Coronavirus disease 2019 (COVID-19) and immune-mediated rheumatic diseases. Recommendations of the association of rheumatologists of Russia

In mid-2021, the SARS-CoV-2 (Severe Acute Respiratory coronavirus 2) infection, which caused the coronavirus disease (COVID-19) pandemic, affected more than 157 million people in all regions of the world and led to more than 3.2 million deaths. It is assumed that elderly age, uncontrolled inflammation, anti-inflammatory therapy, comorbid pathology, genetic and other factors can potentially lead to an increase in “sensitivity” to viral and bacterial infections, including SARS-CoV-2. The new version of the recommendations of the Association of Rheumatologists of Russia formulates the main provisions concerning the tactics of managing patients with Immune-mediated Rheumatic Diseases during the ongoing COVID-19 pandemic.

COVID-19: what pediatricians learned about peculiarities of the immune response to a new coronavirus infection after year of fighting it

A year ago, the world heard about an outbreak of a new severe coronavirus infection in China, which later, after its rapid spread across the globe, WHO defined as a pandemic. Pediatricians, of course, expected the worst-case scenario and mass illness of the most vulnerable patients - children and people of older age groups with a new infectious disease. From the immunological point of view, everything is obvious - the new pathogen is most dangerous for those who have not yet formed a defense against it, or for those with weakened defense. But it quickly became clear that, unlike, for example, a flu pandemic, there is an unexpected situation when adults, including elderly and senile patients, become seriously ill and die, and children remain practically outside the spread of the infectious process. During a year of living «in a new reality», not only physicians, but all of humanity learned to respond to a new infectious challenge, empirically looking for possible therapeutic or diagnostic interventions and at the same time trying to plan and implement scientific research that would help shed light on the questions posed. For the first time, the international medical community united to perform serious clinical trials of drugs that were proposed for the treatment or prevention of COVID-19. As a result of actions of scientists and clinicians around the world, answers to some questions were obtained, however, most of the information on the impact of the new coronavirus on the human body, including children, is still unavailable to medical practitioners. The review presents latest data on the causative agent of the new coronavirus infection, its effect on the body of children and adults, describes peculiarities of immune response to the new virus, and outlines basic principles of managing such patients in real clinical practice. Год назад мир услышал о вспышке в КНР новой тяжелой коронавирусной инфекции, которую позже, после ее стремительного распространения по всему земному шару, ВОЗ определила как пандемию. Педиатры, безусловно, ожидали наихудшего сценария и массового поражения новой инфекционной болезнью самых уязвимых пациентов - детей и людей старших возрастных групп. Ведь с иммунологической точки зрения все очевидно - новый возбудитель наиболее опасен для тех, кто еще не сформировал защиту против него, или у кого она уже не столь совершенна. Но достаточно быстро стало ясно, что, в отличие, например, от пандемии гриппа, имеет место неожиданная ситуация, когда тяжело заболевают и умирают люди взрослые, в том числе пожилого и старческого возраста, а дети остаются практически вне распространения инфекционного процесса. В течение года жизни «в новой реальности» не только медики, но и все человечество училось реагировать на новый инфекционный вызов, эмпирически нащупывая возможные лечебные или диагностические интервенции и параллельно пытаясь спланировать и реализовать научные исследования, которые помогли бы пролить свет на поставленные вопросы. Впервые международная медицинская общественность, объединившись широким фронтом, проводила серьезные клинические исследования лекарственных средств, которые предлагалось применять для лечения или профилактики COVID-19. В результате действий ученых и клиницистов мира получены ответы на некоторые вопросы, однако большая часть информации, касающейся воздействия нового коронавируса на организм человека, в том числе ребенка, пока все еще недоступна представителям практической медицины. В обзоре представлены последние данные о возбудителе новой коронавирусной инфекции, его воздействии на организм детей и взрослых, описаны особенности иммунного реагирования пациентов на новый вирус, а также изложены основные принципы ведения таких пациентов в реальной клинической практике.

COVID-19 and children

In December 2019, the world became aware of an epidemic of a very severe infection caused by a new coronavirus. Later, WHO declared a pandemic. The pediatricians were ready for the worst. The novel infection was expected to promptly spread among the most vulnerable population, children. But the clinicians soon understood that the situation is unbelievable: adults develop severe disease and die, while the children remain almost excluded from the infection spreading. 9 months have passed in the “new reality”. The humankind was learning to respond to the new infection challenge by empirical search for the potential therapeutic and diagnostic solutions and conducting wide clinical studies in parallel. A few questions have been answered because of consolidated and/or isolated actions of researchers and clinicians at the national, regional, and international levels. However, most aspects of how the new coronavirus affects the humans, including children, is still unclear and our knowledge of these aspects cannot be transferred in the routine practice. This review presents latest understanding of the course of the novel coronavirus infection in children, its treatment and outcomes. © 2020 Medical Education. All rights reserved.

Coronaviral infection (COVID-19) in children (situation on June 2020)

Dear friends, colleagues! The number of cases of new coronaviral infection has begun to decrease over the past two months, whereas, the number of publications on the accumulated experience of diagnosis, management and rehabilitation is increasing. It allows us to share knowledge and enhance our tactics. We present updated data on SARS-CoV-19 coronavirus and the disease it causes in this review.

Statement on management of children with allergic diseases during new coronaviral infection SARS-CoV-2 pandemic (COVID-19 infection)

The COVID-19 infection caused by the new coronavirus SARS-CoV-2 has become the real pandemic. Children account for 1-6% of all diagnosed COVID-19 cases. Generally, children have mild disease in comparison to adults, and their mortality rates are extremely low. Despite the fact that all the main efforts of the medical and political community are now focused on preventing the pandemic spread and organizing medical care for patients with moderate and severe COVID-19 course, we still have to remember to implement adequate help for patients with chronic diseases, especially for children with allergic diseases. The pandemic period coincided with natural weather period of dusting of causative plants, that led to annual escalation of both allergic rhinitis and asthma in patient group with specific sensitization to tree pollen. Leading experts of allergology (adapting to modern conditions) have created key guidelines on management of children with allergic diseases during the COVID-19 pandemic. These guidelines are based on the data and results from the Union of Pediatricians of Russia, Russian Association of Allergologists and Clinical Immunologists, European Academy of Allergy and Clinical Immunology (EAACI), European Respiratory Society (ERS), American Thoracic Society (ATS), Global Strategy for Asthma Management (GINA), Initiative on Allergic Rhinitis and its Impact on Asthma (ARIA/MACVIA).