2 research outputs found
Π₯Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠ° COVID-19 Ρ Π΄Π΅ΡΠ΅ΠΉ: ΠΏΠ΅ΡΠ²ΡΠΉ ΠΎΠΏΡΡ ΡΠ°Π±ΠΎΡΡ Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ΅ Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π°
Objective: to identify the clinical, laboratory and epidemiological features of the new coronavirus (CV) infection in the provision of specialized medical care to children in the megalopolis of the Russian Federation. Methods: 674 cases of hospitalization of patients from birth to 17 years old inclusive with confirmed COVID-19 in the period from March 26 to June 26, 2020 in a childrenβs multidisciplinary hospital in St. Petersburg. Diagnostics of SARS-COV-2 in upper respiratory tract (URT) smears was carried out by PCR (a set of reagents for detecting RNA of coronavirus 2019-nCoV by PCR with hybridization-fluorescence detection βVector-PCRRV-2019-nCoV-RGβ). Patients underwent 4 (3; 5) repeated examinations depending on the diagnosis of the referral, as well as the duration of the convalescent virus carriage. The analysis of the severity of the course of the disease, the main clinical manifestations and their relationship with the development of pneumonia, as well as the epidemiological features of COVID-19 in children. The duration of inpatient treatment, outcomes and the need for intensive care are described. Changes in a number of laboratory parameters on analyzers made in the USA were assessed: a clinical blood test on a hematological one - Coulter UniCel (Beckman Coulter), a biochemical blood test on a biochemical one - Uni Cel DxC (Beckman Coulter), a coagulogram on a hemostasis analyzer (Instrumentation Laboratory). Results: Overall, there was a favorable course of COVID-19 in children. Intensive therapy was required only in 3.6% of cases with a total mortality rate of 0.15%, Kawasakilike syndrome was recorded in 0.3% of cases. In 1/3 of patients, prolonged viral shedding from the upper respiratory tract was detected. In children, intrafamilial infection from adults was in the lead; schoolchildren accounted for half of all hospitalizations. A distinctive feature of the new infection was mild clinical symptoms with fever and catarrhal symptoms up to 4/5 of cases, gastrointestinal symptoms - in every third patient. There were no significant differences in the severity of the disease by age. Pneumonia, diagnosed in ΒΎ cases by computed tomography, complicated the course in 13.1% of cases. The defeat of the lungs was accompanied by fever and dry cough, and in a more severe course: desaturation, chest pains, a feeling of insufficiency of inspiration. The age peaks of the incidence of pneumonia were revealed: at 4, 9, 12 years old and at the age of 17 years, the maximum (in 1/3 of cases). Laboratory changes were insignificant and quickly reversible. Conclusion: the course of COVID-19 in children in the megalopolis of Russia is comparable with foreign information. However, taking into account the experience of βSpanish βfluβ, it is possible that in pediatric practice the number of severe forms and unfavorable outcomes may change in the near future, especially due to the difficulty of diagnosing Kawasaki-like syndrome and the need for a multidisciplinary approach to the treatment of such patients. Currently, the most vulnerable to the new CV are children with severe oncological, neurological and cardiovascular pathology, who have a rapid decompensation of the underlying disease against the background of COVID-19.