Background. In 2020, a new human coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), became a pandemic, causing the disease course from mild symptoms to severe cases. In this article we analyze the features of the course of coronavirus disease among children from 3 to 18 years. Materials and methods. Medical records of 69 pediatric inpatients aged 3 to 18 years were analysed. They were hospitalized in the Lviv Regional Children’s Clinical Hospital “OHMATDYT” from April to December 2020 with a diagnosis of coronavirus disease. Laboratory tests for the presence of SARS-CoV-2 RNA were performed in samples of nasopharyngeal swabs by polymerase chain reaction at the Lviv Regional Laboratory Center of the Ministry of Health of Ukraine. The results were processed statistically using Excel software from Microsoft Office 2019 packages. Results. It was found that 88.4 % of children came into contact with infected family members. The presence of comorbidities was observed in 17.3 % of patients. The main manifestations of coronavirus disease in children were: fever > 38 °C — 52.2 %, < 38 °C — 39.1 %, sore throat — 14.5 %, runny nose — 13 %, loss of smell and taste — 8.7 %, cough — 24.6 %, abdominal pain and diarrhea — 10.1 %, general weakness — 52.2 %. Laboratory examination showed leukocytosis in 5.9 % of children, leukopenia in 53.6 %. Pneumonia was observed in 36.2 % of cases. Two patients had complications in the form of systemic inflammatory response syndrome, which had a severe, life-threatening course. In the period from 14 to 48 days after COVID-19, this syndrome was diagnosed in 10 children. Conclusions. Children, regardless of age, are susceptible to coronavirus and have not been the primary source of SARS-CoV-2 in the family. The clinical course of the disease was manifested in most cases by fever and general weakness. Pneumonia was observed in 36.2 % of patients, severe complications in the form of systemic inflammatory response syndrome was detected in 2 children on the background of the acute course of the disease and in 10 children this syndrome occurred within 48 days after COVID-19.

The article presents a clinical case of a child with an infantile form of Pompe disease. At the age of 5 months, the girl became ill with acute bronchitis and the gentle systolic murmur over the surface of the heart detected by the district pediatrician during auscultation was the reason for referral to a cardiologist. Echocardiography diagnosed hypertrophic cardiomyopathy and the child was hospitalized for further examination. The mother did not complain. Given the slightly reduced muscle tone, elevated levels of transaminases and hypertrophic cardiomyopathy, and after consultation with a neurologist and geneticist, it was decided to conduct a genetic examination. A pathogenic variant of p.1447G> A (p.Gly483Arg) was detected in the GAA gene in a homozygous state and a clinical diagnosis was made: Pompe disease, infantile classical form. One month after diagnosis, pre-existing human recombinant α-glucosidase replacement therapy was initiated. During 18 months of treatment, the child's condition was satisfactory, no adverse side effects from enzyme replacement therapy were recorded, but lysosomal glycogenic load in the heart tissue was significantly reduced (according to echocardiography). Pompe disease is a rare genetic disease that is important to diagnose in a timely manner. Today, it is extremely important for doctors to understand the timeliness of referral to specialized centers for the necessary genetic scanning of children with suspected CP. Diagnosis of CP involves the detection of characteristic symptoms, confirmation of the diagnosis based on the detected low level of α-glucosidase in the patient's blood. The appointment of specific therapy for CP can stop the progression of the disease and significantly improve the quality and life expectancy of such patients. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: Pompe disease, diagnosis, treatment.

