FEATURES OF THE CLINICAL PICTURE OF NEW CORONAVIRUS INFECTION IN CHILDREN HOSPITALIZED IN THE LIPETSK REGIONAL CLINICAL INFECTIOUS HOSPITAL

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Relevance. The new coronavirus infection COVID-19 is still one of the main medical and social problems. The disease caused by the SARS-CoV-2 virus is characterized by high contagiousness and a high number of deaths. Children make up to 12% of those infected with COVID-19 worldwide, in Russia this figure is 7% [1]. Diagnosed clinical cases of a new coronavirus infection are registered, including in newborns [2]. According to the data presented in the scientific literature, in the pediatric population, COVID-19 occurs more often in a mild or asymptomatic form [3, 4].
Purpose of the study. To study the features of the clinical picture of COVID-19 in children in the Lipetsk region and the city of Lipetsk, who were hospitalized at the Lipetsk Regional Clinical Infectious Diseases Hospital.
Materials and methods. On the basis of the Lipetsk Regional Clinical Infectious Diseases Hospital, from the beginning of July 2021 to the end of December 2021, we conducted a retrospective analysis of medical records of case histories of 210 children aged from 1 day of life to 17 years. All children had a confirmed coronavirus infection (detection of virus RNA by PCR).
Results. According to the age structure, children were divided into the following age groups: up to 1 year old - 46 children (21.9%), from 1 to 5 years old - 54 children (25.7%), from 6 to 11 years old - 43 children (20. 4%), from 12 to 17 years old - 67 children (32%). Having studied the epidemic history, it was found that 115 children (55%) did not come into contact with people who had signs of infectious diseases, or the source of the infection was not identified. Less than half of the patients, namely 84 children (40%), were from family or other foci of coronavirus infection. The percentage of children who had contact with people who had symptoms of SARS was 4% (9 children). The smallest percentage were children traveling or living in the focus of coronavirus infection during the 14 days preceding the onset of the disease (1%). On average, patients were admitted to the hospital on the 6th day of illness. The average duration of hospitalization of children was 8 bed-days. Most children were dominated by moderate forms of the disease (197 children - 93.8%). 63% of hospitalized children had no history of comorbidities. 78 hospitalized children (37%) had a comorbid background in the form of pathologies of the central nervous system (epilepsy, cerebral palsy, autonomic dysfunction syndrome), cardiovascular system (hypertension, ventricular septal defect, patent ductus arteriosus), respiratory system (bronchial asthma), mental disorders (autism, schizophrenia), gastrointestinal disorders (chronic gastritis, irritable bowel syndrome, acute intestinal infection, chronic pancreatitis), autoimmune diseases (autoimmune polyglandular syndrome, type 1 diabetes mellitus), blood diseases (anemia, T-cell lymphoma) , allergic reactions.
Among hospitalized patients, pneumonia was detected in 77 people (37%). The disease with a mild course had the following clinical picture: fever up to 38.5 ºС, pain and sore throat, cough, rhinitis or nasal congestion. A number of patients experienced abdominal pain, nausea, vomiting, often revealed a variety of exanthems. During auscultation of the lungs, no changes were observed, or hard breathing was noted; According to X-ray or CT of the chest, there were no lesions of the lung tissue. Patients with mild COVID-19 were hospitalized in the following cases: age up to 3 years; the presence of an unfavorable premorbid background and / or a chronic disease; according to epidemic indications.
The course of moderate severity was characterized by hyperthermia from 38.5°C and above; an increase in respiratory rate, the appearance of shortness of breath during physical exertion; changes on radiography or CT of the chest (minimal and moderate lesions); in some patients, there was a decrease in saturation (SpO2<96%).
In severe form, the disease proceeded in 10 (4.7%) patients, six of them were in the intensive care unit. They noted: shortness of breath (at rest), decreased saturation (SpO2≤93%), change in consciousness, prolonged fever, significant lung damage on CT.
Based on the collected data, the clinical picture showed an increase in temperature in 180 patients (85.7%), of which subfebrile fever occurred in 73 children (40%), febrile - in 68 children (38%), high - in 39 children (22 %). Cough bothered 118 people (56%), signs of intoxication (myalgia, nausea, general weakness, headache, loss/lack of appetite) in 185 children (88%). Some patients experienced dyspeptic phenomena such as vomiting (9%) and diarrhea (14%). Skin rashes appeared either from the onset of the disease, or preceded the main clinical picture, were noted in 18% of children. Rashes of the type of urticaria were more common. This type of exanthema could be a manifestation of the disease or developed against the background of ongoing (usually antibiotic) therapy.
When conducting a laboratory examination in the general blood test, anemia occurred in 63

About the authors

Angelina Y. Cherkasova

Воронежский государственный медицинский университет им. Н.Н. Бурденко

Author for correspondence.
Email: angelina.tcherkasova@yandex.ru
ORCID iD: 0000-0002-3057-7340
SPIN-code: 6938-7290
Russian Federation

Kseniya V. Safronova

Воронежский государственный медицинский университет им. Н.Н. Бурденко

Email: ksuxan.ru@mail.ru
ORCID iD: 0000-0002-3579-6454
SPIN-code: 9236-2082
Russian Federation

Victoriya V. Kolomatskaya

Воронежский государственный медицинский университет им. Н.Н. Бурденко

Email: viktoriaklm@mail.ru
ORCID iD: 0000-0002-4674-5804
SPIN-code: 4799-8166
Russian Federation

Dayana R. Chernyavskaya

Воронежский государственный медицинский университет им. Н.Н. Бурденко

Email: dayana.chernyavskaya.99@mail.ru
ORCID iD: 0000-0002-0061-1480
SPIN-code: 9022-2874
Russian Federation

References