Abstract:According to the World Health Organization (WHO), viral diseases form serious public health problem. WHO announced that the disease caused by the new virus named coronavirus disease 2019 or Coronavirus disease 2019 (COVID-19), and the virus causing the infection was named SARS-Cov-2 by the International Committee on Taxonomy of Viruses. Children usually have asymptomatic or mild forms. However, children with comorbidity are in risk of developing severe forms of COVID-19. The review presents modern ideas about … Show more
A new coronaviral infection in the Russian Federation is registered less in a child treatment than in an adult one. Children’s COVID-19 is mainly asymptomatic or in mild, severe form occurs rarely. The percentage of paediatric-age patients that require in-patient medical care is from 5,7% to 20% of children with COVID-19. However, clinical observations show that children’s COVID-19 may be severe and extremely severe, also resulting in death. A risk group of unsmooth course of the new coronaviral infection is patients with serious comorbide pathology, in particular oncohematological disease, passing radiation, chemotherapy, transplantation of hematopoietic stem cells. Acute lymphoblastic leukaemia, the most frequent paediatric-age oncological disease, may be one of the factors, predisposing to severe course of the new coronaviral infection. However, COVID-19 is likely to cause the deterioration of leukaemia treatment and an adverse outcome. The article presents a clinical observation of a 12-year-old child with a critical form of the new coronaviral infection and acute lymphoblastic leukaemia in the post-transplantation period. The accumulation of COVID-19 was accompanied by deterioration in the underlying disease. Despite high-quality medical care, using modern technologies, the child had progressive deterioration with a poor outcome.
A new coronaviral infection in the Russian Federation is registered less in a child treatment than in an adult one. Children’s COVID-19 is mainly asymptomatic or in mild, severe form occurs rarely. The percentage of paediatric-age patients that require in-patient medical care is from 5,7% to 20% of children with COVID-19. However, clinical observations show that children’s COVID-19 may be severe and extremely severe, also resulting in death. A risk group of unsmooth course of the new coronaviral infection is patients with serious comorbide pathology, in particular oncohematological disease, passing radiation, chemotherapy, transplantation of hematopoietic stem cells. Acute lymphoblastic leukaemia, the most frequent paediatric-age oncological disease, may be one of the factors, predisposing to severe course of the new coronaviral infection. However, COVID-19 is likely to cause the deterioration of leukaemia treatment and an adverse outcome. The article presents a clinical observation of a 12-year-old child with a critical form of the new coronaviral infection and acute lymphoblastic leukaemia in the post-transplantation period. The accumulation of COVID-19 was accompanied by deterioration in the underlying disease. Despite high-quality medical care, using modern technologies, the child had progressive deterioration with a poor outcome.
The risk of a severe course of new coronavirus infection (COVID-19) due to the development of acute respiratory distress syndrome is extremely high, which is especially true for patients with comorbidities. The aim of the study is to demonstrate the peculiarities of the course and intensive care measures in new coronavirus infection COVID-19 in children with comorbidities. Patients and methods: On the example of clinical cases, the characteristics of the course of a new coronavirus infection of COVID-19 in children with systemic lupus erythematosus and bronchopulmonary dysplasia are considered. Results: The main data from the history and clinical laboratory examination are reflected, which made it possible to identify a cytokine storm in a timely manner, a high risk of adverse course and begin timely specific pathogenetic therapy, including immunoglobulins for intravenous administration, hydroxychloroquine, ritonavir in combination with lopinavir, azithromycin and dexamethasone. Particular attention is paid to the need to limit infusion therapy, maintain a negative water balance and optimal blood oxygen capacity, ambiguity of opinions on the need for routine use of albumin and dexamethasone solutions in patients with COVID-19 has been demonstrated. Conclusion: Children with comorbidities are characterized by a severe course of a new coronavirus infection COVID-19, which requires timely pathogenetic therapy taking into account the individual characteristics of the patient.
Objective. To study the opinion of the managers of healthcare organizations (HOs) of the Gomel region on the specifics of the functioning of outpatient and inpatient HOs in the region in the context of the third wave of COVID-19 spread, the impact of the current situation on the delivery of health care to the population.Materials and methods. A survey of 96 managers of outpatient and inpatient HOs was conducted, the features of the work in the context of an increased COVID-19 incidence rate and associated difficulties were identified.Results. The vast majority of the surveyed managers of outpatient HOs (77.3%) are convinced that the professional qualifications of medical personnel in their institutions fully meet the requirements for the work with COVID-19 patients, while this belief is shared by less than half (46.7%) of the managers of inpatient ones. However, with such a high assessment of the staffing, the managers of outpatient HOs are experiencing a real shortage of personnel: only 10.6% of them responded that they had not experienced difficulties with staffing during their work in the conditions of the COVID-19 pandemic, and 56.7% of the managers of inpatient HOs responded the same. This is probably why outpatient health care tier managers one and a half times more often noted a significant increase in the duration and intensity of the work of medical personnel during the pandemic than their colleagues from inpatient institutions (62.1 and 40%, respectively). But the opinion about the moral and psychological climate in teams practically coincides in both groups of the managers: deterioration in outpatient HOs was noted in 47% of cases, stability in inpatient ones - in 53.3% of cases. Also, in both the groups, the managers of HOs were satisfied with the normative documentation regulating the delivery of health care in the conditions of the COVID-19 pandemic (managers of outpatient HOs - 7.63 ± 1.35 points, managers of outpatient ones - 7.18 ± 1.92 out of maximum 10 points).Conclusion. The fight against the coronavirus has become a serious test for the healthcare system of the Republic of Belarus. The performed survey has revealed problematic issues that arose in the course of the professional activities of the managers of inpatient and outpatient HOs. According to the respondents, during the COVID-19 pandemic, there was a significant increase in the duration and intensity of work. There were also difficulties related to carrying out the diagnostics, shortcomings in the interaction of medical personnel, etc.
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