Aim: to optimize outcomes of the treatment and prevention of gastrointestinal diseases in adults and children. Key points. The Methodological Guidelines contain sections on the terminology, classification, mechanisms of action, requirements for sale in the Russian Federation, requirements for proving the efficacy and safety of probiotics, prebiotics, synbiotics and metabiotics, as well as functional foods enriched with them. An overview of relevant data allowing to include these drugs and products in the treatment an d prevention of gastrointestinal diseases in adults and children is presented. Conclusion. The clinical efficacy of probiotics, prebiotics, synbiotics and metabiotics depends on the specificity and quantity of their components, the dosage form, the regimen and duration of treatment. Products and functional foods with proven efficacy and safety are recommended for the treatment and prevention of gastrointestinal diseases in adults and children.

Целью данного исследования было определить клинико-лабораторные особенности течения герпетической инфекции у семейных пар при нарушении репродуктивной функции. В исследование методом сплошного скрининга было включено 149 семейных пар, обратившихся с жалобами на нарушения репродуктивной функции – отсутствием беременности или неблагоприятными исходами с гибелью эмбриона или плода. В основную группу вошли 80 семейных пар, у которых были выявлены признаки урогенитальной герпетической инфекции, а группу сравнения составили 69 семейных пар, не имеющих маркеров инфицирования вирусом простого герпеса 1-го и 2-го типа. Оценивали клинические, лабораторные и ультразвуковые отклонения в сравниваемых группах. При оценке симптоматики среди женщин оказалось, что различные жалобы, помимо отсутствия или неразвития беременности, имели 58,75% пациенток из основной группы и 38,75% в группе сравнения. Среди мужчин основной группы жалобы предъявляли 43,75% пациентов, а в группе сравнения – 6,25%. При гинекологическом осмотре у женщин с вирусом простого герпеса 1-го и 2-го типа чаще выявляли трещины задней спайки, везикуло-эрозивные элементы наружных половых органов, контактные кровотечения, увеличение матки и паховых лимфоузлов. Лабораторное исследование спермограммы у подавляющего большинства пациентов основной группы выявило тератозооспермию. Детекция вируса простого герпеса 1-го и 2-го типа культуральным методом в 100% случаев наряду с обнаружением антител класса IgА или IgM (реже) подтверждает инфицирование. Таким образом, при обследовании семейных пар с нарушениями репродуктивной функции в виде бесплодия или неразвивающейся беременности необходимо учитывать вероятность поражения урогенитального тракта вирусом простого герпеса 1-го и 2-го типа. Для подтверждения или исключения значимого инфицирования вирусом простого герпеса следует учитывать жалобы, данные анамнезаи осмотра. Среди лабораторных методов для оценки значимости инфекции, связанной с вирусом простого герпеса 1-го и 2-го типа, наиболее информативными методами являются культуральный и серологический с выявлением антител класса IgA. При подтверждении инфекции семейным парам следует назначать противогерпетическую терапию. The aim of the study was to determine the clinical and laboratory features of the course of herpetic infection in married couples with impaired reproductive function. Patients and methods. The study by continuous screening included 149 married couples who complained of reproductive dysfunction. The main group included 80 married couples who had signs of urogenital herpetic infection, and the comparison group consisted of 69 married couples who did not have markers of HSV-1, 2 infection. Clinical, laboratory and ultrasound deviations were evaluated in the compared groups. It was revealed that 58.75% of patients from the main group and 38.75% in the comparison group had various complaints when assessing the symptoms among women. 43.75% of patients complained among men of the main group, and in the comparison group – 6.25%. Gynecological examination of women with HSV-1, 2 more often revealed cracks in the posterior adhesions, vesicular erosive elements of the external genitalia, contact bleeding, enlargement of the uterus and enlargement of inguinal lymph nodes. Laboratory examination of the spermogram in the vast majority of patients of the main group revealed teratozoospermia. Detection of HSV-1, 2 by the culture method in 100% of cases, along with the detection of antibodies of class IgA or IgM (less often) confirms infection. It was concluded that it is necessary to take into account the probability of damage to the urogenital tract of HSV-1, 2 when examining couples with reproductive disorders in the form of infertility or undeveloped pregnancy. Complaints, anamnesis and examination data should be taken into account to confirm or exclude significant infection with herpes simplex virus. The most informative are the culture method, as well as serological with the detection of IgA class antibodies among the laboratory methods for assessing the significance of infection associated with HSV-1, 2. Couples should be prescribed antiherpetic therapy if infection is confirmed.