Π¦Π΅Π»Ρ: Π²ΡΡΠ²ΠΈΡΡ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΠ΅ ΠΈ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ Π½ΠΎΠ²ΠΎΠΉ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ ΠΏΡΠΈ ΠΎΠΊΠ°Π·Π°Π½ΠΈΠΈ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π΄Π΅ΡΡΠΌ Π² ΠΌΠ΅Π³Π°ΠΏΠΎΠ»ΠΈΡΠ΅ Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ: 674 ΡΠ»ΡΡΠ°Ρ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΎΡ ΡΠΎΠΆΠ΄Π΅Π½ΠΈΡ Π΄ΠΎ 17 Π»Π΅Ρ Π²ΠΊΠ»ΡΡΠΈΡΠ΅Π»ΡΠ½ΠΎ Ρ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½Π½ΡΠΌ COVID-19 Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ Ρ 26 ΠΌΠ°ΡΡΠ° ΠΏΠΎ 26 ΠΈΡΠ½Ρ 2020 Π³. Π² Π΄Π΅ΡΡΠΊΠΈΠΉ ΠΌΠ½ΠΎΠ³ΠΎΠΏΡΠΎΡΠΈΠ»ΡΠ½ΡΠΉ ΡΡΠ°ΡΠΈΠΎΠ½Π°Ρ Π‘Π°Π½ΠΊΡΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π°. ΠΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° SARS-COV-2 Π² ΠΌΠ°Π·ΠΊΠ°Ρ
ΠΈΠ· Π²Π΅ΡΡ
Π½ΠΈΡ
Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»Π°ΡΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΠ¦Π (Π½Π°Π±ΠΎΡ ΡΠ΅Π°Π³Π΅Π½ΡΠΎΠ² Π΄Π»Ρ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ Π ΠΠ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ° 2019- nCoV ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΠ¦Π Ρ Π³ΠΈΠ±ΡΠΈΠ΄ΠΈΠ·Π°ΡΠΈΠΎΠ½Π½ΠΎ-ΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½ΠΎΠΉ Π΄Π΅ΡΠ΅ΠΊΡΠΈΠ΅ΠΉ Β«ΠΠ΅ΠΊΡΠΎΡ-ΠΠ¦Π Π Π-2019-nCoVβRGΒ»). ΠΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ 4 (3; 5) ΠΏΠΎΠ²ΡΠΎΡΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΡ, Π° ΡΠ°ΠΊΠΆΠ΅ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΡΠ΅ΠΊΠΎΠ½Π²Π°Π»Π΅ΡΡΠ΅Π½ΡΠ½ΠΎΠ³ΠΎ Π²ΠΈΡΡΡΠΎΠ½ΠΎΡΠΈΡΠ΅Π»ΡΡΡΠ²Π°. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· ΡΡΠΆΠ΅ΡΡΠΈ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠΉ ΠΈ ΠΈΡ
Π²Π·Π°ΠΈΠΌΠΎΡΠ²ΡΠ·ΠΈ Ρ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ΠΌ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠΈ, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ COVID-19 Ρ Π΄Π΅ΡΠ΅ΠΉ. ΠΠΏΠΈΡΠ°Π½Π° ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ, ΠΈΡΡ
ΠΎΠ΄Ρ ΠΈ ΠΏΠΎΡΡΠ΅Π±Π½ΠΎΡΡΡ Π² ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΡΠ΅Π½Π΅Π½Ρ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΡΠ΄Π° Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ Π½Π° Π°Π½Π°Π»ΠΈΠ·Π°ΡΠΎΡΠ°Ρ
ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π° Π‘Π¨Π: ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΊΡΠΎΠ²ΠΈ Π½Π° Π³Π΅ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ β Coulter UniCel (Beckman Coulter), Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΊΡΠΎΠ²ΠΈ Π½Π° Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠΌ β Uni Cel DxC (Beckman Coulter), ΠΊΠΎΠ°Π³ΡΠ»ΠΎΠ³ΡΠ°ΠΌΠΌΠ° Π½Π° Π°Π½Π°Π»ΠΈΠ·Π°ΡΠΎΡΠ΅ Π³Π΅ΠΌΠΎΡΡΠ°Π·Π° (Instrumentation Laboratory). Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ: Π² ΡΠ΅Π»ΠΎΠΌ, ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΠΎΠ΅ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ COVID-19 Ρ Π΄Π΅ΡΠ΅ΠΉ. ΠΠ½ΡΠ΅Π½ΡΠΈΠ²Π½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΠΏΠΎΡΡΠ΅Π±ΠΎΠ²Π°Π»Π°ΡΡ Π»ΠΈΡΡ Π² 3,6% ΡΠ»ΡΡΠ°Π΅Π² Ρ ΠΎΠ±ΡΠ΅ΠΉ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡΡ 0,15%, ΠΠ°Π²Π°ΡΠ°ΠΊΠΈ-ΠΏΠΎΠ΄ΠΎΠ±Π½ΡΠΉ ΡΠΈΠ½Π΄ΡΠΎΠΌ Π·Π°ΡΠΈΠΊΡΠΈΡΠΎΠ²Π°Π½ Π² 0,3% ΡΠ»ΡΡΠ°Π΅Π². Π£ 1/3 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π²ΡΡΠ²Π»Π΅Π½ΠΎ Π·Π°ΡΡΠΆΠ½ΠΎΠ΅ Π²ΠΈΡΡΡΠΎΠ²ΡΠ΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΈΠ· Π²Π΅ΡΡ
Π½ΠΈΡ
Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΏΡΡΠ΅ΠΉ. Π£ Π΄Π΅ΡΠ΅ΠΉ Π»ΠΈΠ΄ΠΈΡΠΎΠ²Π°Π»ΠΎ Π²Π½ΡΡΡΠΈΡΠ΅ΠΌΠ΅ΠΉΠ½ΠΎΠ΅ Π·Π°ΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ ΠΎΡ Π²Π·ΡΠΎΡΠ»ΡΡ
