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Тривалий COVID у дітей: частота та виклики діагностики

Ukrainian Journal of Perinatology and Pediatrics. 2023. 3(95): 101-106; doi 10.15574/PP.2023.95.101
Волянська Л. А., Бурбела Е. І., Перестюк В. О., Косовська Т. М., Боярчук О. Р.
Тернопільський національний медичний університет імені І.Я. Горбачевського, Україна

Для цитування: Волянська ЛА, Бурбела ЕІ, Перестюк ВО, Косовська ТМ, Боярчук ОР. (2023). Тривалий COVID у дітей: частота та виклики діагностики. Український журнал Перинатологія і Педіатрія. 3(95): 101-106; doi 10.15574/PP.2023.95.101.
Стаття надійшла до редакції 12.05.2023 р.; прийнята до друку 10.09.2023 р.

Мета – проаналізувати рівень поширеності симптомів тривалого COVID-19 у дитячій популяції та методи їхньої діагностики.
Проведено електронний пошук наукових досліджень з 2019 року по лютий 2023 року за допомогою таких відомих баз даних: PubMed, SCOPUS, ResearchGate, Wiley Online Library та Google Scholar. Ключовими словами для огляду обрано такі: long COVID, post COVID, COVID-19, pediatrics, children, adolescents, postacute sequelae of SARS‐CoV‐2 infection (PASC). Критерії вилучення: публікації дубльовані, присвячені виключно дорослим, аналізу лише гострого COVID-19. До аналізу внесено дослідження з постковідного періоду в дітей та підлітків, у яких наведено результати оцінювання стану їхнього здоров’я та відображено певні клінічні прояви після завершення гострої інфекції протягом 4-12 тижнів.
Оптимістичні прогнози щодо перебігу інфекції SARS-CoV-2 у дитячій популяції на початку розвитку пандемії доволі швидко перейшли в стадію непевності в прогнозах перебігу постковідного періоду і наслідків перенесеного захворювання. Більшість дітей, інфікованих COVID-19, одужують, але частина з них мають стійкі симптоми після перенесеної інфекції. Істинна поширеність «тривалого COVID» ще в стадії вивчення. Повідомлення про діапазон його проявів є дуже строкатими і різняться щодо висновків про інтенсивність їхнього впливу на якість життя дітей. Тому очевидною є потреба в тривалих клінічних спостереженнях, при цьому їх обов’язково слід порівняти з даними контрольних груп відповідного віку, оскільки ця категорія реконвалесцентів потребуватиме мультидисциплінарного підходу в спостереженні за ними, а отже, лягатиме значним тягарем на систему охорони здоров’я.
Автори заявляють про відсутність конфлікту інтересів.
Ключові слова: COVID-19, long COVID, постковідний період, діти, підлітки.

ЛІТЕРАТУРА

1. Ballering AV, van Zon SKR, Olde Hartman TC, Rosmalen JGM. (2022, Aug 6). Lifelines Corona Research Initiative. Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study. Lancet. 400 (10350): 452-461. https://doi.org/10.1016/S0140-6736(22)01214-4; PMid:35934007

2. Behnood SA, Shafran R, Bennett SD et al. (2022, Feb). Persistent symptoms following SARS-CoV-2 infection amongst children and young people: A meta-analysis of controlled and uncontrolled studies. J Infect. 84 (2): 158-170. https://doi.org/10.1016/j.jinf.2021.11.011; PMid:34813820 PMCid:PMC8604800

3. Blankenburg J, Wekenborg MK, Reichert J et al. (2021, May 11). Mental health of adolescents in the pandemic: long-COVID-19 or long-pandemic syndrome? medRxiv [Preprint]. https://doi.org/10.1101/2021.05.11.21257037

4. Borch L, Holm M, Knudsen M, Ellermann-Eriksen S, Hagstroem S. (2022, Apr). Long COVID symptoms and duration in SARS-CoV-2 positive children – a nationwide cohort study. Eur J Pediatr. 181 (4): 1597-1607. https://doi.org/10.1007/s00431-021-04345-z; PMid:35000003 PMCid:PMC8742700

5. Boyarchuk O, Mudryk U, Borys Z, Volianska L. (2021). Hyperkalemia in newborn: case report. Pharmacology OnLine. 2: 73-79.

