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Acta Medica Bulgarica ; 50(2):10-19, 2023.
Article in English | EMBASE | ID: covidwho-20244214


Compared to other respiratory viruses, the proportion of hospitalizations due to SARS-CoV-2 among children is relatively low. While severe illness is not common among children and young individuals, a particular type of severe condition called multisystem inflammatory syndrome in children (MIS-C) has been reported. The aim of this prospective cohort study, which followed a group of individuals under the age of 19, was to examine the characteristics of patients who had contracted SARS-CoV-2, including their coexisting medical conditions, clinical symptoms, laboratory findings, and outcomes. The study also aimed to investigate the features of children who met the WHO case definition of MIS-C, as well as those who required intensive care. A total of 270 patients were included between March 2020 and December 2021. The eligible criteria were individuals between 0-18 with a confirmed SARS-CoV-2 infection at the Infectious Disease Hospital "Prof. Ivan Kirov"in Sofia, Bulgaria. Nearly 76% of the patients were <= 12 years old. In our study, at least one comorbidity was reported in 28.1% of the cases, with obesity being the most common one (8.9%). Less than 5% of children were transferred to an intensive care unit. We observed a statistically significant difference in the age groups, with children between 5 and 12 years old having a higher likelihood of requiring intensive care compared to other age groups. The median values of PaO2 and SatO2 were higher among patients admitted to the standard ward, while the values of granulocytes and C-reactive protein were higher among those transferred to the intensive care unit. Additionally, we identified 26 children who met the WHO case definition for MIS-C. Our study data supports the evidence of milder COVID-19 in children and young individuals as compared to adults. Older age groups were associated with higher incidence of both MIS-C and ICU admissions.Copyright © 2023 P. Velikov et al., published by Sciendo.

Meditsinski Pregled / Medical Review ; 58(6):57-61, 2022.
Article in Bulgarian | GIM | ID: covidwho-2112067


Over two and a half years have passed since the WHO declared the SARS-CoV-2 pandemic. Thanks to the accumulated vast experience, especially in countries with a well-developed healthcare, systematized and reliable diagnostic approaches have been made available. Using such molecular biological methods, a current infection with SARS-CoV-2 can be diagnosed: either via sequencing viral nucleic acids or by using chromatographic tests demonstrating viral proteins (rapid antigen tests). Individuals presenting with symptoms consistent with COVID-19, should be tested for a SARS-CoV-2 infection and the sample should be taken from the upper respiratory tract (nasopharynx, nasal and/or oropharynx). It is generally accepted that RT-PCR is the most sensitive and specific diagnostic test. This method allows for qualitative detection of SARS-CoV-2 nucleic acid, by specifically targeting ORF1ab, N and Edomain in the viral genome. The "rapid antigen tests" detect the virus as early as 3-7 days after infection. The sensitivity of the rapid antigen tests does not change compared to the variants of the virus discovered thus far, including the new subtypes of the "Omicron" variant. The principal of this test is based on the detection of the N-protein (nuclear protein). Since the N-protein has remained relatively stable with respect to structural changes, the sensitivity of rapid antigen tests remains high.