支气管哮喘患儿的 COVID-19:合并症的各个方面

S. G. Gorbunov, A. V. Bitsueva
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摘要

相关性:迄今为止,对于 COVID-19 在支气管哮喘儿童中的作用还没有一个统一的观点。与此同时,人群中有 14% 的儿童患有支气管哮喘,而且人数还在继续增加。尽管 COVID-19 的大流行已经结束,但它仍然是最常见的感染之一,因此,它在合并症儿童中的病程特点值得关注。目的:确定支气管哮喘患儿的临床病程特点、实验室和仪器检查数据,并分析 COVID-19 治疗的效果。材料和方法:对 25 名患有支气管哮喘的 COVID-19 患儿(观察组)和 25 名未患有哮喘的该感染患儿(对比组)进行监测。所有患者均按照有关 COVID-19 的现行法规文件进行检查,然后对结果进行统计处理。结果发现:合并症患者咳嗽和气短的频率更高,持续时间更长。在患有支气管哮喘的儿童中,出现轻度呼吸衰竭的病毒性肺损伤更为常见。与对比组患者相比,该组患者更容易出现高凝和全身炎症反应。与此同时,在充分治疗的背景下,除抗凝剂外,所有类型的治疗时间都明显延长,凝血图参数和炎症急性期动态蛋白水平在两个观察组中都趋于正常。因此,COVID-19 和支气管哮喘患者的住院时间明显长于没有支气管哮喘病史的儿童。结论与未患支气管哮喘的儿童相比,患有支气管哮喘的儿童 COVID-19 的病情更为严重。咳嗽和气短是这两种疾病的临床常见症状,但该组患儿没有典型的哮喘加重症状。
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COVID-19 in children with bronchial asthma: aspects of comorbidity
Relevance: to date, there is no single view on how COVID-19 proceeds in children with bronchial asthma. At the same time, bronchial asthma is observed in 14% of children in the population and their number continues to increase. COVID-19, despite the end of the pandemic, also remains one of the most common infections, and therefore the features of its course in comorbid children are of interest. Objective: to determine the features of the clinical course, laboratory and instrumental examination data, and to analyze the effectiveness of COVID-19 treatment in children with bronchial asthma. Materials and methods: 25 children with COVID-19 who suffered from bronchial asthma (observation group) and 25 children with this infection without asthma (comparison group) were monitored. All patients were examined in accordance with the current regulatory documents on COVID-19, followed by statistical processing of the results. Results: cough and shortness of breath were observed more often and longer in comorbid patients. Viral lung damage with the development of mild respiratory failure was more common in children with bronchial asthma. In this group, there was a more pronounced tendency to hypercoagulation and systemic inflammatory response relative to patients in the comparison group. At the same time, against the background of adequate treatment, which turned out to be significantly longer in all types of therapy, with the exception of anticoagulant, coagulogram parameters and protein levels of the acute phase of inflammation in the dynamics normalized in both observed groups. As a result, patients with COVID-19 and bronchial asthma spent significantly longer in hospital than children who did not have a anamnesis of bronchial asthma. Conclusion: COVID-19 in children with bronchial asthma was somewhat more severe compared to those who did not suffer from bronchial asthma. Cough and shortness of breath were clinically prevalent, symptoms characteristic of both diseases, but there were no typical exacerbations of asthma in this group.
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