6. Boyarchuk O, Predyk L, Yuryk I. (2021). COVID-19 in patients with juvenile idiopathic arthritis: frequency and severity. Reumatologia. 59 (3): 197-199. https://doi.org/10.5114/reum.2021.107590; PMid:34538947 PMCid:PMC8436806

7. Boyarchuk OR, Nykytyuk SO, Borys ZYa, Levenets SS, Shylo OR. (2022). Hepatic vein thrombosis in a child with COVID-19: clinical case. Modern Pediatrics. Ukraine. 3 (123): 94-99. https://doi.org/10.15574/SP.2022.123.94

8. Buonsenso D, Di Giuda D, Sigfrid L et al. (2021, Sep). Evidence of lung perfusion defects and ongoing inflammation in an adolescent with post-acute sequelae of SARS-CoV-2 infection. Lancet Child Adolesc Health. 5 (9): 677-680. https://doi.org/10.1016/S2352-4642(21)00196-6; PMid:34339624

9. Buonsenso D, Munblit D, De Rose C et al. (2021, Jul). Preliminary evidence on long COVID in children. Acta Paediatr. 110 (7): 2208-2211. https://doi.org/10.1111/apa.15870; PMid:33835507 PMCid:PMC8251440

10. Buonsenso D, Pujol FE, Munblit D, Pata D, McFarland S, Simpson FK. (2022, May). Clinical characteristics, activity levels and mental health problems in children with long coronavirus disease: a survey of 510 children. Future Microbiol. 17(8): 577-588. https://doi.org/10.2217/fmb-2021-0285; PMid:35360923 PMCid:PMC9248023

11. Charfeddine S, Ibn Hadj Amor H, Jdidi J et al. (2021, Nov 30). Long COVID 19 Syndrome: Is It Related to Microcirculation and Endothelial Dysfunction? Insights From TUN-EndCOV Study. Front Cardiovasc Med. 8: 745758. https://doi.org/10.3389/fcvm.2021.745758; PMid:34917659 PMCid:PMC8670225

12. Cooper S, Tobar A, Konen O et al. (2022, Sep 1). Long COVID-19 Liver Manifestation in Children. J Pediatr Gastroenterol Nutr. 75 (3): 244-251. https://doi.org/10.1097/MPG.0000000000003521; PMid:35687535

13. Crook H, Raza S, Nowell J, Young M, Edison P. (2021). Long COVID – mechanisms, risk factors, and management. BMJ. 374: n1648. https://doi.org/10.1136/bmj.n1648; PMid:34312178

14. Datta SD, Talwar A, Lee JT. (2020, Dec 8). A proposed framework and timeline of the spectrum of disease due to SARS-CoV-2 infection: illness beyond acute infection and public health implications. JAMA. 324 (22): 2251-2252. https://doi.org/10.1001/jama.2020.22717; PMid:33206133

15. Davis HE, Assaf GS, McCorkell L et al. (2021, Aug). Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine. 38: 101019. https://doi.org/10.1016/j.eclinm.2021.101019; PMid:34308300 PMCid:PMC8280690

16. Davis HE, McCorkell L, Vogel JM, Topol EJ. (2023, Mar). Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol. 21 (3): 133-146. https://doi.org/10.1038/s41579-022-00846-2; PMid:36639608 PMCid:PMC9839201

17. De Almeida VM, Engel DF, Ricci MF et al. (2022, Jun 22). Gut microbiota from patients with mild COVID-19 cause alterations in mice that resemble post-COVID syndrome. Res. Sq. [Preprint]. https://doi.org/10.21203/rs.3.rs-1756189/v1

18. Debski M, Tsampasian V, Haney S et al. (2022). Post-COVID-19 syndrome risk factors and further use of health services in East England. PLOS Glob Public Health. 2 (11): e0001188. https://doi.org/10.1371/journal.pgph.0001188; PMid:36962824 PMCid:PMC10022108

