NEW CORONAVIRUS INFECTION AS TRIGGER FACTOR FOR MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN: LITERATURE REVIEW AND ANALYSIS OF ORIGINAL DATA

2020 ◽  
Vol 99 (6) ◽  
pp. 127-134
Author(s):  
S.R. Rodionovskaya ◽  
◽  
L.N. Mazankova ◽  
I.M. Osmanov ◽  
E.R. Samitova ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Epidemiological Data ◽  
Original Data ◽  
Trigger Factor ◽  
Laboratory Markers ◽  
Systemic Glucocorticoids ◽  
Coronavirus Infection ◽  
Characteristic Features ◽  
Inflammatory Syndrome

The article presents data on the epidemiology, pathogenesis, features of clinical manifestations and diagnosis of multisystem inflammatory syndrome in children (MIS-C) associated with a new coronavirus infection. Objective of the research: to identify clinical manifestations and results of laboratory and instrumental examination of pediatric patients with confirmed MIS-C caused by a new coronavirus infection, the most characteristic features of this pathology and to analyze the amount of therapy based on the assessment of epidemiological data. Results: median age – 8 years (6; 9,5), median duration of the disease at the time of hospitalization – 6 days (3; 6). A positive result of SARS-CoV-2 analysis in rhinopharyngeal swabs by PCR was in 3 patients, antibodies to SARS-CoV-2 by ELISA were detected in 10. Clinical manifestations included prolonged febrile fever in 11 patients, gastrointestinal symptoms of varying severity – in 10, polymorphic rash was noted in 7 cases, conjunctivitis/scleritis – in 7, edema of the eyelids, face, extremities – in 4. CNS lesion manifested itself with general cerebral and meningeal symptoms. All patients had an increase in the level of inflammation laboratory markers. In 2 children chest MSCT revealed characteristic changes for SARS-CoV-2, interpreted as CT 3–4. Therapy included intravenous immunoglobulin infusions, systemic glucocorticoids, antiviral and antibacterial drugs, anticoagulants; two patients received tocilizumab infusions.

scholarly journals MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN: DIAGNOSTIC MARKERS AND FEATURES OF PHARMACOTHERAPY

2021 ◽  
Vol 17 (1) ◽  
pp. 24-28
Author(s):  
M.V. Кhaitovych ◽  
L.M. Voroniuk ◽  
G.Yu. Borisova ◽  
N.V. Diudenko ◽  
N.M. Miagka
Keyword(s):  
Distress Syndrome ◽  
The United States ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Laboratory Markers ◽  
Mucous Membranes ◽  
Coronavirus Infection ◽  
Polymerase Chain ◽  
Inflammatory Syndrome

Relevance. In 2020, children were hospitalized with fever and multisystem inflammation throughout the world during the COVID-19 pandemic. In the United States, this condition is called MIS-C (Multisystem Inflammatory Syndrome in Children). This syndrome is thought to be similar to the severe course of COVID-19 in adults (cytokine storm). The objective of the work is to evaluate the features of the course and pharmacotherapy of multisystem inflammatory syndrome in children. Materials and methods. The study included 17 children (10 boys and 7 girls) aged 3-16 years (on average – 9.5±3.4 years). Diagnosis of coronavirus infection was performed by polymerase chain reaction with real-time detection, determined the level of immunoglobulins M and G before coronavirus infection. Results. The duration of fever in patients was 5-21 days (average 8.1±4.0 days), the duration of inpatient treatment – 7-35 days (average 15.7±7.0 days). Blood albumin levels were reduced in 53.8% of children; the level of fibrinogen was increased in 88.2% of children, the level of C-reactive protein, ferritin, and D-dimer – in all patients. 15 (88.2%) children had pathology of the digestive system, 13 (76.5%) – cardiovascular system (7 children were diagnosed with carditis, 2 – dilation of coronary arteries, 7 – cardiac arrhythmia). Acute respiratory distress -syndrome was found in a 13-year-old girl, shock - in an 11-year-old boy, 11 children (64.7%) were diagnosed with the pathology of the respiratory system (pleurisy, pneumonia), skin and mucous membranes, and 4 children (23.5%) there were manifestations of central nervous system disorders (meningism, decreased reflexes, ataxia), in 2 (11.8%) – renal failure. On average, each patient had lesions of 3.9 ±1.2 systems. Conclusions. MIS-C was manifested by prolonged fever, high levels of laboratory markers of inflammation, hypoalbuminemia, hypercoagulation, often – pathological manifestations of the cardiovascular, digestive, respiratory systems, skin, and mucous membranes. The treatment included intravenous immunoglobulin, steroids, anticoagulant, and antibacterial therapy and was effective.