Cough in children is one of the most common symptoms both in outpatient and hospital practices. It is the main reason why parents of these patients (especially of younger kids) seek for medical care. The article highlights the current view on the cough in pediatric practice. It elucidates cough classification, etiology, and therapy in children. The authors describe characteristics of the respiratory epithelium, a multicellular layer, that extends from the nasopharynx to the small airways and acts as a respiratory barrier coordinating immune response in the early childhood, undergoing the process of development, maturation, and regeneration to adapt to the changing environment. The article presents findings of the clinical studies assessing the medications of choice that were used for the treatment of coughs in children. The selection of right drugs should be based on individual patient’s needs and depend on the extent of cough impact on the patient condition. Also, it is necessary to consider whether the cough is intense, productive, for how long it lasts and to analyse bronchial mucus characteristics. KEYWORDS: cough, children, respiratory epithelium, immune response, immunity, antitussives, butamirate. FOR CITATION: Nikolaeva S.V., Kanner E.V., Kanner I.D. et al. Cough in children: the current approach to rational pharmacotherapy. Russian Medical Inquiry. 2022;6(11):650–655 (in Russ.). DOI: 10.32364/2587-6821-2022-6-11-650-655.

Probiotics are living organisms that favor human health if administered in adequate amounts. In recent years, mechanisms of action of probiotics have been described. Moreover, strong evidence of their efficacy for preventing intestinal and respiratory infections, managing allergic and gastrointestinal disorders, and other pathologic conditions in children of different years was retrieved. Complex, physiological effects probiotics (if microbial strains are to be carefully selected and monitored for safety) contributed to the emergence of many probiotic preparations on the market. Lactobacillus reuteri, a well-known species of Lactobacillus, modulates immune response modulation, prevents infections and diseases, and is beneficial to human health. This paper addresses critical evidence of the efficacy of L. reuteri in children. Numerous clinical studies established its safety and tolerability. L. reuteri is effective for preventing and treating many diseases, including infantile colic, diarrhea, functional abdominal pain, atopic dermatitis, and allergy. L. reuteri is considered one of the available and effective medications for colic and other functional gastrointestinal disorders in children. KEYWORDS: children, probiotics, Lactobacillus reuteri, infantile colic, diarrhea, atopic dermatitis, allergy. FOR CITATION: Nikolaeva S.V., Kanner E.V., Shushakova E.K., Ploskireva A.A. One strain of L. reuteri implies many options. Important issues in pediatrics. Russian Journal of Woman and Child Health. 2022;5(1):72–77 (in Russ.). DOI: 10.32364/2618-8430-2022-5-1-72-77.

Antibiotic therapy is an integral part of current therapeutic practice to save patients’ lives. However, as with any therapeutic intervention, the development of adverse events is possible, one of which is the antibiotic-associated syndrome (AAS). Objective. To study the pathogenetic features of AAS extraintestinal manifestations using a biological model as an example. Materials and methods. This study was conducted using the biological model (outbred male mice) between 2019 and 2020 on the basis of the Central Research Institute of Epidemiology of Rospotrebnadzor. Experimental animals were injected with amoxicillin/clavulanic acid and cefotaxime in two therapeutic doses, average and maximum. The recalculation of drug doses was carried out depending on the animal’s body weight. The comparison was performed in four study groups and one control group, which were distinguished according to the dose and type of antibacterial agent. The histological examination of internal organs (large intestine, small intestine, liver, pancreas, kidney, lung, heart, testicles, spleen, stomach, duodenum, skin, bladder) was conducted at two time points: 24 hours after antibiotic administration and 7 days after the end of antibiotic therapy. Results. The results of histological examination at the first time point (24 hours after antibiotic administration) demonstrated that the use of the studied antibacterial agents at the average therapeutic dose did not cause significant morphological changes in the organs of mice, while the administration of maximum dose led to the development of reactive changes, primarily in the vascular system. The results of histological examination in the experimental groups at the second control time point (7 days after the end of antibiotic therapy) showed a systemic reaction in the organs of mice, expressed primarily in perivascular leukocyte infiltration. Similar changes were registered in the group of experimental animals that were injected with average therapeutic doses of antibacterial agents. Conclusion. AAS is characterized by systemic and homogeneous pathomorphological changes in various tissues, which explains not only the development of antibiotic-associated diarrhea, but also its extraintestinal symptoms. Our findings allow to suggest that antibiotics, especially when used irrationally, increase the risks of pathology associated with a systemic inflammatory response, in particular atherosclerosis and obesity, at the population level. Key words: antibiotic-associated diarrhea, antibiotic-associated syndrome

