RESUMEN
The problem of the non-smooth course of COVID-19 and deaths in children with severe comorbid pathology is urgent. Among all registered cases of a new coronavirus infection in the Russian Federation, children account for up to 8,6%, of which severe forms are noted, as a rule, in patients with concomitant diseases. A clinical observation of the course of a new coronavirus infection in a child with a severe form of idiopathic aplastic anemia complicated by pancytopenia is presented. COVID-19 infection caused a sharp deterioration in the child's condition. Despite the use of modern methods of therapy, there was a rapid deterioration of clinical and laboratory parameters: an increase in febrility, respiratory failure, interstitial changes in the lungs, a decrease in oxygen saturation to 70%, hemorrhagic, anemic syndromes and multiple organ failure with the development of a fatal outcome. Aplastic anemia is a factor predisposing to the severe course of COVID-19 and contributing to an unfavorable outcome.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
RESUMEN
The problem of the non-smooth course of COVID-19 and deaths in children with severe comorbid pathology is urgent. Among all registered cases of a new coronavirus infection in the Russian Federation, children account for up to 8,6%, of which severe forms are noted, as a rule, in patients with concomitant diseases. A clinical observation of the course of a new coronavirus infection in a child with a severe form of idiopathic aplastic anemia complicated by pancytopenia is presented. COVID-19 infection caused a sharp deterioration in the child's condition. Despite the use of modern methods of therapy, there was a rapid deterioration of clinical and laboratory parameters: an increase in febrility, respiratory failure, interstitial changes in the lungs, a decrease in oxygen saturation to 70%, hemorrhagic, anemic syndromes and multiple organ failure with the development of a fatal outcome. Aplastic anemia is a factor predisposing to the severe course of COVID-19 and contributing to an unfavorable outcome.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
RESUMEN
Fecal zonulin is currently used as a biomarker of intestinal permeability. Objective. To assess the state of intestinal permeability in a novel coronavirus infection (COVID-19) in children based on the determination of fecal zonulin levels. Patients and methods. Fecal zonulin levels were assessed in 35 children with COVID-19, which was mild in most of them. Fecal sampling was performed at the time of diagnosis and 14 days after the start of observation. Patients were then randomized into two groups. Group 1 (study, n = 19) received Maxilac Baby synbiotic (2 sachets once a day) for 1 month, group 2 (control, n = 16) did not receive any probiotics, prebiotics, and adsorbents for a month;the third stool sampling was performed 1 month after the second. The study was carried out by enzyme immunoassay using the IDK Zonulin ELISA test system (Immundiagnostik AG, Germany). Results. Fecal zonulin levels were 77.38 +/- 12.59 ng/mL at the beginning of the disease, 76.26 +/- 13.10 ng/mL on day 14, and 82.64 +/- 11.99 ng/mL after one month (p1-2 = 0.75;p1-3 = 0.04;p2-3 = 0.04). Children who received Maxilac Baby for a month did not have significant increases in zonulin levels (76.26 +/- 13.10 ng/mL and 79.02 +/- 11.87 ng/mL;p = 0.40), while the control group demonstrated significantly elevated zonulin levels (76.26 +/- 13.10 ng/mL and 87.95 +/- 10.96 ng/mL;p = 0.048). Conclusion. A month after the coronavirus infection, the intestinal permeability in children increases significantly, whereas it does not change during the course of the disease. Administration of Maxilac Baby synbiotic in children who had a mild-to-moderate coronavirus infection and did not receive antibiotics effectively prevents intestinal permeability disorders in them. Copyright © 2022, Dynasty Publishing House. All rights reserved.
RESUMEN
According to the available data, children are less susceptible for developing a severe course of COVID-19 and commonly have mild or asymptomatic course of infection. It is reported about an increased risk of having more severe course in infants, at the same time, according to the literature data, the course in children receiving antineoplastic and immunosuppressive therapy is milder in comparison with other concomitant pathologies. This article presents the unique clinical case and the literature review of combined COVID-19-pneumonia and extremely rare congenital myeloid leukemia in the infant with the description of long-term infection persistence, changes in clinical data in dynamics, bone marrow test results and the experience of using donor plasma with antibodies to SARS-CoV-2. © 2022, Graphica Ltd. All rights reserved.
RESUMEN
In the Russian Federation, the proportion of children among all cases of new coronavirus infection is up to 8.6%. Mild forms are registered in 80% of cases, severe – 0.2%, as a rule, in children of the first year of life. The majority of deaths were recorded in children with an unfavorable background:75% of those who died had one concomitant pathology, 45% – two or more. The problem of severe course and fatal outcomes from COVID-19 in children with comorbid pathology, for example, with various forms of leukemia, remains relevant. Severe infectious complications of bacterial nature are observed in 70–80% of sick children, viral and fungal genesis, respectively, in 4–12% and 18–20%. Myeloblastic leukemia is one of the factors that predispose to a severe course of COVID-19 and an unfavorable outcome. The article presents a clinical observation of the course of a critical form of a new coronavirus infection in a young child with acute myeloblastic leukemia. The layering of COVID-19 contributed to a sharp deterioration of the underlying disease. Despite the highly organized treatment process with the use of modern technologies, the child had a rapid deterioration of the condition with a fatal outcome. © 2021, Dynasty Publishing House. All rights reserved.
RESUMEN
The aim of the study was to assess the effective doses and radiation risks of children for X-ray and CT examinations during the diagnosis and treatment of COVID-19, as well as to analyze the dependence of the number of examinations and the total radiation risk for one patient on the severity of the disease. The study used the data of X-ray studies of 71 children admitted to the clinic of the St-Petersburg State Pediatric Medical University with suspicions of COVID-19, 58 children of them underwent 104 X-ray examinations, and 30 CT scans were taken for 22 children. One patient could undergo both several of the same type, as well as a combination of X-ray and CT examinations. The median values of the effective dose for X-ray chest examinations for all age groups are in the range of 0.09-0.13 mSv. The highest values are observed in the 0-4 age group. Effective doses for chest CT scan were 3.21 mSv and 4.68 mSv for groups 5-9 and 15-19 years old, respectively. For X-ray studies for women it ranges from 12.73•10-6 to 27.62•10-6, for men from 2.5•10-6 to 5.52•10-6. The minimum corresponds to the age group 10-14 years old, and the maximum - to the group 0-4 years old. For CT, the risk increases with age from 425.97•10-6 for the 5-9-year group to 434.37•10-6 for 15-19 years. The current study has not received sufficient grounds to assert that the severity of the course of the disease is associated with radiation risks from the performed CT examinations. © 2021 Author(s).