ABSTRACT
Purpose - to study the features of COVID-19 in hospitalized children. Materials and methods. Retrospective multicenter clinical and epidemiological study which includes 328 hospitalized children with laboratory-confirmed COVID-19 for the period from January to August 2021. Results, the highest specific weight among all hospitalized children falls on children of the first year (75/328;22.8%), in general, early childhood (up to 3 years) accounted for 43%(141/328) of all hospitalizations of children with COVID-19. Common symptoms of the disease included fever, upper respiratory symptoms, intoxication, diarrhea. In 99/328 (30.1%) hospitalized children pneumonia has developed, 50/99 (50.5%) of which needed oxygen support, 10/99 (10.1%) - mechanical ventilation. Pneumonia was most common in children under 1 year, children of the first 5 years of life accounted for more than a half of all pneumonia cases (53/99;53,5%). 13/328 (3.9%) children were hospitalized to the intensive care unit. Comorbidities including endocrine, oncological, neurological diseases, congenital malformations and others, were noted n 24.6% of hospitalized children. In children with comorbid conditions, pneumonia occurred 2 times more often (relative risk factor RR=1.98, CI 95%), the relative risk of getting into resuscitation RR in the presence of comorbidity is 10.86 (CI 95%). In addition to children with pneumonia, oxygen support or mechanical ventilation required children with obstructive syndrome, pancytopenia, convulsions. The largest proportion of comorbidities in patients hospitalized to the intensive care unit were diseases of the nervous system (congenital malformations of the CNS, cerebral palsy, epilepsy, astrocytoma). Lymphopenia and thrombocytopenia were most commonly associated with severe COVID-19. Conclusions. Children of all ages are susceptible to COVID-19. The main risk factors for severe disease are early age and the presence of comorbid conditions, among which the most relevant are diabetes, obesity, neurological diseases and cancer. The presence of comorbidities in children determines the priority groups for the prevention of coronavirus infection through vaccination. © 2022 by the Author(s).
ABSTRACT
The aim of the study - systematization and analysis of information on the prevalence of SARS-CoV-2 virus variants according to information databases and own cross-sectional studies. Materials and methods. The analysis was conducted in the period 2020-2021 using information databases and research re-sources: Google Scholar, Cochrane Library, Scirus, Springer, Medline, Embase, PubMed, Web of Science. Our own examination included a total of 80 nasopharyngeal swabs (at least two specimens in each case) collected from ARVI symptomatic or suspected COVID-19 patients, who were treated at the MNE KRC "Regional Clinical Infectious Diseases Hospital" from June to October 2021 and tested positive on SARS-CoV-2. The first study was performed in the inter-peak period, and the second one - on the rise of the disease. A real-time polymerase chain reaction (PCR) method was used for primary identification with the diagnostic kit "Bio-core (R) SARS-CoV-2" (LLC "Biocor Technology Ltd.", Ukraine) in accordance with the manufacturer's instructions. Multiplex analysis SNPsig (R) VariPLEXTM Covid-19 (PrimerdesignTM Ltd., UK) was used in the first cross-sectional study for secondary identification. Results. Systematization and analysis of the prevalence of SARS-CoV-2 variants according to information databases were per-formed. According to the results of our cross-sectional studies on SARS-CoV2 variants circulating in the Kharkiv region in June - October 2021, the complete replacement of the alpha variant, which was dominant in June - 87.5 %, with the delta variant - 95.0 %. All patients had signs of respiratory failure, community-acquired pneumonia was visualized instrumentally (computed tomography, radiography, ultrasound) at the first study in 90 % of cases, and at the second - in 100 %. The median age of patients was 60.4 years (minimum - 25 years, maximum - 91 years) during the first study, but during the second - 52.6 years (minimum - 18 years, maximum - 84 years). Thus, the more aggressive and contagious delta variant has become dominant requiring thorough public health anti-epidemic measures. Conclusions. Monitoring and control of the virus evolution using epidemiological studies, viral genetic sequence, as well as la- boratory PCR are necessary to prevent the spread of COVID-19, to study the effectiveness of test systems and optimize diagnosis and etiotropic therapy as well as vaccine modifications.