Features of mahagment of a patient with a new coronaviral infection in the observator on the basis of student’s dormitory

2020 ◽  
Vol 24 (2) ◽  
pp. 45-51
Author(s):  
Olga Yu. Kuznetsova ◽  
Alexandr V. Meltser ◽  
Anna V. Lubimova ◽  
Zhanna V. Pleshanova ◽  
Olga S. Zamyatina ◽  
...  
Keyword(s):  
Young Patients ◽  
Clinical Manifestations ◽  
Hypochromic Anemia ◽  
Lung Damage ◽  
Outpatient Basis ◽  
History Of ◽  
Complicated Course ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome ◽  
Severe Weakness

The article is devoted to the peculiarities of clinical manifestations and the severity of a new coronary virus infection in a university student transferred to an observatory organized in a hotel-type hostel to prevent the spread of COVID-19 among students living in hostels. The data on the epidemiological history of the patient, the results of clinical observation and examination are provided. The tactics of managing a patient with a suspected of COVID-19 on an outpatient basis, symptoms that determine the indications for hospitalization, the results of examination and treatment in a hospital, and further observation at the observatory are considered. A new coronavirus infection can lead to a rapid deterioration in the condition of young patients, which does not correlate with indicators indicating lung damage on the 5th day of the disease. Persistent hyperthermia and severe weakness with anorexia can be indicators of the complicated course of the disease, including the development of hyperactive inflammatory syndrome. Hypochromic anemia can be another disease, which is an unfavorable background for the development of COVID-19. The course of the new coronavirus infection in young patients requires careful attention and further study.

scholarly journals Dermatological Manifestations of COVID-19 in Children

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Vivek Athwani ◽  
Sunil Gothwal
Keyword(s):  
Toxic Shock Syndrome ◽  
Gastrointestinal Symptoms ◽  
Skin Lesions ◽  
Skin Involvement ◽  
Toxic Shock ◽  
Cutaneous Manifestations ◽  
Systemic Involvement ◽  
Atypical Kawasaki Disease ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome

: Coronavirus infection 2019 (COVID-19) primarily has a respiratory system and multi-systemic involvement. Respiratory and gastrointestinal symptoms are predominantly seen in children. In adults, few COVID-19 cases are reported with cutaneous manifestations. Although children are less severely affected by COVID-19, there is increasing evidence for skin involvement, which is in the form of chilblain (e.g., lesions, vesicular, and maculopapular) and erythema multiforme (e.g., rash). Also, few COVID-19 cases are presented with a clinical picture of atypical Kawasaki disease and toxic shock syndrome, later defined as pediatric multisystem inflammatory syndrome (PMIS). The present study aims to summarize various skin lesions with COVID-19.

scholarly journals Multisystem inflammatory syndrome in children associated with COVID-19: nursing care

2021 ◽  
Vol 11 (2) ◽  
pp. 10-17
Author(s):  
Sofia Panato Ribeiro ◽  
Simone Boettcher
Keyword(s):  
Nursing Care ◽  
Pediatric Patients ◽  
Quality Care ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Viral Disease ◽  
Provide Quality Care ◽  
Generalized Lymphadenopathy ◽  
Inflammatory Syndrome

In 2019, a new viral disease, known as SARS-Cov-2 infection, was identified. Scientists believed that it was a disease with low morbidity for pediatric patients; however, a small percentage of children infected with the new coronavirus developed a multisystem inflammatory response, which aroused the interest of many researchers and health professionals. The objective of the study is to describe the main characteristics related to the Pediatric Multisystemic Inflammatory Syndrome Associated with Covid-19 (MIS-C), its complications and nursing care. The main clinical manifestations of MIS-C are hyperthermia, gastrointestinal symptoms, skin manifestations, generalized lymphadenopathy, cardiac and neurological disorders. The main nursing care was listed according to the signs and symptoms, such as monitoring of neurological and hydroelectrolytic changes. The nurse professional must add knowledge about MIS-C so that he is able to qualify his care and improve his skills to provide quality care to pediatric patients.

