Measles occurs at any age. Outbreaks appear to be exacerbated during periods of low vaccination coverage. In Ukraine in 2016, the level of vaccinations with the first dose was only in 45% of children, and the second — in 31%. Thus, during 2017 only in the Odessa region the number of measles patients reached 1 016. The purpose was to identify the features of the clinical course of measles in young children and infants. Materials and methods. A retrospective study of the medical histories of 111 young children, 68 of them in the first year of life. Results. Measles in children 3 years old retains the typical features of acute onset, manifestations of intoxication (71.82%), fever (99.09%), cough (94.55%), catarrhal phenomena and rash. At the same time, rhinitis (95.59%) and puffiness of the face (100%) are characteristic of children under one year compared with children 1–3 years (51.16% and 58.14%, respectively) p<0.001. Measles severity depends on the age of the child (in children (35.29%) younger than 12 months there was a severe course, and in (55.62%) children younger than 6 months). Complications were found in (44.14%) children. Among them, pneumonia (32.35%) is more common in children under 1 year of age, bronchitis (18.6%) and pneumonia (16.28%) in children aged 1–3 years are approximately the same in frequency. Otitis media (7.35%) was found only in children under 12 months. Conclusions. Thus, the clinical manifestations, severity and complications of measles depend on the age of the child, and the presence of children less than 6 months (28.81%) indicates the existence of a non3immune layer among women of childbearing age. 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 the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: measles, complications, young children, infants.
У статті описані особливості клінічного перебігу інфекційного мононуклеозу в дитини, викликаного збудниками сімейства герпесвірусів (Епштейна — Барр та герпесу 6-го типу).
COVID-19 is an infectious disease caused by a new coronavirus first discovered in 2019. The infection has spread rapidly throughout the world and affects people of all ages. Thus, 12.7% of all SARS-CoV-2 patients are children. Purpose - to establish the clinical and paraclinical manifestations of the course of COVID-19 in children, depending on age to predict the severity of the disease’s manifestation. Materials and methods. The 60 children aged from 3 months to 17 years old with laboratory-confirmed SARS-CoV-2 were examined. All patients underwent general clinical, laboratory, and instrumental examinations and received therapy according to Ukrainian National protocol. SARS-CoV-2 infection was confirmed by real-time PCR. Results. Thus, in young children COVID-19 begins acutely (90.0%) with intoxication (75.0%), fever (65.0%), nasal congestion (25.0%), rhinorrhea (20.0%), dry cough (60.0%), increased ESR and C-reactive protein (55.0%). The course of COVID-19 in children 4-6 years is accompanied by acute onset (85.71%), fever (85.71%), pharyngitis (85.71%), lymphopenia (28.56%), and no CT signs of lesions (71.43%). In children 7-12 years old, COVID-19 causes intoxication (88.89%), fever (83.33%), pharyngitis (55.56%), dry cough (77.78%), lymphocytosis (16.67%) with accelerated ESR (38.89%) and pneumonia (38.89%). The course of COVID-19 in children was older than 13 years old characterized by fever (73.33%), pharyngitis (66.67%), dry cough (73.33%), olfactory loss (20.0%), leukopenia (20.0%), ESR acceleration (20.0%), and a decrease in prothrombin (13.33%) without pulmonary lesions (73.33%). Conclusions. These data suggest that the severity and duration of clinical and laboratory manifestations of COVID-19 depend on the child’s age. The course of COVID-19 in children of all age groups is mostly of moderate severity with a favorable prognosis ((56.67%) hospitalized children did not have any complications). Only children from 7 to 12 years old need additional attention due to the severe manifestations of intoxication (88.89%) and the risk of complications with pneumonia (38.89%). 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 the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
Background. Pandemic of coronavirus disease COVID-19 caused by a new coronavirus SARS-CoV-2 still remains a global problem, but the data about the features of the course of COVID-19 infection among children of different ages are limited. The purpose was to conduct a generalized analysis of demographic, epidemiological and clinical features of COVID-19 in children of different ages from different regions of Ukraine. Materials and methods. In accordance with the principles of bioethics, a multicenter retrospective open cohort study of 669 cases of infection caused by coronavirus SARS-CoV-2 in children was conducted at the departments of hospital bases of Kyiv, Vinnytsia, Chernivtsi and Odesa. Clinical, laboratory and instrumental markers of COVID-19 coronavirus infection were determined in hospitalized children. Results. The first (І) group included 67 infants under 2 months of age, the second (ІІ) one — 320 children aged from 60 days to 6 years, a subgroup of 127 patients of junior and middle school age formed the third (ІІІ) group, and the fourth (IV) group consisted of 155 adolescents at the age over 12. Damage to internal organs by SARS-CoV-2 virus was characterized by a multi-systemic type and manifested by changes in the upper respiratory tract in 70.1 % of cases, lower respiratory tract lesions — in 54.7 %, infectious and inflammatory changes — in 57.2 %, gastrointestinal symptoms — in 9.2 %, and neurological signs — in 17.8 % of observations. According to the results of study, the most frequent clinical symptoms found in the total cohort of patients were fever (51.1 %), general fatigue (51.6 %), sore throat (70.1 %), cough (54.7 %) and poor appetite (52.8 %). Damage to the lung parenchyma with specific clinical and radiological manifestations as a sign of coronavirus disease COVID-19 was detected in 23.9–25.9 % of children from the different regions of Ukraine, with a significantly increased risk of pneumonia among adolescents (odds ratio (OR) = 7.5). The most frequent changes when using additional methods of examination were leukocytosis (18.8 % of cases), thrombocytosis (14.5 %), leukopenia (11.1 %), increased С-reactive protein (43.7 %). Elevated content of platelets was mainly found in children of the first two months of life (38.3 % of cases), and it reliably increased during the period of in-patient treatment, which coincided with the tendencies to increasing the level of C-reactive protein in this age group (OR = 5.0). Conclusions. The analysis of epidemiological, clinical and laboratory features of the course of coronavirus disease caused by SARS-CoV-2 in children of different age groups from different regional hospital bases of Ukraine was consistent with the course in adult patients with COVID-19, but with higher chances of milder forms of the disease (OR = 3.1) among young children, and with involvement of the lower respiratory tract and higher risk of severe course among older children (OR = 7.3).
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