Rheumatic diseases in children during the COVID-19 pandemic: what the pediatrician and family physician should know

Purpose - to familiarize general practitioners and pediatricians with the real risks and modern, relevant principles of the observation of children with rheumatic diseases during the COVID-19 pandemic. It was described which risks should be primarily considered in patients with rheumatic diseases during the COVID-19 pandemic. It was described the data from the literature on the safety of treatment of children with rheumatic diseases and the peculiarities of their management against the background of the pandemic of infection, caused by the SARS-CoV-2 virus. It was generalized the data on the purpose and frequency of the laboratory tests depending on the received therapy is given. It was focused on the leading issues of monitoring children with rheumatic diseases, adaptation of these patients in the conditions of the COVID-19 pandemic. It was described in detail some differences in the follow-up of patients receiving biological and basic therapy. Emphasis is placed on issues of the monitoring treatment with methotrexate, which is the most often prescribed in pediatric rheumatology. There were discussed the main features of the infectious syndrome in children with rheumatic diseases depending on the prescribed medications (biological drugs and basic treatment). There were proposed the tactics of the first-line doctors in providing medical care to children with rheumatic diseases in the event of the development of an intercurrent infection. It is noted which changes in the treatment of rheumatic disease should be applied to the rheumatic patient in case of the development of an infectious process. Emphasis is placed on the management of pediatric patients with a rheumatic profile in a case of the contact with a patient with COVID-19, asymptomatic carrier or disease of COVID-19. There were described the issues of the vaccination of children with rheumatic diseases. There were added a new data of agreed modern recommendations on calendar and additional vaccine prophylaxis of children with rheumatic diseases, including vaccination against COVID-19. No conflict of interests was declared by the authors. Keywords: children, rheumatic diseases, management, vaccination, COVID-19.