Influenza is an acute respiratory infection, mainly affecting the respiratory tract (often the trachea), with a tendency to develop symptoms rapidly and in most cases not requiring hospitalization. All acute respiratory infections are non-specific, with symptoms of intoxication, catarrhal symptoms (nasal congestion, rhinorrhoea, sore throat or pharyngeal discomfort), fever and cough. Improvement and widespread implementation of molecular methods to identify respiratory pathogens has led to the establishment of a higher frequency of co-infections. A literature review of the frequency of influenza co-infections is presented. Clinical cases of monoinfluenza and co-infections of influenza and respiratory syncytial infection are described, demonstrating the antagonistic effect of the two viruses on the course of the disease. In the first case, the patient, 1 year 1 month old, was hospitalised with a fever of 39 ºC in a moderate condition. A nasopharyngeal swab showed RNA of influenza A virus by PCR and was diagnosed with influenza. In the second case, the patient, 2 years old, at the beginning of the disease complained of an increase in body temperature to 38.7 ºC, cough, and difficulty in nasal breathing. On admission, the patient was in moderate condition with a body temperature of 36.6 ºC, clear consciousness and well-being. On auscultation, breathing in the lungs was rigid, single moist rales, scattered on both sides. A nasopharyngeal swab showed RNA of influenza A virus and respiratory syncytial virus by PCR. A viral acute respiratory infection of combined etiology and acute bronchitis was diagnosed. In the third case, a 14-year-old patient presented with complaints of fever up to 39 ºC, headache, weakness, muscle pain, dry cough. The condition was of moderate severity. The diagnosis of influenza A was confirmed by a rapid test for influenza A/B/C. In the treatment and prevention of both monoinfection and co-infections of influenza and other viruses, these clinical examples demonstrate the effectiveness of oseltamivir. These clinical examples highlight some key parameters: respiratory co-infections change the typical clinical picture of the disease, making it difficult to clinically diagnose the infection, highlighting laboratory diagnosis, which in turn facilitates rapid verification of the diagnosis and timely prescription of adequate therapy.

Acute respiratory infections are one of the most common infections in children worldwide. The implementation of novel highly accurate diagnostic methods demonstrated that a significant proportion of respiratory tract infections are caused by more than one pathogen (virus plus virus or virus plus bacterium). Most frequently, mixed infections are observed in young children, which, in addition to non-specificity of most clinical manifestations, necessitates pathogen identification in order to prevent inadequate use of antibiotics. Key words: respiratory infections, children, respiratory pathogen

The spectrum of the clinical manifestations in patients with COVID-19 varies from asymptomatic to severe forms of the disease leading to death. The most commonly affected in patients with COVID-19 system is the respiratory system, but other organ systems can also be affected by the virus. We propose a classification of the clinical forms of COVID-19, which includes: acute respiratory infection (affecting only the upper respiratory tract); pneumonia: without ARF, with ARF; anosmia/parosmia/cacosmia; cerebral form (meningitis, meningoencephalitis); gastrointestinal form, including hepatitis; oligosymptomatic form/asymptomatic form; combined forms. Sepsis, septic (infectious-toxic) shock; DIC, thrombosis and thromboembolism are proposed to be considered as complications of the underlying disease. Present classification can help clinicians to diagnose COVID-19 at an early stage, identify atypical infection forms, and assign appropriate treatment. Key words: COVID-19, classification, clinical manifestations