19. Du W, Yu J, Wang H, Zhang X, Zhang S, Li Q, Zhang Z. (2020, Jun). Clinical characteristics of COVID-19 in children compared with adults in Shandong Province, China. Infection. 48 (3): 445-452. https://doi.org/10.1007/s15010-020-01427-2; PMid:32301099 PMCid:PMC7161094

20. Esposito S, Marchetti F, Lanari M et al. (2021, Apr 8). COVID-19 Management in the Pediatric Age: Consensus Document of the COVID-19 Working Group in Paediatrics of the Emilia-Romagna Region (RE-CO-Ped). Italy. Int J Environ Res Public Health. 18 (8): 3919. https://doi.org/10.3390/ijerph18083919; PMid:33917940 PMCid:PMC8068343

21. Fainardi V, Meoli A, Chiopris G et al. (2022, Feb 14). Long COVID in Children and Adolescents. Life (Basel). 12 (2): 285. https://doi.org/10.3390/life12020285; PMid:35207572 PMCid:PMC8876679

22. Fashina TA, Miller CM, Paintsil E, Niccolai LM, Brandt C, Oliveira CR. (2023, Feb 27). Computable Clinical Phenotyping of Postacute Sequelae of COVID-19 in Pediatrics Using Real-World Data. J Pediatric Infect Dis Soc. 12 (2): 113-116. https://doi.org/10.1093/jpids/piac132; PMid:36548966

23. Glynne P, Tahmasebi N, Gant V, Gupta R. (2022, Jan). Long COVID following mild SARS-CoV-2 infection: characteristic T cell alterations and response to antihistamines. J Investig Med. 70 (1): 61-67. https://doi.org/10.1136/jim-2021-002051; PMid:34611034 PMCid:PMC8494538

24. Haffke M, Freitag H, Rudolf G et al. (2022, Mar 22). Endothelial dysfunction and altered endothelial biomarkers in patients with post-COVID-19 syndrome and chronic fatigue syndrome (ME/CFS). J Transl Med. 20(1): 138. https://doi.org/10.1186/s12967-022-03346-2; PMid:35317812 PMCid:PMC8938726

25. Hageman JR. (2021, Jun). Long COVID-19 or Post-Acute Sequelae of SARS-CoV-2 Infection in Children, Adolescents, and Young Adults. Pediatr Ann. 50 (6): e232-e233. https://doi.org/10.3928/19382359-20210519-02

26. ISARIC Clinical Characterisation Group. (2021, Oct). COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study. Infection. 49 (5): 889-905. https://doi.org/10.1007/s15010-021-01599-5; PMid:34170486 PMCid:PMC8231091

27. Kompaniyets L, Bull-Otterson L, Boehmer TK et al. (2022, Aug 5). Post-COVID-19 Symptoms and Conditions Among Children and Adolescents – United States, March 1, 2020-January 31, 2022. MMWR Morb Mortal Wkly Rep. 71 (31): 993-999. https://doi.org/10.15585/mmwr.mm7131a3; PMid:35925799 PMCid:PMC9368731

28. Liu Q, Mak JWY, Su Q et al. (2022, Mar). Gut microbiota dynamics in a prospective cohort of patients with post-acute COVID-19 syndrome. Gut. 71 (3): 544-552. https://doi.org/10.1136/gutjnl-2021-325989; PMid:35082169

29. Logue JK, Franko NM, McCulloch DJ et al. (2021, Feb 1). Sequelae in Adults at 6 Months After COVID-19 Infection. JAMA Netw Open. 4 (2): e210830. https://doi.org/10.1001/jamanetworkopen.2021.0830; PMid:33606031 PMCid:PMC7896197

30. Lorman V, Rao S, Jhaveri R et al. (2022). Understanding pediatric long COVID using a tree-based scan statistic approach: An EHR-based cohort study from the RECOVER Program. medRxiv [Preprint]. 2022.12.08.22283158. doi: 10.1101/ 2022.12.08.22283158.

