ABSTRACT
There is a global problem of increment of the number of children with clinical features that mimic Kawasaki Disease (KD) during the ongoing Coronavirus Disease 2019 (COVID-19) pandemic. The disease was first reported by Tomisaku Kawasaki, a Japanese pediatrician, in a four-year-old child with a rash and fever at the Red Cross Hospital in Tokyo in January 1961. Now Kawasaki disease is recognized worldwide. The complexity of symptoms was defined as an <<acute febrile mucocutaneous lymphnode syndrome". At the moment, it is still unclear whether the coronavirus itself can lead to development of mucocutaneous lymph node syndrome. However, it is believed that COVID-19 virus infection worsens the course of Kawasaki disease, and in some cases, children affected by SARS-V-2 may develop a disease that has a clinical picture similar to Kawasaki disease.
ABSTRACT
The rapid spread of COVID-19 and the large number of cases put a significant burden on the health systems of any developed country. Specialists in natural disasters and military medicine should be involved in the provision of medical care and observance of anti-epidemic measures. In some countries, including Italy, they were involved only after the situation was dramatically worsening with many clinical units and hospitals overloaded by infected patients. To curb the spread of COVID-19, most countries declared a state of emergency, and unprecedented measures have been taken to strengthen quarantine in suspected or positive symptomatic subjects. Nevertheless, the crisis associated with the unexpectedly global scale and tragedy of the pandemic and the inconsistency of actions of both society and individuals and specialized medical services, lead to insufficient effectiveness of the measures taken in a number of regions. In the present day, it is vital for every person to change its mindset ― relying on personal responsibility to comply with all recommendations of quarantine and anti-epidemic measures, and to reorganize departments and resources of medical institutions at all levels in order to withstand the spread of infection and at the same time provide all those in need with the necessary and appropriate medical care. Particular attention should be paid to the obstetric care service, given that even in “normal” times, the obstetric hospital is an area of increased responsibility for the life and health of mother and child and future mankind. Fulfillment of existing orders, instructions of national and regional committees, international and national protocols and clinical protocols should undoubtedly lead to a positive result, but this requires additional training of medical personnel at all levels. The purpose of this review is to propose quick key strategies for reassessing the maternity and neonatal wards/ hospitals based on the experience of health systems and organizations which faced the spread of this new coronavirus;this advice may be applied along with binding tight instructions in obstetric hospitals in order to proactively respond to a likely wave of growth in COVID-19.
ABSTRACT
The rapid spread of COVID-19 and the large number of cases put a significant burden on the health systems of any developed country. Specialists in natural disasters and military medicine should be involved in the provision of medical care and observance of anti-epidemic measures. In some countries, including Italy, they were involved only after the situation was dramatically worsening with many clinical units and hospitals overloaded by infected patients. To curb the spread of COVID-19, most countries declared a state of emergency, and unprecedented measures have been taken to strengthen quarantine in suspected or positive symptomatic subjects. Nevertheless, the crisis associated with the unexpectedly global scale and tragedy of the pandemic and the inconsistency of actions of both society and individuals and specialized medical services, lead to insufficient effectiveness of the measures taken in a number of regions. In the present day, it is vital for every person to change its mindset ― relying on personal responsibility to comply with all recommendations of quarantine and anti-epidemic measures, and to reorganize departments and resources of medical institutions at all levels in order to withstand the spread of infection and at the same time provide all those in need with the necessary and appropriate medical care. Particular attention should be paid to the obstetric care service, given that even in normal times, the obstetric hospital is an area of increased responsibility for the life and health of mother and child and future mankind. Fulfillment of existing orders, instructions of national and regional committees, international and national protocols and clinical protocols should undoubtedly lead to a positive result, but this requires additional training of medical personnel at all levels. The purpose of this review is to propose quick key strategies for reassessing the maternity and neonatal wards/ hospitals based on the experience of health systems and organizations which faced the spread of this new coronavirus;this advice may be applied along with binding tight instructions in obstetric hospitals in order to proactively respond to a likely wave of growth in COVID-19. ;ÐктуальноÑть. БыÑтрое раÑпроÑтранение COVID-19 и большое количеÑтво заболевших накладывает значительную нагрузку на ÑиÑтемы Ð·Ð´Ñ€Ð°Ð²Ð¾Ð¾Ñ…Ñ€Ð°Ð½ÐµÐ½Ð¸Ñ Ñ€Ð°Ð·Ð²Ð¸Ñ‚Ñ‹Ñ… гоÑударÑтв. Ð’ Ñ€Ñде Ñтран к оказанию медицинÑкой помощи и Ñоблюдению противоÑпидемичеÑких мероприÑтий привлекаютÑÑ ÑпециалиÑты по Ñтихийным бедÑтвиÑм и военной медицине, однако в некоторых Ñтранах, в том чиÑле в Италии, они были задейÑтвованы поÑле того, как многие клиничеÑкие Ð¿Ð¾Ð´Ñ€Ð°Ð·Ð´ÐµÐ»ÐµÐ½Ð¸Ñ Ð¸ Ñтационары были перегружены. Ð”Ð»Ñ ÑÐ´ÐµÑ€Ð¶Ð¸Ð²Ð°Ð½Ð¸Ñ Ñ€Ð°ÑпроÑÑ‚Ñ€Ð°Ð½ÐµÐ½Ð¸Ñ COVID-19 большинÑтво Ñтран объÑвили чрезвычайное положение, были принÑты беÑпрецедентные меры по уÑилению карантинных мероприÑтий. Тем не менее кризиÑ, ÑвÑзанный Ñ Ð½ÐµÐ¾Ð¶Ð¸Ð´Ð°Ð½Ð½Ð¾ глобальным маÑштабом и трагичноÑтью пандемии, и неÑоглаÑованноÑть дейÑтвий как общеÑтва и отдельных граждан, так и Ñпециализированных медицинÑких Ñлужб приводÑÑ‚ к недоÑтаточной ÑффективноÑти проводимых мероприÑтий в Ñ€Ñде регионов. ОÑобое внимание Ñледует уделить Ñлужбе родовÑпоможениÑ, учитываÑ, что и в Ñпокойное Ð²Ñ€ÐµÐ¼Ñ Ð°ÐºÑƒÑˆÐµÑ€Ñкий Ñ ‚ационар ÑвлÑетÑÑ Ð·Ð¾Ð½Ð¾Ð¹ повышенной ответÑтвенноÑти за жизнь и здоровье матери и ребенка. ИÑполнение дейÑтвующих приказов, указаний национальных и региональных комитетов, международных/национальных и клиничеÑких протоколов, неÑомненно, приведет к положительному результату, но требует дополнительного Ð¾Ð±ÑƒÑ‡ÐµÐ½Ð¸Ñ Ð¸ тренировки медицинÑкого перÑонала вÑех уровней. Цель обзора ― предложить ключевые Ñтратегии, оÑновываÑÑÑŒ на опыте регионов, ранее ÑтолкнувшихÑÑ Ñ Ñ€Ð°ÑпроÑтранением нового коронавируÑа, которые могут быть быÑтро применены нарÑду Ñ Ð¾Ð±Ñзательными к иÑполнению дейÑтвующими приказами и раÑпорÑжениÑми в акушерÑких Ñтационарах, чтобы превентивно отреагировать на вероÑтную волну роÑта заболеваемоÑти и ноÑительÑтва COVID-19.