Introduction. The global spread of SARS-CoV-2 coronavirus infection worldwide determines the need to study the clinical features, complications, extrapulmonary manifestations and long-term consequences of the infection in children. While many studies have been described in adult patients, there are limited data analyzing the clinical course of the disease in pediatric patients infected with SARS-CoV-2. Aim. Review of the literature containing currently reported cases of SARS-CoV-2 infection in children to present the state of the art, understand the direction of research and unresolved issues. Materials and methods. An analysis of publications containing data from studies of SARS-CoV-2 cases in children was carried out. Results. Researchers from different countries agree that children are less susceptible to COVID19. This can create a dangerous situation, which can lead to a weakening of attention to children. Although their clinical manifestations are mainly mild to moderate symptoms, nevertheless, severe cases of the disease occur in children, which can lead to death. Conclusion. The complexity and variability of COVID-19 manifestations support the hypothesis that further research is needed on the long-term and chronic symptoms of COVID-19 in children. Failure to understand the underlying biological mechanisms behind these persistent symptoms increases missed opportunities to identify patients at risk of chronicity in order to prevent such conditions and seek rehabilitation approaches for children with COVID-19.

Хабаровский филиал Федерального государственного бюджетного учреждения «Дальневосточный научный центр физиологии и патологии дыхания» -Научно-исследовательский институт охраны материнства и детства, 680022, г. Хабаровск, ул. Воронежская 49, корп. 1 Контактная информация Елена Владимировна Книжникова, научный сотрудник группы молекулярно-генетической диагностики, Хабаровский филиал Федерального государственного бюджетного научного учреждения «Дальневосточный научный центр физиологии и патологии дыхания» -Научно-исследовательский институт охраны материнства и детства, 680022, Россия, г. Хабаровск, ул. Воронежская 49, корп. 1.

Aim. Demonstration of the clinical case of pneumomediastinum in a teenager with severe COVID-19- associated pneumonia.Materials and methods. The clinical case of spontaneous pneumomediastinum was presented, which was a complication of the severe course of COVID-19 pneumonia in a teenager.Results. Patient Ch., 15 years old, with obesity of the 1st degree, was admitted to the hospital of infectious diseases for patients with a COVID-19 on the 7th day of the illness in a severe condition and had complaints of an increase in body temperature to 40ºC, pronounced cough and weakness, dyspnea when walking and at rest. The PCR test for SARS-CoV-2 gave a positive result. Multispiral computed tomography showed polysegmental interstitial lesion of both lungs, which had multiple areas of “ground glass”, signs of pneumomediastinum, subcutaneous emphysema of the upper third of the chest, left-sided pleural effusion. The volume of lung tissue lesion was 50% on the right and 85% on the left. The positive effect of treatment was not observed after 2-3 days in the hospital. The condition of heavy severity continued due to intoxication syndrome, respiratory failure, inflammatory changes in lung tissue syndrome. In this regard, the patient was injected intravenously with tocilizumab (Actemra®) 400 mg. The child was released on the 20th day of hospitalization with a positive clinical effect.Conclusion. The above clinical case demonstrates that in children a novel coronavirus infection can occur not only in severe form, but also with the possible development of complications in the form of pneumomediastinum and low effectiveness of antibacterial and antiviral therapy, which required the use of humanized monoclonal antibodies (tocilizumab).

A brief review on the epidemiology, clinical picture, diagnostic assessment and treatment of respiratory mycoplasmosis in children is presented. Based on the data offered by the pediatric department of the clinical unit and on examination results given by the laboratory of molecular genetic research methods, the peculiarities of mycoplasmosis extension among children in Khabarovsk in recent years have been noted. The example of the case of mycoplasmosis infection in a family, when 3 out of 4 members of the same family were diagnosed with one of the most serious forms of respiratory mycoplasmosis – community-acquired pneumonia, is described. Different variants of the major disease course depending on the age, premorbid background and therapy are described. The efficiency of the use of macrolides for the treatment of Mycoplasma pneumonia under significant etiological verification of the pathogen using PCR is described.

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