On the pathogenesis of destructive pneumonia during COVID-19: a clinical case.

Community-acquired pneumonia is a potentially serious infection in children with high morbidity rate, risk of severe course and unfavorable outcomes. Specialists have noted the increased incidence of the destructive forms in the recent years. Aim. To present a clinical case of destructive pneumonia in a 1 year 2 month old child, hospitalized in the State Budgetary Healthcare Institution "Children's City Clinical Hospital of St. Vladimir Moscow Healthcare Department", and analyze it in terms of current understanding on the disease pathogenesis. Conclusion. During COVID-19 (COronaVIrus Disease 2019) pandemic, pulmonologists and pediatric surgeons encountered an unconventional course of destructive pneumonia. A large number of studies of pathophysiological processes in acute viral interstitial pneumonias have recently allowed to expand our understanding of the role of coagulation system. At the same time, new questions arose concerning the clinical course and development of the pathological infectious process.Copyright © Zaytseva O.V. et al., 2023.

On the pathogenesis of destructive pneumonia during COVID-19: a clinical case

Community-acquired pneumonia is a potentially serious infection in children with high morbidity rate, risk of severe course and unfavorable outcomes. Specialists have noted the increased incidence of the destructive forms in the recent years. Aim. To present a clinical case of destructive pneumonia in a 1 year 2 month old child, hospitalized in the State Budgetary Healthcare Institution "Children's City Clinical Hospital of St. Vladimir Moscow Healthcare Department”, and analyze it in terms of current understanding on the disease pathogenesis. Conclusion. During COVID-19 (COronaVIrus Disease 2019) pandemic, pulmonologists and pediatric surgeons encountered an unconventional course of destructive pneumonia. A large number of studies of pathophysiological processes in acute viral interstitial pneumonias have recently allowed to expand our understanding of the role of coagulation system. At the same time, new questions arose concerning the clinical course and development of the pathological infectious process. © Zaytseva O.V. et al., 2023.

On the pathogenesis of destructive pneumonia during COVID-19: a clinical case.

Community-acquired pneumonia is a potentially serious infection in children with high morbidity rate, risk of severe course and unfavorable outcomes. Specialists have noted the increased incidence of the destructive forms in the recent years. Aim. To present a clinical case of destructive pneumonia in a 1 year 2 month old child, hospitalized in the State Budgetary Healthcare Institution "Children's City Clinical Hospital of St. Vladimir Moscow Healthcare Department", and analyze it in terms of current understanding on the disease pathogenesis. Conclusion. During COVID-19 (COronaVIrus Disease 2019) pandemic, pulmonologists and pediatric surgeons encountered an unconventional course of destructive pneumonia. A large number of studies of pathophysiological processes in acute viral interstitial pneumonias have recently allowed to expand our understanding of the role of coagulation system. At the same time, new questions arose concerning the clinical course and development of the pathological infectious process.Copyright © Zaytseva O.V. et al., 2023.

A contemporary view of the problem of destructive pneumonia in children

The problem of community-acquired pneumonia in children remains relevant at the present time. Complicated forms, which include pleural empyema, abscess, necrotizing pneumonia, bronchopleural fistulas and acute respiratory distress syndrome do not decrease, despite modern antibacterial therapy and the availability of vaccination against pneumococcus. The main pathogens associated with lung destruction in children are S. pneumoniae and S. aureus, often MRSA. The role of other pathogens in necrotizing pneumonia is much less frequently reported: Streptococcus pyogenes, Haemophilus influenzae, Pseudomonas aeruginosa, Fusobacterium nucleatum, Legionella pneumophila, Klebsiella pneumoniae, anaerobes. However not only pathogenic factors of the pathogen are important for necrotizing pneumonia development. Often, a viral prodrome, often associated with the influenza A (H1N1) virus, precedes complicated pneumonia. During the epidemic of COVID-19, endothelial damage with a high degree of probability was a predisposing factor for the development of a secondary bacterial infection with lung tissue necrosis. Significant destruction and liquefaction of the lung tissue may develop despite adequate antibiotic therapy. Great importance in the development of necrosis is attached to the activation of hemostasis and thrombus formation in the vessels of the lungs. Timely diagnosis often is difficult due to the predominance of general symptoms over local ones, especially in young children. Chest x-ray is the standard for diagnosing. However, the diagnostic capabilities of this method in necro-tizing pneumonia are limited. To assess a number of parameters of the state of the pleural cavity and lung tissue, ultrasound is preferred. It is necessary to analyze the current features of the course of necrotizing pneumonia in children and develop clinical guidelines for the management of patients in the acute period and rehabilitation. © 2023, Remedium Group Ltd. All rights reserved.

Diagnostics of a new coronavirus infection in children admitted to a multidisciplinary hospital

The second decade of the 21st century started with the emergence of a new coronavirus SARS-CoV-2, affecting humans and causing COVID-19 infection. Children usually have mild disease with one-third of them being asymptomatic, which hinders diagnostics of this infection and does not prevent hospitalization of infected children with non-respiratory disorders to hospitals. Objective. To assess the incidence and specific characteristics of COVID-19 among children emergently admitted to a multidisciplinary hospital not intended for hospitalization of patients with COVID-19. Patients and methods. We performed retrospective analysis of medical records of children admitted to different departments of a multidisciplinary hospital in Moscow between 20.03.2020 and 20.07.2020 (9,779 were discharged during this period). Results. A total of 64 children aged 1 month to 17 years admitted to 10 different departments had positive PCR results for COVID-19 (nasal/oropharyngeal swabs) upon admission to hospital. Fifteen patients (23.4%) had asymptomatic coronavirus infection. These were primarily children of school age and less often of preschool age admitted to the Departments of Traumatology, Surgery with injuries, fractures, exacerbation of chronic nephrological or abdominal disorders. Twenty-four participants (37.5%) presented with mild or none catarrhal symptoms, whereas 12 children were diagnosed with pneumonia. The highest number of SARS-CoV-2-positive children (n = 30;46.9%) were admitted to the Department of Infectious Diseases, as could be expected. Conclusion. Our findings suggest that, in general, the current situation reflects our knowledge about COVID-19. Children usually have mild or asymptomatic COVID-19 and play a significant role in virus transmission, contributing to the continuation of the pandemic. Our results have high clinical and epidemiological significance and require further investigations among children of different ages to accumulate the data. © 2021, Dynasty Publishing House. All rights reserved.