laparoscopy, of whom 5 children had no surgical pathology and 2 were diagnosed with adhesions. Laparoscopy revealed mesadenitis in all patients. Conclusion. Acute surgical pathology and gastrointestinal syndrome against the background of COVID-19 have similar manifestations during the acute period in children. Surgical interventions performed against the background of COVID-19 in the acute period provoke complications and prolong the recovery period. Key words: children, COVID-19, gastrointestinal syndrome, acute surgical pathology in children

COVID-19 и коморбидная патология у детей

Objective. To analyze clinical and laboratory characteristics of COVID-19 in children with comorbidities admitted to the intensive care unit (ICU). Patients and methods. This study included 155 infants/children aged 1 month to 18 years with confirmed COVID-19 who were admitted to the ICU No. 2 of Z.A. Bashlyaeva Children's City Clinical Hospital, Moscow Healthcare Department between March 2020 and June 2021. The diagnosis was confirmed by epidemiological, clinical, and laboratory data. Results. Thirty-six out of 155 patients admitted to the ICU (23.2 ± 3.4%) had no comorbidities. Comorbidities were detected in 119 children (76.8±3.4%) with severe COVID-19, which manifested as multisystem inflammatory syndrome in children (MIS-C) (n = 16; 13.4 ± 2.7%), CT 1-2 pneumonia (n = 25; 21 ± 3.3%), CT 2-3 pneumonia (n = 7; 5.9 ± 1.9%), and CT 3-4 pneumonia (n = 19; 16 ± 3.0%). Viral pneumonia with MIS-C was observed in 10 children (8.4 ± 2.2%). Six patients (3.9 ± 1.6%) were diagnosed with generalized bacterial infection, which aggravated the course of COVID-19. Conclusion. A total of 76.8% of children in our study were found to have some comorbidities, which is a risk factor for severe COVID-19. The most common comorbidities included nervous system diseases, metabolic disorders (such as obesity), concomitant infectious diseases, etc. So far, the information on the effects of different comorbidities on the course of COVID-19 in children is limited, which necessitated the analysis of COVID-19 course in this cohort of patients. Key words: children, new coronavirus infection, SARS-CoV-2, COVID-19, pneumonia, multisystem inflammatory syndrome, comorbidity