The question of COVID-19 and long-COVID-19 course in children remains unsolved. This infection in children, which is associated with COVID-19, can vary from asymptomatic to systemic damage of various systems. Multisystem inflammatory syndrome in children, associated with SARS-CoV-2 (MIS-C), is a serious condition in children and adolescents after experiencing COVID-19. Published data on MIS-C have indicated that the inflammation can be registered in the gastrointestinal tract (60–100%), as well as in cardiovascular (80%), nervous (29–58%), and respiratory (21–65%) systems. However, with the changing characteristics of SARS-CoV-2, the manifestations of COVID-19 and long-COVID-19 in children have also been changing. Currently, there is no clear understanding of the development of severe COVID-19 and MIS-C in children, especially after being exposed to patients with COVID-19. We presented two new clinical courses of multisystem inflammatory syndrome in children with severe multisystem damage after close contact to relatives with COVID-19 or long-COVID-19. Thus, high-risk children, who are positive for SARS-CoV-2 infection after contact with COVID-19 patients, should be clinically managed during the first few months. The identification of the disease complexity requires the involvement of neurologists, cardiologists, and other specialists.

РезюмеВ ежедневной клинической практике методы лучевой диагностики широко применяют при оказании медицинской помощи пациентам с часто встречающимися заболеваниями брахиоцефальных сосудов (БЦС). В работе приведены рекомендации по методикам выполнения трудоемких и дорогостоящих лучевых методов исследований (ультразвуковое исследование (УЗИ), компьютерная томография (КТ), компьютерно-томографическая ангиография (КТА) артерий, КТА вен, магнитно-резонансная томография (МРТ)) у пациентов с заболеваниями брахиоцефальных сосудов. В их основу легли рекомендации экспертов, литературные источники и практический опыт применения методов лучевой диагностики.Статья содержит структурированные сведения, касающиеся технологии проведения УЗИ, КТА артерий, КТА вен и МРТ у пациентов при стенозе артерий, расслоении (диссекции) артерий, сосудистой мальформации, синус-тромбозе, атеросклерозе. Данные рекомендации являются универсальными и подходят для большинства медицинских учреждений, выполняющих УЗИ, КТ и МРТ брахиоцефальных сосудов.

Purpose. To moderate computed tomography angiography (CTA) of the heart scanning protocol in children with dilated cardiomyopathy and low left ventricle ejection fraction (LVEF) for optimal visualization of the heart and its major vessels.Materials and methods. We examined 38 patients aged from 9 months to 17 years, undergoing treatment at the cardiology department in the of the Rehabilitation Clinic for Children of the Almazov National Medical Research Centre. Firstly, all patients were performed echocardiography (Echo). Echo data evaluated LVEF. The patients were selected based on the clinical diagnosis, the LVEF index, the patient’s height (or the length of the scan area). 2 groups of patients with DCM (with low LVEF) were formed - younger and older patients; for each group was formed a control group of patients with normal LVEF values. All patients underwent CTA on a 128-sliced computed tomograph Ingenuity Elite (Philips, Netherlands) after a bolus intravenous contrast medium injection.Results. There was revealed a relationship between the start time of the scan and the LVEF, the patient’s height. For patients with low LVEF were created study protocols, where scan start time offset was set as: for the group 1 in the early arterial phase +3c, in the late arterial phase +5c, in the venous phase +15c; for the group 2 in the early arterial phase +5c, in the late arterial phase +5c, in the venous phase +29c.Conclusion. The moderated scanning protocol presents good contrast enhancement by chambers of the heart and its major vessels. It is necessary for an assessment of the anatomy and pathological changes. The identified criteria (LVEF, patient height) should be considered for CTA of the heart in children with dilated cardiomyopathy.

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The advent of the COVID-19, specialists are increasingly encountering previously unknown pathological conditions in their practice. For some time, we have believed that COVID-19 in children is most often mild and asymptomatic. However, with the passage of time and the accumulation of the experience, it became obvious that the new infectious disease it will be quite severe in children. Differential diagnosis of multiple organ disorders in children during the COVID-19 pandemic should be primary carried out with the Multisystem Inflammatory Syndrome in Children, associated with COVID-19 (MIS-C), as well as Long-COVID-19. According to published data, the manifestations of these conditions are due to frequent lesions of the gastrointestinal tract (60–100 %), cardiovascular (80 %), nervous (29–58 %) and respiratory (21–65 %) systems. At present, there is no exact idea of these pathological conditions, the criteria for their diagnosis and the tactics of managing children, not only at the stage of diagnosis, but also at the stage of observation. The authors present a diagnostically complex clinical case describing the development of multiple organ damage in a 7-year-old child after contact with a mother who was sick with COVID-19. The data on the course features, the results of the examination and the difficulties of differential diagnosis of this case with other diseases with a similar clinic are summarized.