Coronavirus infection poses a particular danger in relation to decompensation of existing chronic diseases and specific damage to the cardiovascular system (CVS) both during an acute infection and during convalescence. Objective of the study: to summarize current knowledge about the potential involvement of CVS in the development and progression of acute COVID-19 infection and multisystem inflammatory syndrome (MIS) in children and to form an sense of the predictive value, diagnostic tactics and treatment of cardiac anomalies during the coronavirus pandemic. A search was performed in MEDLINE, PubMed, e-library using the search terms «cardiovascular disease in COVID-19/MIS in children», «congenital heart disease/pulmonary hypertension/prolonged QT interval and COVID-19 in children» to identify articles published from April 1, 2020 to May 1, 2021. A literature review indicates that cardiac disorders associated with the new coronavirus infection in children, in the vast majority of cases, developed during MIS, which manifests itself in the form of febrile fever, external signs of Kawasaki disease, hyperinflammatory state and multi-organ damage with an emphasis on CVS. Cardiovascular symptoms occur in the vast majority of children with MIS, and in more than half of the patients – by the type of myocardial dysfunction and/or shock, somewhat less often – in the form of ECG changes, pericardial effusion, сoronary artery ectasia. Against the background of treatment with steroids, intravenous human immunoglobulin (IVIG) and biologic drugs in combination with inotropic support in almost all children, the morphofunctional characteristics of CVS are restored to normal or subnormal levels in a few days. The need for extracorporeal membrane oxygenation and lethal cases are rare. The possibility of developing myocarditis (including fatal), pulmonary hypertension and cardiac arrhythmias associated with COVID-19 in pediatric patients with discussion of possible pathophysiological mechanisms was also described. Long-term observation of this category of persons is necessary due to the uncertain prognosis and the risk of progression of cardiac manifestations. An early comprehensive diagnosis of cardiac disorders and monitoring of the identified changes in children with MIS and acute coronavirus infection are needed.

A steady increase in the number of young sportsmen predetermines the relevance of studying the nature and severity of cardiovascular system remodeling in young athletes, including the development of arterial hypertension (AH) and left ventricular myocardial hypertrophy (LVHM).Objective. To study the prevalence and nature of arterial hypertension (AH) and its associations with signs of cardiovascular remodeling in young athletes taking into account pathogenetic relationship and genetic determination.Characteristics of children and methods. The study included 80 young athletes (including 42 boys, average age 14,5±1,54 years), divided into 4 groups depending on the kind of sports (1 – cyclic, 2 – game, 3 – complex coordination, 4 – power). We used the following research methods: “office” (i.e. during visit to the doctor) measurement of blood pressure, electrocardiography, echocardiography, color Doppler scanning of the neck vessels, daily monitoring of blood pressure, bicycle ergometry, genetic testing using the original panel with 448 markers.Results. An increase in blood pressure at rest was detected in 2,5% of children engaged in power sports, an insufficient decrease at night – in 16,3% of children, and an excessive reaction of blood pressure to dosed physical activity – in 25% of children. These changes correlated with signs of sports remodeling, in particular with the formation of left ventricular myocardial hypertrophy, which was diagnosed in 7–12,5% of athletes. According to the results of genetic testing, pronounced polymorphism in the NO synthase gene at three loci (rs10918594, rs12143842, rs16847548) was associated with a reorganization of the cardiovascular system in 45% of athletes.Conclusion. Violation of the circadian profile of blood pressure and excessive reaction to physical activity demonstrate 7,5–25% of young athletes, especially those involved in complex coordination and power sports. These changes were associated with the severity of sports remodeling and determined by a genetic predisposition.

Peritonitis is a common complication in pediatric surgery. It can occur not only in acute surgical pathology, but also in diseases of the general pediatric profile, for example, in diabetes mellitus. Quite often just the peritonitis is the manifestation of diabetes mellitus. However, when there is a syndrome of the “acute” abdomen, “stressful” hyperglycemia may occur, which is aimed at maintaining the vital activity of the body. Determination the level of blood glucose fails to provide an opportunity to differentiate them. There is always a risk of diagnostic errors.

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