S.V. KHALIULLINA¹, YU.A. RAIMOVA¹, V.A. ANOKHIN¹, V.A. POZDNYAK¹, KH.S. KHAERTYNOV¹, O.A. NAZAROVA¹, I.I. NURGATINA^1, 2

 ¹Kazan State Medical University, Kazan

²Interregional Clinical Diagnostic Center, Kazan

Contact details:

Khaliullina S.V. M—D, Professor of the Department of Childhood Infections

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-917-860-92-46, e-mail: svekhal@mail.ru

 The combined course of any diseases, as a rule, is characterized by severity, a high incidence of complications, and a protracted course.

The purpose is to describe the clinical and laboratory features of the combined course of COVID-19 and herpesvirus infections in children hospitalized in an Infectious Diseases Hospital.

Material and methods. In the period from December 2021 to October 2022, an observational retrospective study was conducted on the basis of the RCCH in Kazan, which included monitoring 36 children hospitalized with an acute infectious disease clinic, laboratory confirmation of COVID-19 and herpes virus infection. A complete sample was used. The data were copied from the medical records of in-patients (f/003u). The observation period for each patient was limited to the period of hospitalization. Laboratory examination included standard methods and etiological interpretation of the diagnosis (PCR, ICA). Statistical data processing was performed using an online calculator https://medstatistic.ru/calculators.html.

Results. Against the background of SARS-CoV-2 infection, active replication of EBV was observed in 83.3% of cases, in about half of cases in combination with HHV-6. The clinic was dominated by pyretic fever (77.7%), tonsillitis syndrome (66.7%), including with lesions of the pharyngeal tonsil (52.8%), hepato- (75%) and splenomegaly (44.4%). Diarrheal syndrome was recorded in 47.2% of the examined. Pneumonia was diagnosed only in 11.1% of hospitalized patients, hepatitis — in 36.1%. In general, the clinic was more consistent with herpesvirus infection («mononucleosis-like syndrome») than COVID-19. Leukocytosis was recorded in 94.4% of the study participants, an increase in the level of CRP — in 97.3% of the examined, and significant — in 30.6%, an increase in the level of D-dimer — in 63.9%. The average length of stay of a child in the hospital was 6 days. No lethal outcomes were registered.

Conclusion. The study of the features of epidemiology, pathophysiology, clinic and long-term consequences (prognosis) will help improve our understanding of coinfection scenarios.

Key words: COVID-19, herpes virus infections, children.

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