31. Malone LA, Morrow A, Chen Y et al. (2022, Oct). Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of postacute sequelae of SARS-CoV-2 infection (PASC) in children and adolescents. PMR. 14 (10): 1241-1269. https://doi.org/10.1002/pmrj.12890; PMid:36169159 PMCid:PMC9538628

32. Matviyenko IM, Ignatova TB. (2023). Long-term consequences of the coronavirus infection: review of scientific sources. Ukrainian Journal of Perinatology and Pediatrics. 1 (93): 118-122. https://doi.org/10.15574/PP.2023.93.118

33. Miller F, Nguyen DV, Navaratnam AM et al. (2022, Dec 1). Prevalence and Characteristics of Persistent Symptoms in Children During the COVID-19 Pandemic: Evidence From a Household Cohort Study in England and Wales. Pediatr Infect Dis J. 41 (12): 979-984. https://doi.org/10.1097/INF.0000000000003715; PMid:36375098 PMCid:PMC9645448

34. Molteni E, Sudre CH, Canas LS et al. (2021, Oct). Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. Lancet Child Adolesc Health. 5 (10): 708-718. https://doi.org/10.1016/S2352-4642(21)00198-X; PMid:34358472

35. Nasserie T, Hittle M, Goodman SN. (2021, May 3). Assessment of the Frequency and Variety of Persistent Symptoms Among Patients With COVID-19: A Systematic Review. JAMA NetwOpen. 4(5): e2111417. https://doi.org/10.1001/jamanetworkopen.2021.11417; PMid:34037731 PMCid:PMC8155823

36. NICE. (2020, Dec 18). COVID-19 rapid guideline: managing the long-term effects of COVID-19. London: National Institute for Health and Care Excellence (NICE). PMID: 33555768.

37. Nikolopoulou GB, Maltezou HC. (2022, Jan). COVID-19 in Children: Where do we Stand? Arch Med Res. 53 (1): 1-8. https://doi.org/10.1016/j.arcmed.2021.07.002; PMid:34311990 PMCid:PMC8257427

38. Nurek M, Rayner C, Freyer A, Taylor S, Järte L, MacDermott N, Delaney BC. (2021, Oct 28). Delphipanellists. Recommendations for the recognition, diagnosis, and management of long COVID: a Delphi study. Br J GenPract. 71 (712): e815-e825. https://doi.org/10.3399/BJGP.2021.0265; PMid:34607799 PMCid:PMC8510689

39. Office for National Statistics. (2021). Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK: 1 April 2021. Statistical bulletin [Internet]. London: ONS: 16. URL: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/1april2021.

40. Paalanne N, Honkila M, Mattila S, Pokka T, Renko M, Tapiainen T. (2023, Apr). Duration of clinical symptoms in children with acute respiratory infection. Acta Paediatr. 112(4): 813-819. Epub 2022 Dec 2. https://doi.org/10.1111/apa.16607; PMid:36427274

41. Page MJ, Moher D, Bossuyt PM et al. (2021, Mar 29). PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 372: n160. https://doi.org/10.1136/bmj.n160; PMid:33781993 PMCid:PMC8005925

42. Palacios S, Krivchenia K, Eisner M, Young B, Ramilo O, Mejias A et al. (2022, Oct). Long-term pulmonary sequelae in adolescents post-SARS-CoV-2 infection. Pediatr Pulmonol. 57 (10): 2455-2463. Epub 2022 Jul 8. https://doi.org/10.1002/ppul.26059; PMid:35775163 PMCid:PMC9349789

43. Peluso MJ, Deveau TM, Munter SE et al. (2022, Jul 22). Impact of Pre-Existing Chronic Viral Infection and Reactivation on the Development of Long COVID. medRxiv [Preprint]. 2022.06.21.22276660. https://doi.org/10.1101/2022.06.21.22276660

44. Phetsouphanh C, Darley DR, Wilson DB et al. (2022, Feb). Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection. Nat Immunol. 23 (2): 210-216. https://doi.org/10.1038/s41590-021-01113-x; PMid:35027728

