ABSTRACT
The risk of severe type I diabetes mellitus in children with new coronavirus infection (COVID-19) is extremely high, which is associated, with a high risk of intracranial hypertension, cerebral edema and multiple organ dysfunction, syndrome. On the example of a clinical case, the features of the course of diabetic ketoacidosis and. intensive care measures in children with COVID-19 were considered. The main data of the history and clinical and laboratory examination are reflected, specialattention is paid to the applied aspects of therapy, it was noted that with a severe course of a new coronavirus infection and diabetic ketoacidosis, the risk of developing cerebral injury, acute kidney injury and. thromboembolic complications is quite high, which, may require artificial lung ventilation, for the purpose of cerebral protection, renal replacement therapy and. the use of anticoagulants. The new coronavirus infection is a risk factor for the severe course of diabetic ketoacidosis in children with type I diabetes, regardless of the age of the child, which is the basis for clinicalalertness in order to timely identify and treat potential life-threatening complications.Copyright © 2022 Authors. All rights reserved.
ABSTRACT
Objective: To describe the burden of COVID-19 in a children's multidisciplinary hospital for two years of the pandemic, taking into account of age, severity of the disease, the spectrum of underlying conditions and the intensive care need. Method(s): An assessment of 6048 cases of COVID-19 in patients under 18 years of age hospitalized from March 26, 2020 to December 31, 2021 was carried out. The diagnosis was confirmed by PCR on an outpatient basis or after hospitalization with the help of diagnostic kits registered in the Russian Federation. The features of the work of a children's multidisciplinary hospital in new conditions, the dynamics of hospitalization, age characteristics and new coronavirus (CV) infection severity in the pandemic development process are presented. The analysis of the underlying condition's structure depending on the severity of the disease, as well as the need and volume of therapy in the intensive care unit. The frequency and main characteristics of children's multisystem inflammatory syndrome (MIS-C) in hospital conditions, long-term PCR positivity and its effect on the duration of inpatient treatment of children have been established. Result(s): The spread of SARS-COV-2 in St. Petersburg required a radical change in the work of the children's multidisciplinary hospital. During the two years of the pandemic, four waves of hospitalization of children with new CV were revealed, differing in duration, intensity, and frequency of lung damage, but having no significant differences in the proportion of severe forms of the disease (1.7-2.8% of cases). Intensive therapy was required in 3.6% of cases, of which only 1/3 was due to the severe course of COVID-19 with a lung lesion volume of up to 100%. In 1/3 of cases, patients had risks of developing severe forms and in 1/3 - other pathology. Severe course of new CV was significantly more often accompanied by the need for respiratory support, anticoagulants and anti-inflammatory therapy. Contributing factors of severe forms and unfavorable outcomes were: pathology of the central nervous system, genetic diseases and malformations, obesity, as well as chronic bronchopulmonary pathology. Mortality in the hospital was recorded only among children with severe underlying conditions (0.1% of cases). D-MVS was registered significantly more often in boys (7 out of every 10 patients), accounting for 1.2% of cases of hospitalization of children with new CV over the entire period. Convalescent PCR-positivity in the outcome of COVID-19 was detected in 1/3 of children, significantly more often during the autumn-winter waves of the pandemic and among patients of high school age. Conclusion(s): New CV is gradually strengthening its position in the structure of acute respiratory pathology in children. Some of SARS-COV-2 infection cases is accompanied by extensive lung damage, as well as severe systemic inflammation independently or in the other infectious diseases structure, induction of the debut of various somatic pathology is not excluded. The presented data confirm the need for increased attention at high risk of adverse respiratory diseases outcomes children. All severe cases of COVID-19 in children require a personalized approach, taking into account the existing background diseases and possible options for the progression of the process. MIS-C should be considered as a systemic inflammatory response syndrome within the framework of an infectious disease of various etiologies, differentiated with Kawasaki disease and the debut of systemic diseases. The long-term PCR-positivity in the outcome of COVID-19 requires further study to address the need and nature of therapy in order to prevent further spread of infection in the population.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
Objective: To describe the burden of COVID-19 in a children's multidisciplinary hospital for two years of the pandemic, taking into account of age, severity of the disease, the spectrum of underlying conditions and the intensive care need. Methods: An assessment of 6048 cases of COVID-19 in patients under 18 years of age hospitalized from March 26, 2020 to December 31, 2021 was carried out. The diagnosis was confirmed by PCR on an outpatient basis or after hospitalization with the help of diagnostic kits registered in the Russian Federation. The features of the work of a children's multidisciplinary hospital in new conditions, the dynamics of hospitalization, age characteristics and new coronavirus (CV) infection severity in the pandemic development process are presented. The analysis of the underlying condition's structure depending on the severity of the disease, as well as the need and volume of therapy in the intensive care unit. The frequency and main characteristics of children's multisystem inflammatory syndrome (MIS-C) in hospital conditions, long-term PCR positivity and its effect on the duration of inpatient treatment of children have been established. Results: The spread of SARS-COV-2 in St. Petersburg required a radical change in the work of the children's multidisciplinary hospital. During the two years of the pandemic, four waves of hospitalization of children with new CV were revealed, differing in duration, intensity, and frequency of lung damage, but having no significant differences in the proportion of severe forms of the disease (1.7-2.8% of cases). Intensive therapy was required in 3.6% of cases, of which only 1/3 was due to the severe course of COVID-19 with a lung lesion volume of up to 100%. In 1/3 of cases, patients had risks of developing severe forms and in 1/3 – other pathology. Severe course of new CV was significantly more often