Acute respiratory infections hold the leading position in the structure of infectious pathology in children and are one of the main reasons for visits to the doctor. Most often causative agents of acute respiratory infections are viruses. In recent years, respiratory infections of combined etiology are becoming an increasingly significant problem, the proportion of which is increasing. In co-infections, clinical diagnosis is difficult, which once again emphasizes the importance of the widespread introduction of highly sensitive etiological diagnostic methods, in particular polymerase chain reaction. Data on the tendency to a more severe course of co-infections compared to mono-infections are ambiguous, which seems to depend on the specific causative agent and the level of viral load. Another urgent problem of acute respiratory infections in children is the frequent registration of concomitant respiratory viral and herpes virus infections. The clinical picture of acute respiratory tract infections is not very diverse: fever, intoxication symptoms, cough, nasal congestion, rhinorrhea, sore throat, etc. At the same time, pathognomonic symptoms can be identified in some monoinfections, but in coinfections such clinical diagnosis is difficult, suggesting the importance of etiological diagnosis, especially polymerase chain reaction (PCR). All of the above, as well as age and clinical manifestations largely determine the rational selection of antiviral therapy simultaneously effective against both respiratory viruses and herpes viruses. One such drug is Cycloferon, which has not only a broad antiviral spectrum, but also a high level of safety. Inclusion of an interferon inducer in the treatment of acute respiratory infections will reduce the need to prescribe other drugs, including antibiotics, and reduce the medication load on the body.

Вирусные инфекции дыхательных путей являются наиболее частой причиной инфекционных заболеваний, особенно у детей. В большинстве случаев, особенно при поражении верхних дыхательных путей, острые респираторные вирусные инфекции протекают в легкой или среднетяжелой форме и часто купируются самостоятельно. Фармакологические средства для лечения или профилактики данных инфекций у детей в настоящее время ограничены. Многочисленные исследования доказали эффективность пробиотиков в лечении и профилактике заболеваний желудочно-кишечного тракта, таких как инфекционные и антибиотик-ассоциированные диареи, диареи путешественников, некротизирующий энтероколит, инфекция Helicobacter pylori, а также атопических заболеваний. Становится актуальным изучение эффективности пробиотиков в качестве средств профилактики острых респираторных инфекций среди детей и взрослых. Данные in vitro демонстрируют, что пробиотики обладают штаммоспецифическим иммуномодулирующим действием на иммунные клетки. Показано, что пробиотики эффективны в подавлении репликации различных респираторных вирусов, включая вирусы гриппа и респираторно-синцитиальный вирус. Подобные эффекты были продемонстрированы на мышах, было показано, что пробиотики способны снижать титры вируса в тканях легких и модулировать экспрессию противовирусных и провоспалительных генов до и после вирусной инфекции. Доклинические исследования также показывают уменьшение симптомов заболевания у мышей, что указывает на потенциальную клиническую пользу. Данные литературы по изучению применения пробиотиков и синбиотиков при вирусных инфекциях респираторного тракта показывают, что их использование связано с более низкой частотой и меньшей продолжительностью легких форм респираторной инфекции как у детей, так и у взрослых. Целесообразно дальнейшее проведение исследований для получения адекватных выводов об эффективности пробиотиков и синбиотиков при острых респираторных инфекциях. Viral infections of the respiratory tract are the most common cause of infectious diseases, especially in children. In most cases, especially when the upper respiratory tract is affected, acute respiratory viral infections are mild to moderate and often stop spontaneously. Pharmacological agents for the treatment or prevention of these infections in children are currently limited. Numerous studies have proven the effectiveness of probiotics in the treatment and prevention of diseases of the gastrointestinal tract, such as infectious and antibiotic-associated diarrhea, traveler's diarrhea, necrotizing enterocolitis, Helicobacter pylori infection, as well as atopic diseases. It is becoming urgent to study the effectiveness of probiotics as prophylactic agents for acute respiratory infections. among children and adults. In vitro data demonstrate that probiotics have strain-specific immunomodulatory effects on immune cells. Probiotics have been shown to be effective in suppressing the replication of various respiratory viruses, including influenza viruses and respiratory syncytial virus. Similar effects have been demonstrated in mice with the ability of probiotics to reduce viral titers in lung tissues and modulate the expression of antiviral and pro-inflammatory genes before and after viral infection. Preclinical studies also show improvement in symptoms in mice, indicating potential clinical benefit. Literature data on the use of probiotics and synbiotics for viral infections of the respiratory tract show that their use is associated with a lower frequency and duration of mild forms of respiratory infection in both children and adults. It is advisable to further conduct research necessary to obtain adequate conclusions about the effectiveness of probiotics and synbiotics in acute respiratory infections.

