actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.29413/ABS.2021-6.6-2.3actabiomedica-3134Research ArticleИНФЕКЦИОННЫЕ БОЛЕЗНИINFECTIOUS DISEASESКлинико-эпидемиологическая характеристика и эффективность противовирусной терапии COVID-19 у детей: опыт первого года пандемииClinical and epidemiological characteristics and effectiveness of antiviral therapy for COVID-19 in children: The experience of the first year of the pandemichttps://orcid.org/0000-0003-4845-3757ЧерноваТ. М.ChernovaT. M.

 кандидат медицинских наук, доцент кафедры инфекционных заболеваний у детей им. проф. М.Г. Данилевича

194100, г. Санкт-Петербург, ул. Литовская, 2, Россия 

 Cand. Sc. (Med.), Associate Professor at the Department of Infectious Diseases in Children named after Professor M.G. Danilevich

 Litovskaya str 2, Saint Petersburg 194100, Russian Federation 

t-chernova@mail.ruhttps://orcid.org/0000-0002-7596-1004ПавловаЕ. Б.PavlovaE. B.

 кандидат медицинских наук, доцент кафедры фармакологии с курсом клинической фармакологии и фармакоэкономики

194100, г. Санкт-Петербург, ул. Литовская, 2, Россия 

 Cand. Sc. (Med.), Associate Professor at the Department of Pharmacology with a course in Clinical Pharmacology and Pharmacoeconomics 

 Litovskaya str 2, Saint Petersburg 194100, Russian Federation 

infarm@bk.ruhttps://orcid.org/0000-0002-4068-1731ТимченкоВ. Н.TimchenkoV. N.

 доктор медицинских наук, профессор, заведующий кафедрой инфекционных заболеваний у детей им. проф. М.Г. Данилевича

194100, г. Санкт-Петербург, ул. Литовская, 2, Россия 

 Dr. Sc. (Med.), Professor, Head of the Department of Infectious Diseases in Children named after Professor M.G. Danilevich 

 Litovskaya str 2, Saint Petersburg 194100, Russian Federation 

timchenko220853@yandex.ruhttps://orcid.org/0000-0001-5019-9271ЕрмаковаЕ. О.ErmakovaE. O.

 студентка педиатрического факультета

194100, г. Санкт-Петербург, ул. Литовская, 2, Россия 

 Student at the Pediatric Faculty 

 Litovskaya str 2, Saint Petersburg 194100, Russian Federation 

katekate0009@gmail.comhttps://orcid.org/0000-0002-6239-9358УсковаС. Ю.UskovaS. Yu.

 студентка педиатрического факультета 

194100, г. Санкт-Петербург, ул. Литовская, 2, Россия 

 Student at the Pediatric Faculty 

 Litovskaya str 2, Saint Petersburg 194100, Russian Federation 

suskovamiss@gmail.comhttps://orcid.org/0000-0002-4469-3537АстаховаА. А.AstakhovaA. A.

 студентка стоматологического факультета

194100, г. Санкт-Петербург, ул. Литовская, 2, Россия 

 Student at the Faculty of Dentistry 

 Litovskaya str 2, Saint Petersburg 194100, Russian Federation 

myynameisanna@gmail.comhttps://orcid.org/0000-0002-6288-5559ЕгороваИ. А.EgorovaI. A.

 заведующая детским поликлиническим отделением № 18

190013, г. Санкт-Петербург, наб. Обводного канала, 123, Россия

 Head of the Children Polyclinic Department No. 18

 Obvodny Canal emb. 123, Saint Petersburg 190013, Russian Federation 

gp24_egorova@mail.ruhttps://orcid.org/0000-0002-2380-1367ЖеребцоваА. А.ZherebtsovaA. A.

 заведующая кабинетом инфекционных, паразитарных заболеваний и иммунопрофилактики детского  поликлинического отделения

190068, г. Санкт-Петербург, ул. Глинки, 8А, Россия

 Head of the Office of Infectious, Parasitic Diseases and Immunoprophylaxis of the Children Polyclinic Department

 Glinki str. 8A, Saint Petersburg 190068, Russian Federation 

zherebtsova2a@rambler.ruФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет» Минздрава РоссииSaint Petersburg State Pediatric Medical University СПб ГБУЗ «Городская поликлиника № 24»Saint Petersburg City Polyclinic No. 24 СПб ГБУЗ «Городская поликлиника № 27»Saint Petersburg City Polyclinic No. 27 20212812202166-21828Copyright © Чернова Т.М., Павлова Е.Б., Тимченко В.Н., Ермакова Е.О., Ускова С.Ю., Астахова А.А., Егорова И.А., Жеребцова А.А., 20212021Чернова Т.М., Павлова Е.Б., Тимченко В.Н., Ермакова Е.О., Ускова С.Ю., Астахова А.А., Егорова И.А., Жеребцова А.А.Chernova T.M., Pavlova E.B., Timchenko V.N., Ermakova E.O., Uskova S.Y., Astakhova A.A., Egorova I.A., Zherebtsova A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/3134

