ETIOLOGICAL AND CLINICAL-LABORATORY FEATURES OF THE COURSE OF RESPIRATORY INFECTIONS IN CHILDREN HOSPITALIZED DURING THE COVID-19 PANDEMIC

Objective: to determine the main clinical signs of COVID-19 that allow differentiating COVID-19 from seasonal respiratory infections in hospitalized children in the initial period of the disease.Material and methods. The case histories of 44 patients (24 boys, 20 girls) aged from 1 to 17 years old who were admitted to a specialized hospital in Moscow with symptoms of acute respiratory infection (ARI) were retrospectively analyzed. To verify the etiology of the disease, the RNA of the SARS-CoV-2 virus was determined in nasopharyngeal smears( PCR), IgM and IgG antibodies to SARS-CoV-2 (ELISA), and infection markers (Mycoplasma, chlamydia, herpesvirus infections, and respiratory viruses). Statistical analysis was performed using the IBM SPSS Statistics 26 program. The calculations used Student's t-test, Mann-Whitney's Utest, Pearson's χ2 test, and Fisher's exact test. Differences in indicators were considered statistically significant at p<0.05.Results. Group 1 included 17 children (39%) who had SARS-CoV-2 RNA detected in oropharyngeal smears, and the comparison group included 27 children (41%) with negative test results. Coughing was more common in patients with ARI (p=0.04), while complaints of sore throat, in contrast, were more common in children with COVID-19 (p=0.01). Fever was reported equally frequently in children of both groups. Upper respiratory tract (URT) damage occurred in 55% of patients, lower respiratory tract (LRT) damage with the development of pneumonia or bronchitis - in 45%. When comparing the levels of airway damage depending on the presence of COVID-19, statistically significant differences were obtained: LRT pathology was more often observed in patients with ARI (p=0.005).Conclusion. The course of COVID-19 in children has few specific clinical and laboratory signs, which makes differential diagnosis with seasonal ARI difficult. The high proportion of combined infections makes it necessary to screen for major respiratory pathogens.

children, acute respiratory infections, COVID-19, combined infections

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