Pediatric Inflammatory Multisystem Syndrome Temporally Associated with Sars-Cov-2 Infection

Despite the low incidence, low mortality and relatively mild symptoms of COVID-19 in children, there has been a rise in pediatric patients who develop a condition resembling Kawasaki disease after COVID-19 or contact with individuals infected with SARS-CoV-2. This condition is known as the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS). This review introduces the reader to the hypotheses of PIMS-TS pathogenesis, provides information about its diagnosis and treatment, presents clinical and laboratory data and describes treatments strategies used in children and adolescents hospitalized to the intensive care unit of the Pediatric Research and Clinical Center for Infectious Diseases. Besides, the review outlines the main diagnostic and prognostic challenges of PIMS-TS.Copyright © Extreme Medicine.All right reserved.

Medical Rehabilitation and Infectious Diseases in Children

Today, medical rehabilitation is undergoing significant transformation. The new system built around the biopsychosocial model includes assessment of physical constraints and rehabilitation diagnosis, determination of rehabilitation potential, formulation of goals and objectives of individual interventions, development of rehabilitation plans, and progress evaluation. All of these rehabilitation components can be implemented using a personalized, problem-oriented, multidisciplinary approach, which is now being actively introduced into clinical practice. The current pandemic of the novel coronavirus infection has demonstrated that medical rehabilitation is crucial for convalescents. However, its principles and techniques have not been fully elaborated yet. This review describes the current state of medical rehabilitation of children with or after infectious diseases and identifies its avenues and prospects.Copyright © 2022 Obstetrics, Gynecology and Reproduction. All rights reserved.

Relationship between SARS-COV-2 And autoimmune neurological diseases.

Since the onset of the SARS-CoV-2 infection, there has been an increase in the number of reports of patients who have experienced the development of autoimmune neurological disorders. It is assumed that such an increase in the incidence rate may occur due to an abnormal immune-mediated response of the body to the pathogenic impact of SARSCoV-2. This article discusses the possibility of the influence of SARS-CoV-2 on the onset and exacerbation of the course of autoimmune neurological disorders, possible pathogenetic factors and mechanisms, and analyzes the features of the clinical picture and therapy. The article includes foreign and Russian scientific data and clinical observations of cases of Guillain-Barre syndrome, multiple sclerosis, acute disseminated encephalomyelitis, myasthenia gravis and other autoimmune diseases that have changed their typical course on the background of COVID-19.Copyright © 2022 Authors. All rights reserved.

Relationship between SARS-COV-2 And autoimmune neurological diseases

Since the onset of the SARS-CoV-2 infection, there has been an increase in the number of reports of patients who have experienced the development of autoimmune neurological disorders. It is assumed that such an increase in the incidence rate may occur due to an abnormal immune-mediated response of the body to the pathogenic impact of SARSCoV-2. This article discusses the possibility of the influence of SARS-CoV-2 on the onset and exacerbation of the course of autoimmune neurological disorders, possible pathogenetic factors and mechanisms, and analyzes the features of the clinical picture and therapy. The article includes foreign and Russian scientific data and clinical observations of cases of Guillain-Barré syndrome, multiple sclerosis, acute disseminated encephalomyelitis, myasthenia gravis and other autoimmune diseases that have changed their typical course on the background of COVID-19. © 2022 Authors. All rights reserved.

Relationship between SARS-COV-2 And autoimmune neurological diseases.

Since the onset of the SARS-CoV-2 infection, there has been an increase in the number of reports of patients who have experienced the development of autoimmune neurological disorders. It is assumed that such an increase in the incidence rate may occur due to an abnormal immune-mediated response of the body to the pathogenic impact of SARSCoV-2. This article discusses the possibility of the influence of SARS-CoV-2 on the onset and exacerbation of the course of autoimmune neurological disorders, possible pathogenetic factors and mechanisms, and analyzes the features of the clinical picture and therapy. The article includes foreign and Russian scientific data and clinical observations of cases of Guillain-Barre syndrome, multiple sclerosis, acute disseminated encephalomyelitis, myasthenia gravis and other autoimmune diseases that have changed their typical course on the background of COVID-19.Copyright © 2022 Authors. All rights reserved.

INFECTIOUS HYPOTHESIS OF NEURODEGENERATIVE DISEASES. WHAT WAITS US AFTER THE COVID-19 PANDEMIC?