Respiratory viruses are the leading cause of pediatric morbidity and mortality worldwide. Rapid identification of a pathogen, epidemiological surveillance, description of symptoms, and the development of preventive and therapeutic measures are keystones to limit the spread of respiratory infections. Novel viruses with specific properties are regularly discovered. This paper addresses essential data on the most common viruses provoking acute respiratory infections, including whose in children and the pattern of their course. Conventionally, the most vital concern is flu. Influenza viruses provoke seasonal outbreaks, epidemics, and pandemics. Many studies demonstrate the role of rhinovirus C in the development of bronchiolitis and, subsequently, asthma. Severe acute respiratory syndrome-related coronavirus (SARS-CoV), Middle East respiratory syndrome-related coronavirus (MERS-CoV), and SARS-CoV-2 provoking COVID-19 were recently described. Knowledge of known and newly emerging viruses is crucial for timely adequate medical care. The authors discuss major therapeutic strategies for acute respiratory infections that provide a more favorable course of infectious inflammation irrespective of viral etiology. KEYWORDS: acute respiratory infections, influenza virus, rhinovirus, coronavirus, pneumonia, interferon. FOR CITATION: Nikolaeva S.V., Khlypovka Yu.N., Zavolozhin V.A. et al. Respiratory viral infections in children: modalities for pathogenic treatment. Russian Medical Inquiry. 2021;5(11):762–767 (in Russ.). DOI: 10.32364/2587-6821-2021-5-11-762-767.

Dysphonia is a voice disorder manifesting with hoarseness, nasality, weak voice, and vocal fatigue. Being a common complaint, dysphonia is a common cause of medical referral and disability due to absence from work. Voice disorders affect individuals of any age. Meanwhile, voice disorders are more commonly reported in patients over 65 years (29.1%) and children. Moreover, 23.4% of children may have dysphonia at a certain point — this disorder is more common in boys than in girls. There are numerous causes of dysphonia, e.g., head snd neck tumors, neurological, gastrointestinal, or lung diseases, psychological disorders, injuries, iatrogenic injuries, infections, etc. Meanwhile, acute laryngitis, a symptom of acute respiratory infections, is one of the leading causes of dysphonia. The most common causative agents of acute laryngitis are parainfluenza and influenza viruses, adenoviruses, on occasion, respiratory syncytial virus, and viral-bacterial associations. Dysphonia treatment should be complex and include systemic and topical corticosteroids, antihistamines, mucoactive medications, systemic and topical antibiotics, and combined medications (e.g., Homeovox). Clinical trials have demonstrated their efficacy in adults and children. KEYWORDS: acute laryngitis, dysphonia, hoarseness, treatment. FOR CITATION: Nikolaeva S.V., Turovskiy A.B., Khlypovka Yu.N. Dysphonia: state-of-the-art and treatment tools. Russian Medical Inquiry. 2021;5(11):749–754 (in Russ.). DOI: 10.32364/2587-6821-2021-5-11-749-754.

The objective. To evaluate the frequency and laboratory characteristics of pneumonia in children when influenza is combined with other respiratory viruses.Materials and methods. We examined 72 children aged 1 month to 17 years who were hospitalized in a specialized hospital in 2017–2019 with influenza type A (72 %) or B (28 %). The main group included 36 patients who had a laboratory-confirmed combination of influenza with other respiratory viruses, and the comparison group included 36 cases in which influenza was the only pathogen detected.Results. The analysis of the frequency of complications showed that in the main group, pneumonia developed significantly more often – in 22 % (8 children), and in the comparison group – in 6 % (2 children, p < 0.05).Conclusions. 1) The combination of influenza with other respiratory viruses is a risk factor for the development of pneumonia in children. 2) There are no significant changes in the indicators of clinical blood analysis in pneumonia developing against the background of influenza, including in combination with other respiratory viruses.

Currently, great attention is paid to immunologic and preventive effects of probiotics. This review considers results of randomized controlled studies of probiotic products in prevention of respiratory infections.

Objective. To evaluate the efficacy and safety of Ergoferon in children and adults with acute respiratory viral infections (ARVIs). Material and methods. We have analyzed the results of 10 randomized controlled trials involving 1732 patients. The outcome measures included duration of fever, disease severity, frequency of deteriorations, number of adverse events (AEs), and assessment of drug interaction. We have conducted statistical analysis of pooled data and meta-analysis using logistic regression. Results. Patients receiving Ergoferon were 1.5 times more likely to have shorter period of fever than those receiving placebo (ОR = 1.499, р = 0.0002). Patients in the Ergoferon group had milder ARVI and influenza than patients in the placebo group (according to the AUC analysis: 32.83 ± 18.12 vs 36.94 ± 19.08 units in the placebo group, p = 0.0083). The frequency of deterioration in the Ergoferon group was 7 times lower than that in the placebo group (0.6% vs 4.4% of cases). Treatment safety was confirmed by fewer patients having AEs in the experimental group (0.6% vs 10.8%, p = 0.0006.) and no drug interactions. Conclusion. Our findings suggest that Ergoferon significantly reduced duration of fever in patients with ARVI and influenza compared to placebo. Ergoferon alleviated the disease and reduced the incidence of bacterial complications. Moreover, this drug demonstrated good tolerability and compatibility with other drugs. Key words: ARVI, influenza, meta-analysis, ARVI treatment, influenza treatment, Ergoferon