Актуальность. Применение противовирусных средств может уменьшить длительность вирусной инфекции.Цель исследования: проанализировать клинико-эпидемиологические особенности и эффективность противовирусной терапии новой коронавирусной инфекции (COVID-19) у амбулаторных детей.Материалы и методы. С апреля 2020 г. по март 2021 г. проведено рандомизированное обследование на новую коронавирусную инфекцию 9334 амбулаторных детей в возрасте от 0 мес. до 17 лет. РНК SARS-CoV-2 выявляли в материале из ротоглотки и носа методом ПЦР. Пациентам с подтверждённой инфекцией назначались интерферон-альфа (ИФН-α) интраназально, противовирусные средства системного действия. Контрольную группу составили дети с COVID-19, не получавшие лечение.Результаты. При обследовании клинически здоровых контактных детей РНК SARS-CoV-2 выявлена в 7,4 % случаев. В структуре острых респираторных инфекций удельный вес COVID-19 составил 12,3 % с пиками заболеваемости в апреле-мае (до 22,8 %) и ноябре-декабре (до 30,0 %). В половине случаев дети инфицировались в семье и обычно в качестве индексного пациента выступали взрослые. В 47,7 % случаев зарегистрирована бессимптомная форма COVID-19 без статистически значимых отличий у пациентов разного возраста. У трети детей с сопутствующей патологией заболевание протекало в бессимптомной форме, у половины – в лёгкой, в остальных случаях диагностирована средняя степень тяжести. Клиническая картина COVID-19 не отличалась от других острых респираторных инфекций. Аносмия (9,4 %) в половине случаев сочеталась с агевзией (4,4 %) и статистически значимо чаще отмечалась у мальчиков. Длительность клинических проявлений у детей контрольной группы и у получавших противовирусную терапию статистически значимо не отличалась при лёгкой и средней степени тяжести заболевания. Также различные варианты противовирусной терапии статистически значимо не влияли на длительность обнаружения SARSCoV-2 у детей с различными формами COVID-19.Заключение. В первый год пандемии новая коронавирусная инфекция не доминировала в структуре респираторных заболеваний у детей. Для разработки педиатрических рекомендаций по лечению COVID-19 на амбулаторно-поликлиническом этапе требуются дальнейшие исследования.

Background. The use of antiviral agents can shorten the duration of the viral infection. The aim: to study the clinical and epidemiological features and the effectiveness of antiviral therapy for new coronavirus infection (COVID-19) in outpatient children.Materials and methods. From April 2020 to March 2021, 9334 outpatient children aged from 0 months to 17 years were randomly tested for new coronavirus infection. SARS-CoV-2 RNA was detected in oropharyngeal and nasal material by PCR. Patients with confirmed new coronavirus infection were prescribed interferon-alpha (IFN-α) intranasally, antiviral agents of systemic action. The control group consisted of children with COVID-19 who did not receive treatment.Results. When examining clinically healthy contact children, SARS-CoV-2 RNA was detected in 7.4 % of cases. In the structure of ARI, the specific weight of COVID-19 was 12.3 % with the peak incidence in April-May (up to 22.8 %) and NovemberDecember (up to 30.0 %). In half of the cases, children became infected in the family, and usually adults were the index patient. In 47.7 % of cases, an asymptomatic form of COVID-19 was registered without significant differences in patients of different ages. In one third of children with concomitant pathology, the disease was asymptomatic, in half it was mild, in other cases moderate severity was diagnosed. The clinical picture of COVID-19 did not differ from other ARIs. Anosmia (9.4 %) in half of the cases was combined with ageusia (4.4 %) and was significantly more common in boys. The duration of clinical manifestations in children of the control group and those who received antiviral therapy did not statistically significantly differ in mild and severity of the disease. Also, various antiviral therapy options did not significantly affect the duration of SARS-CoV-2 detection in children with various forms of COVID-19.Conclusion. In the first year of the pandemic, the novel coronavirus infection did not dominate the pattern of respiratory diseases in outpatient children. Further research is required to develop pediatric guidelines for the treatment of COVID-19 at the outpatient stage.

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The authors declare that there are no conflicts of interest present.