45. Pretorius E, Venter C, Laubscher GJ et al. (2022, Aug 6). Prevalence of symptoms, comorbidities, fibrin amyloid microclots and platelet pathology in individuals with Long COVID/Post-Acute Sequelae of COVID-19 (PASC). Cardiovasc Diabetol. 21 (1): 148. https://doi.org/10.1186/s12933-022-01579-5; PMid:35933347 PMCid:PMC9356426

46. Principi N, Esposito S. (2021, Sep 18). Are we sure that the neurological impact of COVID 19 in childhood has not been underestimated? Ital J Pediatr. 47 (1): 191. https://doi.org/10.1186/s13052-021-01144-y; PMid:34537061 PMCid:PMC8449691

47. Proal AD, VanElzakker MB. (2021, Jun 23). Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms. Front Microbiol. 12: 698169. https://doi.org/10.3389/fmicb.2021.698169; PMid:34248921 PMCid:PMC8260991

48. Radtke T, Ulyte A, Puhan MA, Kriemler S. (2021, Jul 15). Long-term Symptoms After SARS-CoV-2 Infection in Children and Adolescents. JAMA. 326 (9): 869-871. https://doi.org/10.1001/jama.2021.11880; PMid:34264266 PMCid:PMC8283661

49. Rao S, Lee GM, Razzaghi H et al. (2022, Oct 1). Clinical Features and Burden of Postacute Sequelae of SARS-CoV-2 Infection in Children and Adolescents. JAMA Pediatr. 176 (10): 1000-1009. https://doi.org/10.1001/jamapediatrics.2022.2800; PMid:35994282 PMCid:PMC9396470

50. Roessler M, Tesch F, Batram M et al. (2022, Nov 10). Post-COVID-19-associated morbidity in children, adolescents, and adults: A matched cohort study including more than 157,000 individuals with COVID-19 in Germany. PLoS Med. 19 (11): e1004122. https://doi.org/10.1371/journal.pmed.1004122; PMid:36355754 PMCid:PMC9648706

51. Spudich S, Nath A. (2022, Jan 21). Nervous system consequences of COVID-19. Science. 375 (6578): 267-269. https://doi.org/10.1126/science.abm2052; PMid:35050660

52. Stephenson T, Pinto Pereira SM et al. (2022, Apr). Physical and mental health 3 months after SARS-CoV-2 infection (long COVID) among adolescents in England (CLoCk): a national matched cohort study. Lancet Child Adolesc Health. 6(4): 230-239. https://doi.org/10.1016/S2352-4642(22)00022-0; PMid:35143770

53. Stephenson T, Shafran R, Ladhani SN. (2022, Oct 1). Long COVID in children and adolescents. Curr Opin Infect Dis. 35 (5): 461-467. https://doi.org/10.1097/QCO.0000000000000854; PMid:36098262 PMCid:PMC9553244

54. Su Y, Yuan D, Chen DG et al. (2022, Mar 3). Multiple early factors anticipate post-acute COVID-19 sequelae. Cell. 185 (5): 881-895.e20. https://doi.org/10.1016/j.cell.2022.01.014; PMid:35216672 PMCid:PMC8786632

55. Subbaraman N. (2021, Mar). US health agency will invest $1 billion to investigate 'long COVID'. Nature. 591 (7850): 356. https://doi.org/10.1038/d41586-021-00586-y; PMid:33664445

56. Zimmermann P, Pittet LF, Curtis N. (2022, Jan 20). Long COVID in children and adolescents BMJ. 376: o143. https://doi.org/10.1136/bmj.o143

57. Zubchenko S, Kril I, Nadizhko O, Matsyura O, Chopyak V. (2022, Sep). Herpesvirus infections and post-COVID-19 manifestations: a pilot observational study. Rheumatol Int. 42 (9): 1523-1530. https://doi.org/10.1007/s00296-022-05146-9; PMid:35650445 PMCid:PMC9159383