accompanied by the need for respiratory support, anticoagulants and anti-inflammatory therapy. Contributing factors of severe forms and unfavorable outcomes were: pathology of the central nervous system, genetic diseases and malformations, obesity, as well as chronic bronchopulmonary pathology. Mortality in the hospital was recorded only among children with severe underlying conditions (0.1% of cases). D-MVS was registered significantly more often in boys (7 out of every 10 patients), accounting for 1.2% of cases of hospitalization of children with new CV over the entire period. Convalescent PCR-positivity in the outcome of COVID-19 was detected in 1/3 of children, significantly more often during the autumn-winter waves of the pandemic and among patients of high school age. Conclusion: New CV is gradually strengthening its position in the structure of acute respiratory pathology in children. Some of SARS-COV-2 infection cases is accompanied by extensive lung damage, as well as severe systemic inflammation independently or in the other infectious diseases structure, induction of the debut of various somatic pathology is not excluded. The presented data confirm the need for increased attention at high risk of adverse respiratory diseases outcomes children. All severe cases of COVID-19 in children require a personalized approach, taking into account the existing background diseases and possible options for the progression of the process. MIS-C should be considered as a systemic inflammatory response syndrome within the framework of an infectious disease of various etiologies, differentiated with Kawasaki disease and the debut of systemic diseases. The long-term PCR-positivity in the outcome of COVID-19 requires further study to address the need and nature of therapy in order to prevent further spread of infection in the population. © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
Objective: To describe the burden of COVID-19 in a children's multidisciplinary hospital for two years of the pandemic, taking into account of age, severity of the disease, the spectrum of underlying conditions and the intensive care need. Method(s): An assessment of 6048 cases of COVID-19 in patients under 18 years of age hospitalized from March 26, 2020 to December 31, 2021 was carried out. The diagnosis was confirmed by PCR on an outpatient basis or after hospitalization with the help of diagnostic kits registered in the Russian Federation. The features of the work of a children's multidisciplinary hospital in new conditions, the dynamics of hospitalization, age characteristics and new coronavirus (CV) infection severity in the pandemic development process are presented. The analysis of the underlying condition's structure depending on the severity of the disease, as well as the need and volume of therapy in the intensive care unit. The frequency and main characteristics of children's multisystem inflammatory syndrome (MIS-C) in hospital conditions, long-term PCR positivity and its effect on the duration of inpatient treatment of children have been established. Result(s): The spread of SARS-COV-2 in St. Petersburg required a radical change in the work of the children's multidisciplinary hospital. During the two years of the pandemic, four waves of hospitalization of children with new CV were revealed, differing in duration, intensity, and frequency of lung damage, but having no significant differences in the proportion of severe forms of the disease (1.7-2.8% of cases). Intensive therapy was required in 3.6% of cases, of which only 1/3 was due to the severe course of COVID-19 with a lung lesion volume of up to 100%. In 1/3 of cases, patients had risks of developing severe forms and in 1/3 - other pathology. Severe course of new CV was significantly more often accompanied by the need for respiratory support, anticoagulants and anti-inflammatory therapy. Contributing factors of severe forms and unfavorable outcomes were: pathology of the central nervous system, genetic diseases and malformations, obesity, as well as chronic bronchopulmonary pathology. Mortality in the hospital was recorded only among children with severe underlying conditions (0.1% of cases). D-MVS was registered significantly more often in boys (7 out of every 10 patients), accounting for 1.2% of cases of hospitalization of children with new CV over the entire period. Convalescent PCR-positivity in the outcome of COVID-19 was detected in 1/3 of children, significantly more often during the autumn-winter waves of the pandemic and among patients of high school age. Conclusion(s): New CV is gradually strengthening its position in the structure of acute respiratory pathology in children. Some of SARS-COV-2 infection cases is accompanied by extensive lung damage, as well as severe systemic inflammation independently or in the other infectious diseases structure, induction of the debut of various somatic pathology is not excluded. The presented data confirm the need for increased attention at high risk of adverse respiratory diseases outcomes children. All severe cases of COVID-19 in children require a personalized approach, taking into account the existing background diseases and possible options for the progression of the process. MIS-C should be considered as a systemic inflammatory response syndrome within the framework of an infectious disease of various etiologies, differentiated with Kawasaki disease and the debut of systemic diseases. The long-term PCR-positivity in the outcome of COVID-19 requires further study to address the need and nature of therapy in order to prevent further spread of infection in the population.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
The risk of severe type I diabetes mellitus in children with new coronavirus infection (COVID-19) is extremely high, which is associated, with a high risk of intracranial hypertension, cerebral edema and multiple organ dysfunction, syndrome. On the example of a clinical case, the features of the course of diabetic ketoacidosis and. intensive care measures in children with COVID-19 were considered. The main data of the history and clinical and laboratory examination are reflected, specialattention is paid to the applied aspects of therapy, it was noted that with a severe course of a new coronavirus infection and diabetic ketoacidosis, the risk of developing cerebral injury, acute kidney injury and. thromboembolic complications is quite high, which, may require artificial lung ventilation, for the purpose of cerebral protection, renal replacement therapy and. the use of anticoagulants. The new coronavirus infection is a risk factor for the severe course of diabetic ketoacidosis in children with type I diabetes, regardless of the age of the child, which is the basis for clinicalalertness in order to timely identify and treat potential life-threatening complications.Copyright © 2022 Authors. All rights reserved.
