[Detection SARS-CoV-2 (Coronaviridae: Coronavirinae: Betacoronavirus: Sarbecovirus) in children with acute intestinal infection in Nizhny Novgorod during 2020-2021].

INTRODUCTION: The novel coronavirus infection COVID-19 is a major public health problem worldwide. Several publications show the presence of gastrointestinal (GI) symptoms (nausea, vomiting, and diarrhea) in addition to respiratory disorders.The aim of this study was the monitoring of RNA of COVID-19 pathogen, coronavirus SARS-CoV-2 (Coronaviridae: Coronavirinae: Betacoronavirus; Sarbecovirus) in children hospitalized with acute intestinal infection (AII), with following molecular-genetic characterization of detected strains. MATERIAL AND METHODS: Fecal samples of children with AII hospitalized in infectious hospital of Nizhny Novgorod (Russia) in the period from 01.07.2020 to 31.10.2021 were used as material for the study. Viral RNA detection was performed by real-time polymerase chain reaction (RT-PCR). The nucleotide sequence of S-protein gene fragment was determined by Sanger sequencing. RESULTS AND DISCUSSION: SARS-CoV-2 genetic material was detected in 45 out of 2476 fecal samples. The maximum number of samples containing RNA of the virus occurred in November 2020 (detection rate of 12.2%). In 20.0% of cases, SARS-CoV-2 RNA was detected in combination with rota-, noro-, and adenoviruses. 28 nucleotide sequences of S-protein gene fragment complementary DNA (cDNA) were determined. Phylogenetic analysis showed that the studied SARS-CoV-2 strains belonged to two variants. Analysis of the S-protein amino acid sequence of the strains studied showed the absence of the N501Y mutation in the 2020 samples, which is a marker for variants with a high epidemic potential, called variants of concern (VOC) according to the World Health Organization (WHO) definition (lines Alpha B.1.1.7, Beta B.1.351, Gamma P.1). Delta line variant B.1.617.2 was identified in two samples isolated in September 2021. CONCLUSION: The detection of SARS-CoV-2 RNA in the fecal samples of children with AII, suggesting that the fecal-oral mechanism of pathogen transmission may exist, determines the necessity to optimize its monitoring and to develop an algorithm of actions with patients with signs of AII under the conditions of a novel coronavirus infection pandemic.

Clinical and laboratory characteristics of SARS-CoV-2-related multisystem inflammatory syndrome in children

Objective. To analyze clinical manifestations, laboratory parameters, and findings of instrumental examination in children with SARS-CoV-2-related multisystem inflammatory syndrome (MIS). Patients and methods. This study included 60 children aged 1 to 18 years (mean age 8 years) diagnosed with MIS and treated in Khimki Regional Hospital between 06.2020 and 10.2021. All patients underwent standard examination. Results. The majority of MIS patients (87%) were treated in the intensive care unit (ICU) due to severity of their condition;71% of them were transferred to ICU directly from the admission department. None of children received antiviral therapy upon first encounter with the virus. The proportion of patients with type A blood (group II) was 1.5 times higher than that in the general population. Nine children (15%) were overweight and 5 children (8.3%) were obese. Almost two-thirds of participants (64%) had 3 and 4 systems of organs simultaneously involved in the pathological process. Most commonly, the disease affected the gastrointestinal tract (88%), skin and mucous membranes (77%), cardiovascular system (77%), and urinary tract (43%). Children with MIS were characterized by moderate neutrophilic leukocytosis with a left shift, lymphopenia, thrombocytopenia, anemia, elevated CRP (up to 66x of the upper limit), elevated ferritin (up to 23x of the upper limit), elevated D-dimer, and prolonged aPTT. Conclusion. SARS-CoV-2-related MIS is one of the most severe manifestations of COVID-19 in children, and requires a differential diagnosis with bacterial infections. © 2021, Dynasty Publishing House. All rights reserved.

A case of SARS-CoV-2-associated multisystem inflammatory syndrome in an 8-year-old child

After the first wave of new coronavirus infection caused by SARS-CoV-2, when it became obvious that children carry COVID-19 in a milder form than adults, scientists and doctors around the world faced with a severe delayed form of the disease - SARS-CoV-2-associated multisystem inflammatory syndrome (MIS), characteristic for children and young adults under 21. In this publication authors present the first case of SARS-CoV-2-associated MIS of moderate severity in an 8-year-old girl diagnosed in Khimki Regional Hospital. Disease course had characteristic features, however, considering minimal data available at the time of the child’s treatment in the hospital (May 2020) in the literature, and lack of clinical experience in diagnosing and treating such condition, the differential diagnosis was performed with acute respiratory disease, infectious mononucleosis and acute glomerulonephritis. После первой волны новой коронавирусной инфекции, вызванной SARS-CoV-2, когда стало очевидно, что дети переносят COVID-19 в более легкой форме, чем взрослые, ученые и врачи всего мира столкнулись с тяжелой отсроченной формой заболевания - мультисистемным воспалительным синдромом (МВС), ассоциированным с SARS-CoV-2, характерным для детей и молодых взрослых до 21 года. В настоящей публикации представляем первый диагностированный нами на базе ГАУЗ «Химкинская областная больница» МЗ МО случай течения МВС, ассоциированного c SARS-CoV-2, средней степени тяжести у девочки 8 лет. Течение данного заболевания имело характерные черты, однако, учитывая минимальное количество данных, имевшихся на момент лечения ребенка в стационаре (май 2020 г.) в литературе, и отсутствие у врачей собственного клинического опыта диагностики и лечения подобного состояния, дифференциальный диагноз проводили с острым респираторным заболеванием, инфекционным мононуклеозом и острым гломерулонефритом.