ABSTRACT
Purpose — to analyze of peculiarities of MIS-C in children of Lviv region. Materials and methods. We have analyzed medical records of 16 children who were treated in Communal Non-Commercial Establishment of Lviv Regional Council «Lviv Regional Children Clinical Hospital «OKHMATDYT» in the period from September 2020 to January 2021 with the diagnosis of MIS-C, associated with SARS-CoV-2. Results. MIS-C was diagnosed in 16 children (average age was 8,2±0,065 years, girls:boys = 1:0.6). None of our patients was the «primary source of SARS-CoV-2» in the household but contracted coronavirus disease after a contact with the sick relatives. The disease occurred in 4 (25%) children against the background of acute coronavirus disease, in 4 (25%) more children during the first month and 8 (50%) children more than a month after acute SARS-CoV-2 infection. All children has febrile fever and general weakness. Besides, in most of the patients clinical progression of MIS-C was characterized by typical skin rashes and conjunctivitis (13 children — 81,5%), facial swelling and edema of distal parts of extremities (11 children — 68,75%). Muscle pain was present in 9 (56%) children, hyperesthesia — in 4 (25%) children, gastrointestinal symptoms — in 8 (50%) our patients. Myocarditis was diagnosed in 4 (25%) children, linear dilatation of coronary arteries (2 children — 12,5%) and small aneurysms (1 child — 6,25%) — in 3 (18,75%) our patients. All these changes returned to normal 1 month after discharge from the hospital. Conclusions. MIS-C response before the 48th day after acute coronavirus disease and is characterized by typical clinical course. Treatment with human immunoglobulin at the dose of 1–2 g/kg, glucocorticosteroids at the dose of 1–2 mg/kg, aspirin 3-5 mg/kg against the background of antibacterial therapy is effective for the prevention of changes in the coronary arteries and for the recovery of all patients. The research was conducted in accordance with the principles of bioethics set out in the WMA Declaration of Helsinki and Universal Declaration on Bioethics and was approved by the Commission on Ethics of Scientific Research, Experimental Developments and Scientific Works of Dany-lo Halytsky Lviv National Medical University. The informed consent of the patients was obtained for conducting the studies. No conflict of interests was declared by the authors. © 2022, Group of Companies Med Expert, LLC. All rights reserved.
ABSTRACT
Since March 11, coronavirus infection has become an intercontinental problem - a pandemic has developed.Ukraine (until December 2019) ranks 17th in the world in the number of Covid-19 cases. Although according to statistics, the children are the least vulnerable group for coronavirus infection, unfortunately, severe and serious complications such as pneumonia, Kawasaki disease and Kawasaki-like syndrome, Multisystem inflammatory syndrome in children, toxic shock syndrome, myocarditis occur in children, too. As of the end of November, according to the Ministry of Health in Ukraine, 732,625 cases of coronavirus were laboratory- confirmed, including 13,720 children. According to the Lviv Regional Laboratory Center of the Ministry of Health, in the Lviv region since the beginning of the Covid-19 pandemic, among 46078 of all infected were about 5-6% of children. To analyze clinical, laboratory features of severe coronavirus infection complicated by bilateral pneumonia with acute respiratory distress syndrome (ARDS) in a three-year-old girl who was on V-V ECMO for one week and mechanical ventilation of the lungs for 28 days. The diagnosis was confirmed by detection of SARS-CoV-2 virus RNA by PCR, X-ray and ultrasound examination of the lungs. The disease had a dramatic course but a successful outcome. Life-threatening conditions associated with COVID-19 in children are much less common than in adult patients. However, in some cases, when critical hypoxemia is not eliminated by traditional methods of respiratory support, ECMO can become a life-saving technology and with its timely usage in pediatric patients.