, ΡΠΊΠΎΠ»ΡΠ½ΠΈΠΊΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ ΠΏΠΎΠ»ΠΎΠ²ΠΈΠ½Ρ Π²ΡΠ΅Ρ
ΡΠ»ΡΡΠ°Π΅Π² Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ. ΠΡΠ»ΠΈΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠ΅ΡΡΠΎΠΉ Π½ΠΎΠ²ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ Π±ΡΠ»Π° Π½Π΅ΡΡΠΊΠ°Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΡΠΈΠΊΠ° Ρ Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΎΠΉ ΠΈ ΠΊΠ°ΡΠ°ΡΠ°Π»ΡΠ½ΡΠΌΠΈ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΠΌΠΈ Π΄ΠΎ 4/5 ΡΠ»ΡΡΠ°Π΅Π², ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎ-ΠΊΠΈΡΠ΅ΡΠ½ΡΠΌΠΈ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΠΌΠΈ β Ρ ΠΊΠ°ΠΆΠ΄ΠΎΠ³ΠΎ ΡΡΠ΅ΡΡΠ΅Π³ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°. ΠΠ½Π°ΡΠΈΠΌΡΡ
ΡΠ°Π·Π»ΠΈΡΠΈΠΉ Π² ΡΡΠΆΠ΅ΡΡΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΏΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ°ΠΌ Π²ΡΡΠ²Π»Π΅Π½ΠΎ Π½Π΅ Π±ΡΠ»ΠΎ. ΠΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΡ, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠΎΠ²Π°Π½Π½Π°Ρ Π² ΒΎ ΡΠ»ΡΡΠ°Π΅Π² Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠΈ, ΠΎΡΠ»ΠΎΠΆΠ½ΡΠ»Π° ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ Π² 13,1% ΡΠ»ΡΡΠ°Π΅Π². ΠΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ Π»Π΅Π³ΠΊΠΈΡ
ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π»ΠΎΡΡ Π»ΠΈΡ
ΠΎΡΠ°Π΄ΠΊΠΎΠΉ ΠΈ ΡΡΡ
ΠΈΠΌ ΠΊΠ°ΡΠ»Π΅ΠΌ, Π° ΠΏΡΠΈ Π±ΠΎΠ»Π΅Π΅ ΡΡΠΆΠ΅Π»ΠΎΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠΈ β Π΄Π΅ΡΠ°ΡΡΡΠ°ΡΠΈΠ΅ΠΉ, Π±ΠΎΠ»ΡΠΌΠΈ Π² Π³ΡΡΠ΄Π½ΠΎΠΉ ΠΊΠ»Π΅ΡΠΊΠ΅, ΡΡΠ²ΡΡΠ²ΠΎΠΌ Π½Π΅ΠΏΠΎΠ»Π½ΠΎΡΠ΅Π½Π½ΠΎΡΡΠΈ Π²Π΄ΠΎΡ
Π°. ΠΡΡΠ²Π»Π΅Π½Ρ Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΡΠ΅ ΠΏΠΈΠΊΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠ΅ΠΉ: Π² 4, 9, 12 Π»Π΅Ρ ΠΈ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ 17 Π»Π΅Ρ ΠΌΠ°ΠΊΡΠΈΠΌΠ°Π»ΡΠ½ΡΠΉ (Π² 1/3 ΡΠ»ΡΡΠ°Π΅Π²). ΠΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ Π±ΡΠ»ΠΈ Π½Π΅ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠΌΠΈ ΠΈ Π±ΡΡΡΡΠΎ ΠΎΠ±ΡΠ°ΡΠΈΠΌΡΠΌΠΈ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅: ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ COVID-19 Ρ Π΄Π΅ΡΠ΅ΠΉ Π² ΠΌΠ΅Π³Π°ΠΏΠΎΠ»ΠΈΡΠ΅ Π ΠΎΡΡΠΈΠΈ ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΠΎ Ρ Π·Π°ΡΡΠ±Π΅ΠΆΠ½ΡΠΌΠΈ Π΄Π°Π½Π½ΡΠΌΠΈ. ΠΠ΄Π½Π°ΠΊΠΎ, ΡΡΠΈΡΡΠ²Π°Ρ ΠΎΠΏΡΡ ΠΈΡΠΏΠ°Π½ΠΊΠΈ, Π½Π΅ ΠΈΡΠΊΠ»ΡΡΠ΅Π½ΠΎ, ΡΡΠΎ Π² ΠΏΠ΅Π΄ΠΈΠ°ΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅ ΡΠΈΡΠ»ΠΎ ΡΡΠΆΠ΅Π»ΡΡ
ΡΠΎΡΠΌ ΠΈ Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΡ
ΠΈΡΡ
ΠΎΠ΄ΠΎΠ² ΠΌΠΎΠΆΠ΅Ρ ΠΈΠ·ΠΌΠ΅Π½ΠΈΡΡΡΡ Π² Π±Π»ΠΈΠΆΠ°ΠΉΡΠ΅ΠΌ Π±ΡΠ΄ΡΡΠ΅ΠΌ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎ ΠΏΠΎ ΠΏΡΠΈΡΠΈΠ½Π΅ ΡΠ»ΠΎΠΆΠ½ΠΎΡΡΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΠ°Π²Π°ΡΠ°ΠΊΠΈΠΏΠΎΠ΄ΠΎΠ±Π½ΠΎΠ³ΠΎ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΠΈ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΠΈ ΠΌΡΠ»ΡΡΠΈΠ΄ΠΈΡΡΠΈΠΏΠ»ΠΈΠ½Π°ΡΠ½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π° ΠΊ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠ°ΠΊΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². Π Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΡΠ·Π²ΠΈΠΌΡΠΌΠΈ Π² ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ Π½ΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ° ΡΠ²Π»ΡΡΡΡΡ Π΄Π΅ΡΠΈ Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ, Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠ΅ΠΉ, Ρ ΠΊΠΎΡΠΎΡΡΡ
ΠΏΡΠΎΠΈΡΡ