ABSTRACT
The risk of severe type I diabetes mellitus in children with new coronavirus infection (COVID-19) is extremely high, which is associated, with a high risk of intracranial hypertension, cerebral edema and multiple organ dysfunction, syndrome. On the example of a clinical case, the features of the course of diabetic ketoacidosis and. intensive care measures in children with COVID-19 were considered. The main data of the history and clinical and laboratory examination are reflected, specialattention is paid to the applied aspects of therapy, it was noted that with a severe course of a new coronavirus infection and diabetic ketoacidosis, the risk of developing cerebral injury, acute kidney injury and. thromboembolic complications is quite high, which, may require artificial lung ventilation, for the purpose of cerebral protection, renal replacement therapy and. the use of anticoagulants. The new coronavirus infection is a risk factor for the severe course of diabetic ketoacidosis in children with type I diabetes, regardless of the age of the child, which is the basis for clinicalalertness in order to timely identify and treat potential life-threatening complications.Copyright © 2022 Authors. All rights reserved.
ABSTRACT
Currently, in pandemic settings, the new coronavirus infection is the leading cause of adult fatalities and may cause death of children with comorbidities. The objective of the study is to identify predictors of the fatality of the new coronavirus infection in children. Subjects and Methods. 230 patients with the new coronavirus infections were examined. The main group of 94 patients with severe COVID-19, the fatal outcome occurred in 25 (26.6%) children. The comparison group consisted of 126 children with a moderate degree of severity, and there were no lethal outcomes. Results. Children older than 10 years of age (43%) prevailed in the study cohort. Every fifth patient in the main group suffered from shock, and 79 (84%) children had failure of two or more systems/organs. The presence of pronounced manifestations of the disease was associated with a 20-fold increase in the probability of a severe course of COVID-19 (OR = 0.04). Involvement of two organs and systems doubled the risk of death. An acceptable discriminatory ability of the pSOFA score for predicting COVID-19 outcomes in children was identified: sensitivity 83%, specificity 61%, cut-off point 5.6 points. Conclusion. Predictors of death in severe new coronavirus infection in children include failure of two or more organs and systems, acute renal injury and the pSOFA score above 5. © 2021 Tomsk Polytechnic University, Publishing House. All rights reserved.
ABSTRACT
The risk of a severe course of new coronavirus infection (COVID-19) due to the development of acute respiratory distress syndrome is extremely high, which is especially true for patients with comorbidities. The aim of the study is to demonstrate the peculiarities of the course and intensive care measures in new coronavirus infection COVID-19 in children with comorbidities. Patients and methods: On the example of clinical cases, the characteristics of the course of a new coronavirus infection of COVID-19 in children with systemic lupus erythematosus and bronchopulmonary dysplasia are considered. Results: The main data from the history and clinical laboratory examination are reflected, which made it possible to identify a cytokine storm in a timely manner, a high risk of adverse course and begin timely specific pathogenetic therapy, including immunoglobulins for intravenous administration, hydroxychloroquine, ritonavir in combination with lopinavir, azithromycin and dexamethasone. Particular attention is paid to the need to limit infusion therapy, maintain a negative water balance and optimal blood oxygen capacity, ambiguity of opinions on the need for routine use of albumin and dexamethasone solutions in patients with COVID-19 has been demonstrated. Conclusion: Children with comorbidities are characterized by a severe course of a new coronavirus infection CO-VID-19, which requires timely pathogenetic therapy taking into account the individual characteristics of the patient.