scholarly journals New coronavirus infection (COVID-19) in children: clinical, laboratory and diagnostic aspects

2021 ◽  
Vol 20 (3) ◽  
pp. 23-28
Author(s):  
S. Yu. Nosyreva ◽  
A. S. Pankov ◽  
A. G. Korneev
Keyword(s):  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Epidemiological Data ◽  
Diagnostic Value ◽  
Sex Structure ◽  
Orenburg Region ◽  
Microbiological Laboratory ◽  
Examination Methods ◽  
Coronavirus Infection ◽  
Medical University

The study of a new coronavirus infection (COVID-19) in children is relevant and of interest for practical health care.Purpose: to identify the clinical and laboratory features of COVID-19 in the context of the six-month dynamics of the pandemic in children of the Orenburg region and to formulate recommendations for optimizing the diagnosis of this disease.Materials and methods. A retrospective analysis of 2661 results of detecting SARS-CoV-2 RNA (including 170 children) was carried out on the basis of the microbiological laboratory of the Orenburg State Medical University. Age and sex, structure of preliminary diagnoses, main clinical manifestations, frequency of testing and dynamics of the PCR threshold cycle in September 2020 and January 2021 were assessed.Results. The proportion of children examined in the Orenburg region from September 2020 to January 2021 increased from 4.6 ± 0.6% to 8.1 ± 0.7%. At the same time, the number of PCR + results also significantly increased from 5.0 ± 2.8% to 8.2 ± 2.6% (χ2 = 54.81; p = 0). The average age of children was 9—10 years old. The main reason for referral was pre-hospitalization screening not related to COVID-19. The proportion of PCR + results in this cohort was significantly lower in children than in adults. Among the clinically manifested forms in adults, the leading diagnosis was «pneumonia», and in children «ARVI». In childhood, a predominantly asymptomatic course of the disease was recorded. In children, unlike adults, PCR Ct values did not correlate with the severity and duration of the clinical manifestations of COVID-19.Conclusion. Due to the low diagnostic value of symptoms in children, it is more expedient to focus on epidemiological data and data from the results of laboratory examination methods. When interpreting the results of PCR diagnostics of COVID-19 for prognostic purposes, it is important to take into account the patient's age.

scholarly journals Acute urticaria: differential diagnosis and treatment

2021 ◽  
pp. 187-192
Author(s):  
Alexander N. Pampura ◽  
Irina N. Zakharova ◽  
Evgeniy E. Varlamov ◽  
Maria A. Simakova
Keyword(s):  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Allergic Diseases ◽  
Diet Therapy ◽  
Elimination Diet ◽  
Term Therapy ◽  
Acute Urticaria ◽  
H1 Antihistamines ◽  
Systemic Glucocorticoids ◽  
Inflammatory Processes

Acute urticaria remains one of the most topical pediatric problems. Acute urticaria lasts for up to 6 weeks, during which blisters appear with varying frequency and intensity. In about 40% of cases, urticaria is accompanied by angioedema. The prevalence of acute urticaria is 1 to 5% in the population, and in the child population the frequency of acute urticaria reaches 6.7%. According to recent estimates, 10 to 20% of the population has had an episode of acute urticaria during their lifetime. About 50% of children with acute urticaria have concomitant allergic diseases. The management of children with acute urticaria presents significant diagnostic and therapeutic challenges. Treatment of acute urticaria in children begins with elimination of the significant trigger – appropriate measures are taken (withdrawal of the drug, administration of an elimination diet, therapy of infectious and inflammatory processes). First-line drugs for acute urticaria are H1-antihistamines, and it is recommended to use H1-antihistamines of the II generation. However, if clinical manifestations develop rapidly, if the patient has generalized urticarial rashes, angioedema, gastrointestinal symptoms, parenteral forms of first-generation antihistamines may be used to relieve the acute allergic reaction. Patients who do not respond to treatment with antihistamines may respond to short-term therapy with systemic glucocorticoids, although the efficacy of this treatment has yet to be tested in controlled clinical trials. The prognosis for acute urticaria is favorable – in most cases, acute spontaneous urticaria remains the only episode in the patient’s life. The disease develops into a chronic form in 5% of patients, and other estimates suggest that the symptoms of urticaria persist in 9.5% of children for up to 6 months.

SKIN LESIONS IN CHILDREN WITH COVID-19-ASSOCIATED MULTISYSTEM INFLAMMATORY SYNDROME

2020 ◽  
Vol 99 (6) ◽  
pp. 259-265
Author(s):  
O.B. Tamrazova ◽  
◽  
I.M. Osmanov ◽  
A.S. Stadnikova ◽  
L.N. Mazankova ◽  
...  
Keyword(s):  
Clinical Observation ◽  
Clinical Manifestations ◽  
Chinese American ◽  
Skin Lesions ◽  
Disease Course ◽  
Skin Manifestations ◽  
Mucous Membranes ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome ◽  
First Time

The pandemic of the new coronavirus infection COVID-19, caused by SARS-CoV-2 coronavirus, continues to develop. The first data indicated that children tolerate this infection much easier than adults, the disease course is generally asymptomatic and mild. Chinese, American and European scientists described a variety of skin manifestations in children with COVID-19 coronavirus infection. The article presents literature data on skin manifestations in children, characteristic for COVID-19. In April 2020, the description of a new severe inflammatory syndrome in children associated with SARS-CoV-2, called multisystem inflammation syndrome (MIS), appeared for the first time. The article presents literature data on MIS clinical manifestations and its incidence. The authors describe clinical observation of MIS development in a 7-year-old child with COVID-19 and with lesions of the skin and mucous membranes.

scholarly journals Pediatric multisystem inflammatory syndrome associated with a new coronavirus infection: unresolved issues

2021 ◽  
Vol 13 (1) ◽  
pp. 13-20
Author(s):  
Yu. V. Lobzin ◽  
A. A. Vilnits ◽  
M. M. Kostik ◽  
M. K. Bekhtereva ◽  
A. N. Uskov ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Number Of Children ◽  
Treatment Regimens ◽  
Almost Everywhere ◽  
Laboratory Confirmation ◽  
High Incidence ◽  
Life Threatening ◽  
Symptom Complex ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome

Since March 2020, the first reports have appeared about the increasing, almost everywhere, number of children who have undergone a new coronovirus infection caused by SARS-Cov-2 with a symptom complex resembling the manifestations of Kawasaki disease. A special feature of the clinical manifestations of this syndrome, which is called “Pediatric multisystem inflammatory syndrome associated with COVID-19”, is the high incidence of life-threatening conditions caused by the sharp development of arterial hypotension against the background of cardiogenic or vasogenic shock.In St. Petersburg, since the end of November 2020, there has been a sharp surge in admissions of children to the ICU of various hospitals with the clinic of Pediatric multisystem inflammatory syndrome, who have laboratory confirmation of the transferred COVID-19.The purpose of this article is to attract the attention of doctors of various profiles, to combine efforts to study this pathology, to determine the criteria for verifying the diagnosis, optimal treatment regimens and dispensary monitoring of patients who have been ill.

scholarly journals Coronavirus Disease 2019-Related Multisystem Inflammatory Syndrome in Children: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Ji-Gan Wang ◽  
Zhi-Juan Zhong ◽  
Meng Li ◽  
Jun Fu ◽  
Yu-Heng Su ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Kawasaki Disease ◽  
Fixed Effects ◽  
Clinical Symptoms ◽  
Myocardial Dysfunction ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Musculoskeletal Symptoms ◽  
Hands And Feet ◽  
Inflammatory Syndrome

Background. This study aimed to describe the clinical symptoms, laboratory findings, treatment, and outcomes of coronavirus disease 2019-related multisystem inflammatory syndrome in children to provide a reference for clinical practice. Methods. We employed a literature search of databases such as PubMed, Web of Science, EMBASE, and Johns Hopkins University for articles on COVID-19-related multisystem inflammatory syndrome in children published between April 1, 2020, and January 15, 2021. High-quality articles were selected for analysis on the basis of their quality standard scores. Using R3.6.3 software, meta-analyses of random- or fixed-effects models were used to determine the prevalence of comorbidities. Subgroup analysis was also performed to determine heterogeneity. Results. A total of 57 articles (2,290 pediatric patients) were included in the study. Clinical Manifestations. :ncidences of fever, gastrointestinal symptoms, respiratory symptoms, and musculoskeletal symptoms (myalgias or arthralgias) were 99.91% (95% CI: 99.67–100%), 82.72% (95% CI: 78.19–86.81%), 53.02% (45.28–60.68%), and 14.16% (95% CI: 8.4–21.12%), respectively. The incidences of rash, conjunctival injection, lymphadenopathy, dry cracked lips, neurologic symptoms (headache, altered mental status, or confusion), swollen hands and feet, typical Kawasaki disease, and atypical Kawasaki disease were 59.34% (95% CI: 54.73–63.87%), 55.23% (95% CI: 50.22–60.19%), 27.07% (95% CI: 19.87–34.93%), 46.37% (95% CI: 39.97–52.83%), 28.87% (95% CI: 22.76–35.40%), 28.75% (95% CI: 21.46–36.64%), 17.32% (95% CI: 15.44–19.29%), and 36.19% (95% CI: 21.90–51.86%), respectively. The incidences of coronary artery dilation, aneurysm, pericardial effusion, myocarditis, myocardial dysfunction, high troponin, and N-terminal pro-B-type natriuretic peptide were 17.83%, 6.85%, 20.97%, 35.97%, 56.32%, 76.34%, and 86.65%, respectively. The incidences of reduced lymphocytes, thrombocytopenia, hypoalbuminemia, elevated C-reactive protein, ferritin, LDH, interleukin-6, PCT, and FIB were 61.51%, 26.42%, 77.92%, 98.5%, 86.79%, 80.59%, 89.30%, 85.10%, and 87.01%, respectively. PICU Hospitalization Rate and Mortality. The incidences of PICU hospitalization or with shock were 72.79% and 55.68%, respectively. The mortality rate was 1.00%. Conclusion and Relevance. PICU hospitalization and shock rates of multisystem inflammatory syndrome in children associated with COVID-19 were high, and its cumulative multiorgans and inflammatory indicators are increased, but if treated in time, the mortality rate was low.

scholarly journals Kawasaki-multisystem inflammatory syndrome in children in the delayed period of coronavirus infection (covid-19): modern state of the problem and possible new approaches to treatment (plasmapheresis)

2021 ◽  
Vol 12 (4) ◽  
pp. 45-57
Author(s):  
O. S. Groznova ◽  
V. A. Warriors ◽  
D. Donich ◽  
V. V. Vetrov ◽  
D. O. Ivanov
Keyword(s):  
Interleukin 1 ◽  
Acute Infection ◽  
Clinical Manifestations ◽  
Adaptive Immune Response ◽  
Toxic Shock ◽  
New Associations ◽  
Temporary Connection ◽  
Adaptive Immune ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome

COVID-19 infection usually occurs in children in a mild form, but some of them in a delayed period (one or several weeks after acute infection with COVID-19) may develop a severe inflammatory disease with clinical manifestations similar to toxic shock syndrome (Kawasaki disease), classified as multisystem inflammatory syndrome in children (MISC). It is possible that the syndrome has only a temporary connection with the COVID-19 infection. In the future, new associations of such clinical manifestations with other infectious (or non-infectious) diseases may appear. But currently, all children in the described cohorts with MISC have an association with COVID-19 infection. It is believed that the syndrome is initiated by an excessive adaptive immune response with the formation of autoantibodies. Treatment is based on anti-inflammatory, including steroid therapy, the possible use of intravenous immunoglobulin, aspirin, interleukin 1 and 6 receptor antagonists. The article analyzes current views on Kawasaki-multisystem inflammatory syndrome in children in the delayed period of COVID-19 coronavirus infection in the aspects of diagnosis, pathogenesis, clinical manifestations (with a discussion of foreign and Russian studies) and approaches to therapy and possible prevention, including the possibility of using plasmapheresis in complex therapy.

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