Modern Pediatrics. Ukraine. 4(108): 18-32. doi 10.15574/SP.2020.108.18
Okhotnikova O. M.¹, Ivanova T. P.², Oshlyanskaya O. A.¹, Ponochevnaya O. V.¹, Usova O. I.¹, Sharikadze O. V.¹, Yakovleva N. Yu.¹, Tkacheva T. M.¹, Grishchenko O. M.², Zarudnaya O.
F.², Mostovenko R. V.², Pogodaeva N. L.^2
1Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine^/
2National Children's Specialized Hospital «OKHMATDET», Kyiv, Ukraine

For citation: Okhotnikova OM, Ivanova TP, Oshlyanskaya OA, Ponochevnaya OV et al. (2020). Treatment protocol of coronavirus infection (COVID-19) in children with chronic somatic diseases. Modern Pediatrics. Ukraine. 4(108): 18-32. doi 10.15574/SP.2020.108.18
Article received: May 18, 2020. Accepted for publication: Jun 01, 2020.

The article summarizes the clinical recommendations for the diagnosis and treatment of children with coronavirus infection COVID-19, which occurs against a background of various chronic somatic diseases. This protocol is based on the materials of many international reference documents, as well as the latest Ukrainian protocol for the detection and treatment of coronavirus infection COVID-19 (Order No. 1227 of 05.20.2020). Aspects of the classification of severity and risk factors for the severe course of the disease are reflected, which include background somatic diseases requiring an individualized approach to treatment. The diagnostic criteria for this infection are characterized, as well as the differences in the clinical symptoms of COVID-19 in children and the clinical manifestations in adults. Separately, data are presented on the complication of childhood COVID-19 infection, a multisystemic inflammatory syndrome. The peculiarity of this protocol is recommendations for the management of children with COVID-19 infection, which occurs against a background of diseases of the cardiovascular system (congenital heart defects, pulmonary hypertension, cardiac arrhythmias and conduction disorders, etc.), respiratory diseases (bronchial asthma and bronchopulmonary dysplasia) , rheumatic (juvenile arthritis, connective tissue diseases and systemic vasculitis with lung damage, variants of diseases requiring constant glucocorticoid therapy or occurring in the presence of diabetes mellitus) and other autoimmune diseases (autoimmune hepatitis, glomerulonephritis, especially with chronic liver or kidney failure). Recommendations are also given for the management of children with COVID-19 concurrently with diseases of the kidneys and urinary system, endocrine diseases (diabetes mellitus type I, disorders of the thyroid and adrenal glands), oncological and hematological diseases, including the immunosuppression states.
Key words: COVID-19 infection, diagnosis, background chronic somatic diseases, treatment, children.

REFERENCES

1. WHO. (2020, February 16—24). Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). URL: who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf.

2. Lu X, Zhang L, Du H, Zhang J et al. (2020, April 23). SARS-CoV-2 Infection in Children. N Engl J Med. 382: 1663–1665; published on March 18, 2020, at NEJM.org. https://doi.org/10.1056/NEJMc2005073; PMid:32187458 PMCid:PMC7121177.

3. Dong Y, Mo X, Hu Y et al. (2020, June 1). Epidemiology of COVID-19 Among Children in China. Pediatrics. 145 (6). https://doi.org/10.1542/peds.2020-0702; PMid:32179660.

4. European Centre for Disease Prevention and Control. (2020, March 12). Infection prevention and control for COVID-19 in healthcare settings first update. Technical report. URL: ecdc.europa.eu/sites/default/files/documents/COVID-19-infection-prevention-and-control-healthcare-settings-march-2020.pdf. https://doi.org/10.7748/cnp.19.3.12.s9

5. WHO. (2019). Coronavirus disease (COVID-19) technical guidance: Infection prevention and control. URL: who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/infection-prevention-and-control.

6. WHO. (2020, March 20). Global Surveillance for human infection with coronavirus disease (COVID-19). URL: who.int/publications-detail/global-surveillance-for-human-infection-with-novel-coronavirus-(2019-ncov).

7. ICD-10 Version: 2019. (2019). COVID-19, virus identified. URL: icd.who.int/browse10/2019/en#/U07.1

8. WHO. (2020, May 27). Clinical management of COVID-19. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Іnterim guidance on 13 March 2020. URL: who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected.

9. Gautret P, Lagier J-C, Parola Ph, Raoult D et al. (2020, March 20). Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. International Journal of Antimicrobial Agents. https://doi.org/10.1016/j.ijantimicag.2020.105949; PMid:32205204 PMCid:PMC7102549.

10. Zimmermann P, Nigel C. (2020, May). Coronavirus Infections in Children Including COVID-19. An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children. The Pediatric Infectious Disease Journal. 39 (5): 355–368. Accessed March 12, 2020. https://doi.org/10.1097/INF.0000000000002660; PMid:32310621 PMCid:PMC7158880.

11. Genentech. (2020, March 18). Genentech Initiates Phase III Clinical Trial Of Actemra In Hospitalized Patients With Severe COVID-19 Pneumonia. URL: https://www.gene.com/media/press-releases/14841/2020-03-18/genentech-initiates-phase-iii-clinical-t

12. EAHP. (2020, May). EAHP COVID-19 Resource Centre. URL: eahp.eu/hp-practice/hospital-pharmacy/eahp-covid-19-resource-centre.

13. Spanish Society of Hospital Pharmacy. (2020, March 19). Hospital pharmacy procedures for the management of antiviral treatment in the new coronavirus sars-cov-2 disease covid-19. URL: eahp.eu/sites/default/files/hospital_pharmacy_procedures_covid-19_march19th.pdf.

14. European Centre for Disease Prevention and Control. (2020). Novel coronavirus (SARS-CoV-2). Technical report. Discharge criteria for confirmed COVID-19 cases — When is i tsafe to discharge COVID-19 cases from the hospital or end home isolation? URL: ecdc.europa.eu/sites/default/files/documents/COVID-19-Discharge-criteria.pdf.

15. Chen Y, Li L. (2020, May). SARS-CoV-2: virus dynamics and host response. The Lancet Infectious Diseases. 20 (5). Published: March 23, 2020. https://doi.org/10.1016/S1473-3099(20)30235-8.

16. WHO. (2019). Country & Technical Guidance — Coronavirus disease (COVID-19). Laboratory testing for 2019-nCoV in humans. URL: who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/laboratory-guidance.

17. Wang XF, Yuan J, Zheng YJ, Chen J, Bao YM, Wang YR, Wang LF, Li H, Zeng JX, Zhang YH, Liu YX, Liu L. (2020, February 17). Retracted: Clinical and Epidemiological Characteristics of 34 Children With 2019 Novel Coronavirus Infection in Shenzhen. 58 (0): 008. doi: 10.3760/cma.j.issn.0578-1310.2020.0008. URL: https://pub-med.ncbi.nlm.nih.gov/32062875/

18. Prise en charge a l'hopital des enfants atteints de COVID-19. (2020, March 31). Recommandations pour le traitement des enfants atteints de COVID-19. Belgian Pediatric Covid-19 Task Force. URL: http://gbs-vbs.org/fileadmin/user_upload/Unions/PED/Belg_Recomm_COVID_ped_31mar_FR.pdf

19. BPAIIG. (2020, April). BPAIIG Position Statement: Sars-CoV-2 Treatment Guidance. Position Statement: Management of novel coronavirus (SARS-CoV-2) infection in pediatric patients in the UK and Ireland. URL: https://www.bpaiig.org/sites/default/files/National_paediatric_COVID19%20treatment%20v1.2_0.pdf