Management of Children with Disease Caused by New Coronaviral Infection (SARS-CoV-2)
Yurii S. Alexandrovich,
Elena N. Baybarina,
Alexander A. Baranov,
Elena A. Vishneva,
Nadezda N. Zvereva,
Dmitry O. Ivanov,
Daria S. Kruchko,
Ivan V. Konovalov,
Tatiana V. Kulichenko,
Yuri V. Lobzin,
Ludmila N. Mazankova,
Leyla S. Namazova-Baranova,
Yuriy V. Petrenko,
Dmitry V. Prometnoy,
Konstantin V. Pshenisov,
Alexey Yu. Rtishchev,
Mukhammad A. Sayfullin,
Liliya R. Selimzyanova,
Aleksandr N. Uskov,
Marina V. Fedoseenko,
Andrey V. Khar’kin,
Olga V. Chumakova,
Kamilla E. Efendieva,
Alexey V. Yakovlev https://doi.org/10.15690/pf.v17i2.2096
Abstract
The Ministry of Health of the Russian Federation jointly with professional association and experts in the field of pediatrics, infectious diseases and resuscitation has developed guidelines “Clinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Children” in order to provide the child population with effective medical care during the pandemic of the new coronaviral infection. The practical experience of specialists from various countries was considered during the development of this document. Special attention should be given to the evidence base of the presented data, as well as to the efficiency and safety issues of medications used in treatment of coronaviral infection and its complications. The authors highlight the problems of prevention, diagnostics and management of pathological conditions caused by COVID-19 in the article according to the presented guidelines. Patient’s management is presented depending on the age and severity of the disease itself. The therapy is considered with regard to etiological, pathogenetic and symptom focus.
Keywords
coronaviral infection,
COVID-19,
prevention,
diagnostics,
treatment,
emergency care,
indications for hospitalization,
rehabilitation,
emergency and intensive care,
children
Supporting agencies: Not specified.
About the Authors
Yurii S. Alexandrovich
Saint Petersburg State Pediatric Medical University
Russian Federation
Saint Petersburg
Disclosure of interest:
Russian Federation
Saint Petersburg
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Elena N. Baybarina
Department of Child Healthcare and Delivery Service
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Alexander A. Baranov
Research Institute of Pediatrics and Children’s Health in «Central Clinical Hospital of the Russian Academy of Sciences»
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Elena A. Vishneva
Research Institute of Pediatrics and Children’s Health in «Central Clinical Hospital of the Russian Academy of Sciences»; Pirogov Russian National Research Medical University
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Nadezda N. Zvereva
Pirogov Russian National Research Medical University
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Dmitry O. Ivanov
Saint Petersburg State Pediatric Medical University
Russian Federation
Saint Petersburg
Disclosure of interest:
Russian Federation
Saint Petersburg
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Daria S. Kruchko
National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Ivan V. Konovalov
Pirogov Russian National Research Medical University
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Tatiana V. Kulichenko
Pirogov Russian National Research Medical University
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Yuri V. Lobzin
Pediatric Research and Clinical Center for Infectious Diseases under the Federal Medical Biological Agency
Russian Federation
Saint Petersburg
Disclosure of interest:
Russian Federation
Saint Petersburg
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Ludmila N. Mazankova
Russian Medical Academy of Continuous Professional Education
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Leyla S. Namazova-Baranova
Research Institute of Pediatrics and Children’s Health in «Central Clinical Hospital of the Russian Academy of Sciences»; Pirogov Russian National Research Medical University; Belgorod State National Research University
Russian Federation
Moscow; Belgorod
Disclosure of interest:
Russian Federation
Moscow; Belgorod
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Yuriy V. Petrenko
Saint Petersburg State Pediatric Medical University
Russian Federation
Saint Petersburg
Disclosure of interest:
Russian Federation
Saint Petersburg
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Dmitry V. Prometnoy
Pirogov Russian National Research Medical University; Moscow Regional Center for Maternal and Child Health
Russian Federation
Moscow; Lyubertsy
Disclosure of interest:
Russian Federation
Moscow; Lyubertsy
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Konstantin V. Pshenisov
Saint Petersburg State Pediatric Medical University
Russian Federation
Saint Petersburg
Disclosure of interest:
Russian Federation
Saint Petersburg
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Alexey Yu. Rtishchev
Pirogov Russian National Research Medical University
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Mukhammad A. Sayfullin
Pirogov Russian National Research Medical University
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Liliya R. Selimzyanova
Research Institute of Pediatrics and Children’s Health in «Central Clinical Hospital of the Russian Academy of Sciences»; Sechenov First Moscow State Medical University
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Aleksandr N. Uskov
Pediatric Research and Clinical Center for Infectious Diseases under the Federal Medical Biological Agency
Russian Federation
Saint Petersburg
Disclosure of interest:
Russian Federation
Saint Petersburg
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Marina V. Fedoseenko
Research Institute of Pediatrics and Children’s Health in «Central Clinical Hospital of the Russian Academy of Sciences»; Pirogov Russian National Research Medical University
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Andrey V. Khar’kin
Pirogov Russian National Research Medical University; Morozov Children’s City Clinical Hospital
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Olga V. Chumakova
Department of Child Healthcare and Delivery Service
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Kamilla E. Efendieva
Pirogov Russian National Research Medical University
Russian Federation
Moscow
Disclosure of interest:
Russian Federation
Moscow
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
Alexey V. Yakovlev
Saint Petersburg State Pediatric Medical University
Russian Federation
Saint Petersburg
Disclosure of interest:
Russian Federation
Saint Petersburg
Disclosure of interest:
All authors confirmed the absence of a reportable conflict of interests.
References
1. Tekhnicheskiye rukovodyashchiye ukazaniya VOZ. Naimenovaniye zabolevaniya, vyzvannogo koronavirusom (COVID-19), i virusnogo vozbuditelya. (In Russ). Доступно по: https://www.who.int/ru/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it. Ссылка активна на 12.04.2020.
2. Resolution of the government of the Russian Federation № 66 «O vnesenii izmeneniya v perechen’ zabolevaniy, predstavlyayushchikh opasnost’ dlya okruzhayushchikh”; dated 2020 January 31. (In Russ). Доступно по: http://publication.pravo.gov.ru/Document/View/0001202002030005. Ссылка активна на 12.04.2020.
3. New study on COVID-19 estimates 5.1 days for incubation period. The Johns Hopkins Bloomberg School of Public Health, March 9, 2020. Available from:https://www.jhsph.edu/news/news-releases/2020/new-study-on-COVID-19-estimates-5-days-for-incubation-period.html.
4. Lauer SA, Grantz KH, Bi Q, et al. The incubation period of Coronavirus Disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Ann Intern Med. 2020;172(9):577–582. doi: 10.7326/M20-0504.
5. Ministry of health of the Russian Federation. Vremennyye metodicheskiye rekomendatsii “Profilaktika, diagnostika i lecheniye novoy koronavirusnoy infektsii (COVID-19)”. Versiya 4 (27.03.2020). (In Russ). Доступно по: https://static-3.rosminzdrav.ru/system/attachments/attaches/000/049/881/original/COVID19_recomend_v4.pdf. Ссылка активна на 12.04.2020.
6. Kelvin Kai-Wang To, Owen Tak-Yin Tsang, Wai-Shing Leung, et al. Temporal profiles of viral load in posterior or opharyngeal saliva samples and serum antibody responses during infection by SARS - CoV-2: an observational cohort study. Lancet Infect Dis. 2020;20(5):565–574. doi: 10.1016/S1473-3099(20)30196-1.
7. Shen K, Yang Y. Diagnosis and treatment of 2019 novel coronavirus infection in children: a pressing issue. World J Pediatr. 2020;1–3. doi: 10.1007/s12519-020-00344-6.
8. Scott D. The Covid-19 risks for different age groups, explained. Vox. 23.03.2020.Available from: https://www.vox.com/2020/3/23/21190033/coronavirus-covid-19-deaths-by-age.
9. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5.
10. Zhu N , Zhang D, Wang W, et al. A novel Coronavirus from patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–733. doi: 10.1056/NEJMoa2001017.
11. Guan W, Ni Z, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708–1720. doi: 10.1056/NEJMoa2002032.
12. Baez D. Clinical findings of 6 children with COVID-19, risks factors associated with COVID-19 death, and detection of SARS-CoV-2 in different clinical specimens. Mar 13,2020.
13. Dong Y, Mo X, Hu Y, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 Coronavirus Disease in China. Pediatrics. 2020. Available at https://pediatrics.aappublications.org/content/pediatrics/early/2020/03/16/peds.2020-0702.full.pdf.
14. Lu X, Liqiong Zhang L, Du H, et al. SARS-CoV-2 infection in children. N Engl J Med. 2020;382(17):1663–1665. doi: 10.1056/NEJMc2005073.
15. Chan J-W, Yuan S, Kok K, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514–523. doi: 10.1016/S0140-6736(20)30154-9.
16. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–1062. doi: 10.1016/S0140-6736(20)30566-3.
17. Zhang J, Dong X, Cao Y, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. 2020. doi: 10.1111/all.14238.
18. Boulos MN, Geraghty EM. Geographical tracking and mapping of coronavirus disease COVID-19/severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic and associated events around the world: how 21st century GIS technologies are supporting the global fight against outbreaks and epidemics. Int J Health Geogr.2020;19(1):8. doi: 10.1186/s12942-020-00202-8.
19. Wang S, Guo L, Chen L, et al. A case report of neonatal COVID-19 infection in China. Clin Infect Dis. 2020;ciaa225. doi: 10.1093/cid/ciaa225.
20. Chen H, Guo J, Wang C, et al. Clinical characteristics and intra-uterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809–815. doi: 10.1016/S0140-6736(20)30360-3.
21. The Daily Star. Coronavirus suspicion: 7-month-old baby sent to Dhaka from isolation ward in Kushtia. Mar 26,2020. Available at: https://www.thedailystar.net/coronavirus-suspicion-in-kushtia-7-month-old-baby-isolation-ward-1886209
22. WHO recommendation. Getting your workplace ready for COVID-19. Feb 26, 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/getting-workplace-ready-for-covid-19.pdf?sfvrsn=359a81e7_6.
23. (Released by National Health Commission & National Administration of Traditional Chinese Medicine on March 3, 2020). Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7). Chin Med J (Engl). 2020;133(9):1087–1095. doi:10.1097/CM9.0000000000000819
24. Cao B, Wang Y, Wen D, et al. A trial of Lopinavir-Ritonavir in adults hospitalized with Severe Covid-19. N Engl J Med. 2020;382(19):1787–1799. doi: 10.1056/NEJMoa2001282.
25. Velthuis AJ, van den Worm, Sims AC, et al. Zn2+ inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. PLoSPathog. 2010;6(11):e1001176. doi: 10.1371/journal.ppat.1001176.
26. Gautret P, Lagier J, Parola P, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020;105949. doi: 10.1016/j.ijantimicag.2020.105949.
27. Chang R, Sun W. Repositioning chloroquine as ideal antiviral prophylactic against COVID-19 – time is now. Preprints. 2020;2020030279. doi:10.20944/preprints202003.0279.v1.
28. Advisory on the use of hydroxy-chloroquine as prophylaxis for SARS-CoV-2 infection. Recommendation. Mar 22, 2020. Available at: https://www.mohfw.gov.in/pdf/AdvisoryontheuseofHydroxychloroquinasprophylaxisforSARSCoV2infection.pdf
29. National task force for COVID-19 of Indian Council of Medical Research & Recommendations for Prophylaxis (30.03.2020). Available from: https://main.icmr.nic.in/content/covid-19+&cd=1&hl=ru&ct=clnk&gl=ru
30. Worcester S. COVID-19 characteristics differ in children vs adults. 2020. Available at: https://www.medscape.com/viewarticle/926805.
31. Sarma P, Prajapat M, Avti P, et al. Therapeutic options for the treatment of 2019-novel coronavirus: An evidence-based approach. Indian J Pharmacol. 2020;52(1):1–5. doi: 10.4103/ijp.IJP_119_20.
32. Ong SW, Tan YK, Chia PY, et al. Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA. 2020;323(16):1610–1612. doi:10.1001/jama.2020.3227.
33. Xu Y, Li X, Zhu B, et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med. 2020;26(4):502–505. doi: 10.1038/s41591-020-0817-4.
34. Zeng L, Xia S, Yuan W, et al. Neonatal early-onset infection with SARS-CoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China. JAMA Pediatr. 2020;e200878. doi:10.1001/jamapediatrics.2020.0878.
35. Wang J, Qi H, Bao L, et al. A contingency plan for the management of the 2019 novel coronavirus outbreak in neonatal intensive care units. Lancet Child Adolesc Health. 2020;4(4):258–259. doi: 10.1016/S2352-4642(20)30040-7.
36. Qin C, Zhou L, Hu Z, at al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis. 2020;pii:ciaa248. doi:10.1093/cid/ciaa248.
37. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, et al; Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19). Electronic address: https://www.lancovid.org. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020;101623. doi:10.1016/j.tmaid.2020.101623.
38. Henry BM, Lippi G, Plebani M. Laboratory abnormalities in children with novel coronavirus disease 2019.Clin Chem Lab Med. 2020. doi: 10.1515/cclm-2020-0272.
39. Guo L, Ren L, Yang S, et al. Profiling early humoral response to diagnose novel Coronavirus Disease (COVID-19). Clin Infect Dis. 2020. doi:10.1093/cid/ciaa310.
40. Soldati G, Smargiassi A, Inchingolo R, et al. Is there a role for lung ultrasound during the COVID-19 pandemic? J Ultrasound Med. 2020. doi:10.1002/jum.15284.
41. Islam M, Levitus M, Eisen L, et al. Lung ultrasound for the diagnosis and management of acute respiratory failure. Lung. 2020;198(1):1–11. doi: 10.1007/s00408-019-00309-1.
42. Chen ZM, Fu JF, Shu Q, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. 2020;1–7. doi: 10.1007/s12519-020-00345-5.
43. COVID-19 and breastfeeding. WHO Position Paper. Available from: http://www.euro.who.int/en/health-topics/Life-stages/maternal-and-newborn-health/publications/2020/covid-19-and-breastfeeding-position-paper,-8-april-2020
44. Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. ActaPaediatr. 2020;109(6):1088–1095. doi: 10.1111/apa.15270.
45. Shen K, Yang Y, Wang T, et al. Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts’ consensus statement. World J Pediatr. 2020;1–9. doi: 10.1007/s12519-020-00343-7.
46. Karimi A, RafieiTabatabaei S, Rajabnejad M, et al. An algorithmic approach to diagnosis and treatment of Coronavirus Disease 2019 (COVID-19) in children: iranian expert’s consensus statement. Arch Pediatr Infect Dis. 2020;8(2):e102400. doi: 10.5812/pedinfect.102400.
47. Alder Hey Children’s Hospital: Clinical management of children admitted to hospital with COVID-19. March 2020. Version 1. Available from: https://alderhey.nhs.uk/application/files/1815/8422/1173/COVID_19_IN_CHILDREN_CLINICAL_GUIDANCE_v1.pdf
48. Michigan Medicine University of Michigan. Inpatient Guidance for treatment of COVID-19 in adults and children. Available from: http://www.med.umich.edu/asp/pdf/adult_guidelines/COVID-19-treatment.pdf.
49. WHO Coronavirus disease (COVID-2019) situation reports. Available from:https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/.
50. Order № 198n Ministry of Health Russia «O vremennom poryadke organizatsii raboty meditsinskikh organizatsii v tselyakh realizatsii mer po profilaktike i snizheniyu riskov rasprostraneniya novoy koronavirusnoy infektsii COVID-19” (with changes from March 27, 2020 № 246n), dated 2020 March 27. (In Russ). Доступно по: https://rg.ru/2020/03/20/minzdrav-prikaz198-site-dok.html. Ссылка активна на 12.04.2020.
Review
For citations:
Alexandrovich Yu.S., Baybarina E.N., Baranov A.A., Vishneva E.A., Zvereva N.N., Ivanov D.O., Kruchko D.S., Konovalov I.V., Kulichenko T.V., Lobzin Yu.V., Mazankova L.N., Namazova-Baranova L.S., Petrenko Yu.V., Prometnoy D.V., Pshenisov K.V., Rtishchev A.Yu., Sayfullin M.A., Selimzyanova L.R., Uskov A.N., Fedoseenko M.V., Khar’kin A.V., Chumakova O.V., Efendieva K.E., Yakovlev A.V. Management of Children with Disease Caused by New Coronaviral Infection (SARS-CoV-2). Pediatric pharmacology. 2020;17(2):103-118. (In Russ.) https://doi.org/10.15690/pf.v17i2.2096
Views:
1076
Email this article 