Features of COVID-19 in teenagers. Clinical cases

Abstract

Coronavirus infection in childhood is a common disease and has a number of features of the clinical course. There remain quite a lot of problems related to the variety of clinical symptoms, the severity of the course and treatment tactics in different age categories. Purpose - to study the epidemiological and clinical features of the coronavirus disease COVID-19 in adolescents compared to the younger age group in order to predict the severity of the course and determine treatment tactics. Materials and methods. A single-center retrospective open cohort study of 188 patients under the age of 18 hospitalized in the infectious disease department of the Chernivtsi Regional Children’s Clinical Hospital with a confirmed respiratory infection caused by SARS-CоV-2 was conducted. This cohort of patients is divided into 2 clinical groups. The Group I consisted of children aged 12 to 18 years (43 children), the Group II included children aged 0 to 11 years (145 patients). Results. Epidemiologically, extrafamilial sources of infection prevail in adolescence in the range of 44.2% (n=19), which is explained by greater social activity compared to children from birth to 11 years of age. For the 1st observation group, symptoms of damage to the lower respiratory tract are more characteristic, in particular, cough 81.4% (n=23), shortness of breath 51.1% (n=22), hypoxemia 14.2% (n=6) and symptoms of associated with intoxication syndrome (general weakness, asthenia 97.6% (n=42), decreased appetite, refusal to eat 74.4% (n=32), myalgia 11.6% (n=5), headache 14,2% (n=6)). The severity of the course of the coronavirus infection in adolescence is due to the dominance of lower respiratory tract lesions with the development of pneumonia in 58.2% (n=25) of cases, which required longer and more intensive treatment. Conclusions. The share of adolescents hospitalized due to COVID-19 was 22.9% (n=43), among them with a severe degree of impairment of the general condition - 16.4% (n=7), which is due to the predominance of damage to the lower respiratory tract with the development of pneumonia in 58.2% (n=25) of cases. This cohort of patients is characterized by a longer intoxication syndrome, the epidemiological role of family contacts with regard to COVID-19 decreases, and the value of unidentified non-familial sources of infection increases - 44.2% (n=19). The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of parents or their guardians was obtained for conducting research. No conflict of interests was declared by the authors.