Since the description of the first clinical cases of the most common neurodegenerative diseases, numerous hypotheses have been proposed for their development. At the same time, the failure of therapeutic strategies in various directions of clinical research indicates the fallacy of most theories. In this regard, in recent years, various infectious agents are increasingly considered as a trigger of neuronal inflammation and a factor inducing the onset of the neurodegenerative process. Infectious agents differ in their mechanisms of invasion into the central nervous system and can even enter the brain perineurally. Reactivation of latent viral infection induces the production of viral proteins and the accumulation of abnormal proteins that are markers of Alzheimer's disease and Parkinson's disease. Both bacterial (chlamydia, causative agents of chronic periodontitis, E. coli) and viral (herpes viruses, noroviruses) infectious agents are considered. However, for the development of neurodegeneration, it is not enough just a simple invasion and reactivation of the infectious process: the genetic characteristics of the main histocompatibility complex also play a huge role. Currently, several studies have been initiated on the possible efficacy of antibacterial and antiviral drugs in Alzheimer's disease. Data obtained over the past year suggests that the brain may act as a target for SARS-CoV-2. Neurological manifestations of COVID-19 can occur as a result of both the direct cytopathic action of the pathogen and the activation of neuroinflammation, accompanied by a violation of the integrity of the blood-brain barrier. Further study of the molecular and cellular mechanisms of neuroinflammation and neurodegeneration in COVID-19 will form the basis for the development of treatments for neurological complications.

New onset of generalized myasthenia gravis developed after a new coronavirus infection (COVID-19)

Development of various immune-mediated neurological complications after a viral infection is of particular interest to medical society during a pandemic of COVID-19. It was found that SARS-CoV-2 has the ability to cause hyperstimulation of the immune system, thereby initiating developing of autoimmune diseases. The article describes a clinical case of new onset of generalized myasthenia gravis with thymoma in a patient after previous COVID-19. © 2021 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

Management and rehabilitation of patients with persistent olfactory disorders (hypo- And anosmia) (literature review)

We present a review of the literature and our own data on the management and rehabilitation of impairment or persistent loss of the olfactory function - hypo- and anosmia. Approaches for restoring impaired olfactory function can be divided into olfactory training, pharmacological and physiotherapy. Smell training is carried out according to a number of protocols that differ mainly in the used arsenal of smells, as well as in the frequency of their presentation. Pharmacologically, it is proposed to use steroids used both topically (intranasally) and systemically;there is no common view on the effectiveness of this approach. Physiotherapy involve electrical stimulation of the olfactory filaments in the area of their exit into the nasal cavity (lateral masses of the ethmoid bone). In our opinion the most rational approach is the use of training methods using different smells.

Pediatric multisystem inflammatory syndrome associated with a new coronavirus infection: unresolved issues

Since March 2020, the first reports have appeared about the increasing, almost everywhere, number of children who have undergone a new coronovirus infection caused by SARS-Cov-2 with a symptom complex resembling the manifestations of Kawasaki disease. A special feature of the clinical manifestations of this syndrome, which is called “Pediatric multisystem inflammatory syndrome associated with COVID-19”, is the high incidence of life-threatening conditions caused by the sharp development of arterial hypotension against the background of cardiogenic or vasogenic shock. In St. Petersburg, since the end of November 2020, there has been a sharp surge in admissions of children to the ICU of various hospitals with the clinic of Pediatric multisystem inflammatory syndrome, who have laboratory confirmation of the transferred COVID-19. The purpose of this article is to attract the attention of doctors of various profiles, to combine efforts to study this pathology, to determine the criteria for verifying the diagnosis, optimal treatment regimens and dispensary monitoring of patients who have been ill. © 2021 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

Gastrointestinal tract lesion with a new coronavirus infection

Objective of the research: to analyze clinical and laboratory manifestations of COVID-19 with a predominant lesion of the gastrointestinal tract (GIT) in children. It was revealed that incidence of this form of COVID-19 in children is underestimated. Based on the analysis of literature data and original clinical observations, the article describes current ideas about the frequency of detecting the form of COVID-19 with a predominant lesion of the GIT, its clinical and laboratory characteristics, the mechanisms of infectious process development in the digestive organs and approaches to rational laboratory diagnostics. The feasibility of PCR in feces in patients with suspected COVID-19 is confirmed. A description of a clinical case of COVID-19 severe form, which required differential diagnosis with acute bacterial gastroenterocolitis, is presented. Цель данной работы - проведение анализа клинико-лабораторных проявлений COVID-19 с преимущественным поражением желудочно-кишечного тракта (ЖКТ) у детей. Показано, что частота выявления данной формы COVID-19 у детей недооценивается. В статье на основании анализа данных литературы и собственных клинических наблюдений описаны актуальные представления о частоте выявления формы COVID-19 с преимущественным поражением ЖКТ, ее клинико-лабораторной характеристике, механизмах развития инфекционного процесса в органах пищеварения и подходах к рациональной лабораторной диагностике. Подтверждается целесообразность выполнения ПЦР в кале у пациентов с подозрением на COVID-19. Приведено описание клинического наблюдения течения тяжелой формы COVID-19, потребовавшей дифференциальной диагностики с острым гастроэнтероколитом бактериальной этиологии. Ключевые слова: