IN CHILDREN EXPERIENCE IN THE STUDY OF CORONAVIRUS INFECTION

IN CHILDREN EXPERIENCE IN THE STUDYOF CORONAVIRUS INFECTION

Myrzabek Abubakirov

Rehabilitologist, Kazakh National Medical University,

Kazakhstan, Almaty

Aitkozha Alimkulov

Endoscopic-surgeon, Kazakh National Medical University,

Kazakhstan, Almaty

Aibolat Muratbayev

General practitioner, Kazakh National Medical University,

Kazakhstan, Almaty

Abylaikhan Kazenov

General practitioner, Kazakh National Medical University,

Kazakhstan, Almaty

Nurbol Abilov

Resident anesthesiologist-resuscitator of Kazakh National Medical University,

Kazakhstan, Almaty

RELEVANCE: On March 11, 2020, WHO announced the start of the COVID-19 (Coronavirus disease 2019) pandemic. This article is devoted to the epidemiological, clinical and laboratory features, as well as the tactics of treatment at different periods of the outbreak of a new coronavirus infection (SARS-CoV-2 in the Children's City Infectious Diseases Hospital in Almaty. It has been found that children are much easier to tolerate COVID-19. Researchers note the prevalence of asymptomatic and mild forms of the disease in children. It has been shown that asymptomatic and mild form of COVID-19 disease prevails in children with a significantly more favorable outcome. Despite the fact that the study shows that COVID-19 in children is easier, combined organ damage that is asymptomatic at the onset of the disease can be complicated by pneumonia and bronchitis, as well as prolonged isolation of the virus in various biological environments after the relief of the main symptoms of the disease, dictate the need for a long dynamic monitoring of children, including those who had intra-family contact with a patient with COVID-19.

PURPOSE OF THE STUDY: On March 11, 2020, WHO announced the start of the COVID-19 (Coronavirus disease 2019) pandemic due to the rapid and global spread of the new coronavirus infection. At the same time, starting from the first weeks of registration of infection in individual areas, and subsequently - during the period of an avalanche increase in the incidence in regions, countries and up to its global spread throughout the planet, researchers drew attention to the fact that the proportion of children among COVID-19  patients is significantly lower than other age groups. In addition, it was also noted that children have a milder course of the disease and complications and adverse outcomes are much less common. In Kazakhstan, the very peak of the first wave of coronavirus fell on June-July 2020. According to the Ministry of Health of Kazakhstan, in June-July 2020, the majority of cases of coronavirus were the country's adult population. The anti-record for the incidence of coronavirus among children aged 0 to 18 years, according to the Department of Maternal and Child Health of the Ministry of Health of the Republic of Kazakhstan, was set in July 2021. In total, since January 1, 42 167 children have been registered in the republic with a confirmed diagnosis of COVID-19. The largest number was in July - 13,047. In terms of regions, the largest number of sick children is noted in Almaty, Nur-Sultan and the Karaganda region, the smallest number is in the Turkestan region. According to the Children's City Infectious Diseases Hospital in Almaty, the number of hospitalized children with a positive PCR test for CVI was deducted. So, according to statistics, it was revealed that, in April, the number of children hospitalized with CVI in the Children's City Infectious Hospital reached 231 children, which is the highest incidence of Covid-19 in children in Almaty since the beginning of the pandemic. The next outbreak occurred in the month of July, 245 hospitalized children, while in May and June the number of hospitalized children was significantly less, 125 and 30 hospitalized children, respectively. The largest number of infected patients with subsequent hospitalization was in August, 413 children were hospitalized with confirmed Covid-19. In September, this figure dropped to 237.

MATERIALS AND METHODS: It should be noted that these data were subtracted among hospitalized patients. According to the data collected from the anamnesis of hospitalized patients, the most common symptoms in children are fever, lethargy and cough, which could be accompanied by nasal congestion, runny nose, headache, etc. The deterioration of some children is associated with chronic diseases. Most of the patients admitted to the children's infectious diseases hospital in history have close contact over the past 14 days with persons under observation for an infection caused by coronavirus, who subsequently fell ill, or with persons who have a laboratory confirmed diagnosis of COVID-19. If COVID-19 was suspected, all patients underwent diagnosis verification by detecting coronavirus RNA by PCR. After hospitalization, the patients underwent a clinical analysis of blood, urine, biochemical analysis of blood, C-reactive protein (CRP), coagulogram, pulse oximetry, ECG and chest x-ray, if necessary, chest CT. At the height of the disease, some patients with COVID-19 had lymphocytopenia. To date, no specific biochemical changes have been identified.

Basic approaches to treatment

In the temporary clinical guidelines of the Ministry of Health of the Republic of Kazakhstan, there is no evidence of effective specific therapy for the disease caused by COVID-19, therefore, the main principle in the management of patients with a confirmed diagnosis of COVID-19 remains the optimal pathogenetic and symptomatic treatment, depending on the nature of clinical symptoms, the severity of the disease, the presence of / the absence of pneumonia (X-ray and CT / signs), the type and degree of complications, concomitant diseases, which is carried out in order to alleviate symptoms and maintain the functions of organs and systems in a more severe course.

As an etiotropic treatment for children with COVID-19, Viferon is prescribed 150 thousand units * 2 times a day

Pathogenetic therapy includes adequate hydration, relief of hyperthermia,mucolytic therapy and respiratory support.

At the moment, children with a severe course of the disease and a pronounced immune-inflammatory syndrome are prescribed dexamethasone at a dose of 6 mg / day in combination with anticoagulant therapy.

Discharge from the hospital is carried out with clinical recovery and negative test for coronavirus RNA.

CONCLUSION As experience in studying the epidemiology of CVI has shown, coronavirus infection children of almost any age are affected. The inclusion of children in the epidemic process occurs mainly through intrafamilial contacts. In most cases, CVI occurs in the form of mild ARVI in children. Signs of a severe course of CVI can be the appearance of shortness of breath, difficulty breathing and a decrease in oxygen saturation. It is impossible to unambiguously predict the dynamics of the spread of COVID-19; it is necessary to be prepared for such negative predictive scenarios as mutations of the virus in favor of increasing its virulence. In this regard, it is necessary to have epidemiological alertness and observe the usual preventive measures, including thorough hand washing, using soap and / or alcohol-based hand sanitizers, rinsing the nose, and gargling, contact with patients should be avoided.

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