ΠΎΠ΄ΠΈΡ Π±ΡΡΡΡΠ°Ρ Π΄Π΅ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠ°ΡΠΈΡ ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠ³ΠΎ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π½Π° ΡΠΎΠ½Π΅ COVID-19
Characteristics of CoVID-19 in children: the first experience in the hospital of st. Petersburg
Objective: to identify the clinical, laboratory and epidemiological features of the new coronavirus (CV) infection in the provision of specialized medical care to children in the megalopolis of the Russian Federation. Methods: 674 cases of hospitalization of patients from birth to 17 years old inclusive with confirmed COVID-19 in the period from March 26 to June 26, 2020 in a childrenβs multidisciplinary hospital in St. Petersburg. Diagnostics of SARS-COV-2 in upper respiratory tract (URT) smears was carried out by PCR (a set of reagents for detecting RNA of coronavirus 2019-nCoV by PCR with hybridization-fluorescence detection βVector-PCRRV-2019-nCoV-RGβ). Patients underwent 4 (3; 5) repeated examinations depending on the diagnosis of the referral, as well as the duration of the convalescent virus carriage. The analysis of the severity of the course of the disease, the main clinical manifestations and their relationship with the development of pneumonia, as well as the epidemiological features of COVID-19 in children. The duration of inpatient treatment, outcomes and the need for intensive care are described. Changes in a number of laboratory parameters on analyzers made in the USA were assessed: a clinical blood test on a hematological one - Coulter UniCel (Beckman Coulter), a biochemical blood test on a biochemical one - Uni Cel DxC (Beckman Coulter), a coagulogram on a hemostasis analyzer (Instrumentation Laboratory). Results: Overall, there was a favorable course of COVID-19 in children. Intensive therapy was required only in 3.6% of cases with a total mortality rate of 0.15%, Kawasakilike syndrome was recorded in 0.3% of cases. In 1/3 of patients, prolonged viral shedding from the upper respiratory tract was detected. In children, intrafamilial infection from adults was in the lead; schoolchildren accounted for half of all hospitalizations. A distinctive feature of the new infection was mild clinical symptoms with fever and catarrhal symptoms up to 4/5 of cases, gastrointestinal symptoms - in every third patient. There were no significant differences in the severity of the disease by age. Pneumonia, diagnosed in ΒΎ cases by computed tomography, complicated the course in 13.1% of cases. The defeat of the lungs was accompanied by fever and dry cough, and in a more severe course: desaturation, chest pains, a feeling of insufficiency of inspiration. The age peaks of the incidence of pneumonia were revealed: at 4, 9, 12 years old and at the age of 17 years, the maximum (in 1/3 of cases). Laboratory changes were insignificant and quickly reversible. Conclusion: the course of COVID-19 in children in the megalopolis of Russia is comparable with foreign information. However, taking into account the experience of βSpanish βfluβ, it is possible that in pediatric practice the number of severe forms and unfavorable outcomes may change in the near future, especially due to the difficulty of diagnosing Kawasaki-like syndrome and the need for a multidisciplinary approach to the treatment of such patients. Currently, the most vulnerable to the new CV are children with severe oncological, neurological and cardiovascular pathology, who have a rapid decompensation of the underlying disease against the background of COVID-19