Unlike adults, children are less likely to get infected SARS-CoV-2, their disease has a mild form and fatal cases are rather rare. However, a new disease associated with SARS-CoV-2, the multisystem inflammatory syndrome (MIS-C), has been described in children. Most children with MIS-C in the world are blacks or asians. Purpose - to analyze of peculiarities of MIS-C in children of Lviv Region. Materials and methods. We have analyzed medical records of 16 children who were treated in Communal Non-Commercial Establishment of Lviv Regional Council «Lviv Regional Children Clinical Hospital «OKHMATDYT» in the period from September 2020 to January 2021 with the diagnosis of MIS-C, associated with SARS-CoV-2. Results. MIS-C was diagnosed in 16 children (average age was 8,2±0,065 years, girls:boys = 1:0,6). None of our patients was the «primary source of SARS-CoV-2» in the household but contracted coronavirus disease after a contact with the sick relatives. The disease occurred in 4 (25%) children against the background of acute coronavirus disease, in 4 (25%) more children during the first month and 8 (50%) children more than a month after acute SARS-CoV-2 infection. All children has febrile fever and general weakness. Besides, in most of the patients clinical progression of MIS-C was characterized by typical skin rashes and conjunctivitis (13 children - 81,5%), facial swelling and edema of distal parts of extremities (11 children - 68,75%). Muscle pain was present in 9 (56%) children, hyperesthesia - in 4 (25%) children, gastrointestinal symptoms - in 8 (50%) our patients. Myocarditis was diagnosed in 4 (25%) children, linear dilatation of coronary arteries (2 children - 12,5%) and small aneurysms (1 child - 6,25%) - in 3 (18,75%) our patients. All these changes returned to normal 1 month after discharge from the hospital. Conclusions. The syndrome of multisystem inflammatory response before the 48th day after acute coronavirus disease and is characterized by typical clinical course. Treatment with human immunoglobulin at the dose of 1-2 g/kg, glucocorticosteroids at the dose of 1-2 mg/kg, aspirin 3-5 mg/kg against the background of antibacterial therapy is effective for the prevention of changes in the coronary arteries and for the recovery of all patients. The research was conducted in accordance with the principles of bioethics set out in the WMA Declaration of Helsinki and Universal Declaration on Bioethics and was approved by the Commission on Ethics of Scientific Research, Experimental Developments and Scientific Works of Danylo Halytsky Lviv National Medical University. The informed consent of the patients was obtained for conducting the studies. No conflict of interests was declared by the authors. Keywords: COVID-19, pediatric inflammatory multisystem syndrome, pediatric multisystem inflammatory disease, COVID-19 related, MIS-C associated with COVID-19, PIMS-TS.

The aim. To analyze the features of the coronavirus disease course in young children. Materials and methods. We analyzed case histories of 60 children aged 0 to 3 years who were hospitalized to the Lviv Regional Children’s Clinical Hospital “OHMATDYT” in the period from April to December 2020 with a diagnosis of coronavirus disease. Out of the 60 children 36 (60 %) were boys and 24 (40 %) were girls. Laboratory studies on the presence of SARS-CoV-2 virus RNA were performed in samples of nasal and pharyngeal swabs by PCR at the State Institution “Lviv Regional Laboratory Center of the Ministry of Health of Ukraine”. Blood and urinary laboratory tests were performed on the basis of the Laboratories in Lviv Regional Children’s Clinical Hospital “OHMATDYT”. The result were statistically processed using Excel software from Microsoft Office 2019 packages. Quantitative characteristics were given as M ± m (arithmetic mean ± standard deviation of the arithmetic mean). Results. It was found that 40% of children under 1 year old and only 15% from 1 to 3 years old were hospitalized on the first day of the disease. Parents of sick children in 51 (85 %) cases confirmed the presence of contact with infected family members. The analysis of the disease clinical manifestations showed that during the disease course, most children with coronavirus disease had the following clinical manifestations: fever, runny nose, cough, abdominal pain, diarrhea, and general weakness. Lymphopenia, which is the most common laboratory finding in adults with COVID-19, was found only in 28 % of children hospitalized to the Regional Children’s Clinical Hospital “OHMATDYT”. The presence of complications in the form of pneumonia was observed in 5 children, which amounted to 8.3 %. The average duration of inpatient treatment for children under 1 year of age was 7 days, and it was 6 days for children between 1 and 3 years of age. Conclusions. It was found that 85% of child inpatients were in contact with family members in whom the presence of SARS-CoV-2 infection was confirmed. The main manifestations of coronavirus disease were fever ˃38 °C and general weakness in more than 55% of children aged 0 to 3 years. The level of leukocytes within the age norm was observed in 46.6% of children, leukopenia– in 35.0%, and lymphopenia– in 28.3%. The course of the disease among young children was mild, and only 8.3% of children had the moderately severe course, complicated by pneumonia.