Materials and methods: a pilot open observational prospective study of 218 pediatric patients with laboratory-verified COVID-19 diagnosis was performed. The main epidemiological data were analyzed, including the age structure, as well as the features of the clinical course of this disease. The development of COVID-19 pneumonia was recorded in 11,5% of cases (25 patients), while more often pneumonia was recorded in children of the first year of life, as well as over 12 years of age (23,5% and 20% of cases, respectively) than in children of other age groups (p<0,05). CT-1 stage was recorded in 13 patients (52% of cases), CT-2 stage in 10 patients (40% of cases), CT-3 stage in 2 patients (8% of cases). The leading clinical symptoms of COVID-19 in children were: hyperemia of the mucous membranes of the pharynx – 100% of cases (218 patients); increased body temperature – 95,9% of cases (209 patients), while the average figures were 37,6 (36,6; 38,2)0 С; cough – 19,7% of cases (43 patients, of which 21 with pneumonia); diarrhea – 17,9% of cases (39 patients); vomiting – 6,4% of cases (14 patients); change in the auscultatory picture – 3,7% of cases (8 patients with pneumonia). In infants with COVID-19, diarrhea was more often recorded in comparison with patients in the age group over 13 years old (35% and 4% of cases, respectively; p=0,001). The development of cough was less often recorded in children of the first year of life, in Compared with patients over 13 years of age (9% and 40% of cases, respectively; p=0,004), the same trend was observed in COVID-19 pneumonia (25% and 89% of cases, respectively, p=0,02). Thus, the clinical picture of COVID-19 in pediatric patients is characterized by non-specific symptoms. There is a definite trend towards more frequent development of COVID-19 pneumonia in patients in the first year of life, as well as in puberty. Infants with COVID-19 pneumonia are characterized by a high incidence of atypical course of the disease, while adolescents are more likely to show a manifest clinical picture of COVID-19.
Purpose of the study. To investigate the features of lesions of the gastrointestinal tract in diff erent variants of the course of COVID-19 in children.Materials and methods. A single-center prospective study was carried out to study the clinical and laboratory manifestations of gastrointestinal tract (GIT) lesions in different variants of the course of COVID-19 in children. The study was carried out in the following groups: group No. 1 — pediatric patients with a verified diagnosis (according to ICD 10) “U07.1. COVID-19 virus identified, confirmed by laboratory tests, regardless of the severity of clinical signs or symptoms ”, n = 524; group No. 2 — pediatric patients with a verified diagnosis (according to ICD 10) “U10.9 Multisystem inflammatory syndrome associated with COVID-19, unspecified”, n = 46. The article provides a brief description of the observations of the development of autoimmune pathologies (ulcerative colitis, autoimmune hepatitis) in pediatric patients, for whom a postponed COVID-19 infection could be a probable trigger.Results. The leading symptoms of the gastrointestinal tract in patients of group No. 1 were symptoms of acute gastroenteritis, registered in 37.6% of cases. Diarrhea was detected in 21.2% of cases, vomiting — in 16.5%; abdominal pain syndrome — 9.2%. These manifestations were statistically more significant in patients under one year of age, as well as in children of the first three years of life (p≤0.05). Gastrointestinal syndrome in patients of group No. 2 was registered in 67.4% of cases, with vomiting — 60.9% of cases, diarrheal syndrome — 23.9% of cases, abdominal pain syndrome — 82.6%. Other manifestations of the gastrointestinal tract in patients of this group were: reactive hepatitis — 69.6% of cases (average ALT — 98 (47; 347); AST — 107 (34; 347)), reactive pancreatitis — 60.8% of cases (average values of amylase — 127 (28; 269); lipase — 196 (47; 107)). These lesions were of a reactive inflammatory nature, with a probable immune development mechanism.
Relevance. Meningococcal disease is a relatively rare but still potentially fatal and disabling infection, affecting primarily healthy people of all age groups, and remains an important public health problem.Aims. The aim of the study was to analyze the long-term dynamics of the incidence of MI in the Novosibirsk region (NSO; identification and study of the factors that determined the change in the incidence of MI in 2019 in the region.Materials & Methods. A retrospective comparative epidemiological analysis of the incidence of the population of the Novosibirsk region in 1992–2019 was carried out. using statistical reporting forms No. 2 «Information on infectious and parasitic diseases»; state reports «On the state of sanitary and epidemiological well-being ofthe population oftheRussian Federation» for 1998–2015, and according to the NSO for 2005–2019.Results. An analysis of the epidemiological patterns of MI in the NSO revealed the presence of significant fluctuations in the incidence rates with multiple replacements of the leading strains of meningococcus, in the absence of immunity to all the main pathogens of MI in the vast majority of the region's inhabitants (from 60% to 82.92% of the population in different years remained seronegative to meningococcus serogroup A, 100% of the examined are seronegative to serogroup C). Simultaneously with the change in the epidemic situation in MI in the NSO in 2019, a tendency towards an increase in the incidence of MI was registered during 2016–2019 and in all regions ofCentral Asia, from where the influx oflabor migrants with their families continues. As anti-epidemic measures in risk groups, vaccination was used mainly against meningococcus serogroup A in combination with chemoprophylaxis in contact persons.Conclusion. The NSO (Novosibirsk) is characterized by: dynamic changes in the circulating serogroups of meningococcus, the presence of refugees and migrants with a high risk of infection with local strains and the introduction of new ones, including hypervirulent strains from regions on the transit route; high risk of repeated outbreaks and further complication of the epidemic situation. It is necessary to form a regional vaccine prophylaxis program, taking into account the variability of the etiology of MI and the most effective prevention strategies.
The aim of the study was to determine the frequency and clinical and laboratory features of acute gastroenteritis (OGE) in adult residents of Novosibirsk hospitalized with a new coronavirus infection (COVID-19) in 2020.Materials and methods. We examined 3581 patients aged 18 to 96 years with a diagnosis of “New coronavirus infection”, confirmed by the detection of SARS-CoV-2 RNA in the mucus from the oropharynx by PCR, hospitalized in the State Medical Institution NSO GICB No. 1 in 2020. Along with the generally accepted diagnostic methods, feces were examined by PCR in 50 patients with gastrointestinal syndrome to detect SARS-CoV-2 RNA using a set of original specific primers.Results. Of the 3,581 hospitalized adult patients with COVID-19, 74% of cases were diagnosed with bilateral polysegmental pneumonia, and 26% of cases were diagnosed with acute respiratory infection. Manifestations of OGE were observed in 6.8% (n=243) of patients. In the group of 50 COVID-19 patients, in whom the disease began with symptoms of OGE, it came to the fore in the clinical picture of the disease in 20% of cases, and SARS-Co- V2 RNA in the feces was detected in 62% of patients.Conclusion The established frequency of OGE in COVID-19 in adults shows the need to develop and implement in clinical practice test systems (PCR of SARS-CoV-2 RNA in feces) for the diagnosis of the intestinal form of a new coronavirus infection.
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