The second decade of the 21st century started with the emergence of a new coronavirus SARS-CoV-2, affecting humans and causing COVID-19 infection. Children usually have mild disease with one-third of them being asymptomatic, which hinders diagnostics of this infection and does not prevent hospitalization of infected children with non-respiratory disorders to hospitals. Objective. To assess the incidence and specific characteristics of COVID-19 among children emergently admitted to a multidisciplinary hospital not intended for hospitalization of patients with COVID-19. Patients and methods. We performed retrospective analysis of medical records of children admitted to different departments of a multidisciplinary hospital in Moscow between 20.03.2020 and 20.07.2020 (9,779 were discharged during this period). Results. A total of 64 children aged 1 month to 17 years admitted to 10 different departments had positive PCR results for COVID-19 (nasal/oropharyngeal swabs) upon admission to hospital. Fifteen patients (23.4%) had asymptomatic coronavirus infection. These were primarily children of school age and less often of preschool age admitted to the Departments of Traumatology, Surgery with injuries, fractures, exacerbation of chronic nephrological or abdominal disorders. Twenty-four participants (37.5%) presented with mild or none catarrhal symptoms, whereas 12 children were diagnosed with pneumonia. The highest number of SARS-CoV-2-positive children (n = 30; 46.9%) were admitted to the Department of Infectious Diseases, as could be expected. Conclusion. Our findings suggest that, in general, the current situation reflects our knowledge about COVID-19. Children usually have mild or asymptomatic COVID-19 and play a significant role in virus transmission, contributing to the continuation of the pandemic. Our results have high clinical and epidemiological significance and require further investigations among children of different ages to accumulate the data. Key words: children, SARS-CoV-2

Despite significant public health efforts, acute respiratory infections (ARIs) are still very common among children. Most ARIs (both mono- and mixed forms that became more frequent recently) are caused by viruses. Inappropriate use of antibiotics in patients with ARIs leads to an increase in antibiotic resistance, which is a highly relevant problem now. Administration of antibiotics requires an individual approach and better knowledge of practitioners regarding the problem of antibiotic resistance. Since clinical manifestations of upper respiratory tract infections (that represent a large proportion of all ARIs in children) include both general intoxication symptoms (fever, decreased appetite, weakness, and fatigue) and local symptoms (nasal congestion, rhinorrhea, sore throat increasing during swallowing, and cough) and the most common pathogens causing ARIs are viruses, local anti-inflammatory and bactericidal agents in the form of gargles or tablets for resorption are preferable. Key words: respiratory infections, children, mixed infection, Faringosept

Objective of the research: to determine clinical and epidemiological features of the course of the new coronavirus infection (COVID-19) caused by SARS-CoV-2 in children in the Russian Federation (RF). Materials and methods: a retrospective analysis of all confirmed COVID-19 cases in children in the first half of 2020 in the Russian Federation was performed. Information about patients (age, sex, examination date, place of residence, disease severity final diagnosis, etc.) was taken from the database containing the Rospotrebnadzor report form № 970 «Information on cases of infectious diseases in persons with suspected new coronavirus infection» January – June 2020 across the Russian Federation. Research results were processed using the IBM SPSS Statistics 26 program. To assess the differences in nominal indicators (proportions), the Pearson χ2 test was used. The results were considered statistically significant at p<0,05. Results: in the RF, the total number of children infected with COVID-19 in the first half of 2020 amounted to 8,4% among all patients with this infection. Children of all ages get sick with COVID-19, and boys are slightly more likely than girls (52,2% versus 47,8%, p>0,05). In children, the maximum number of cases is registered in family foci – 75%. Upper respiratory tract infections were diagnosed in 72,1% of patients. The proportion of pneumonia was 1,8%, and 2/3 of children were over 3 years old (p<0,001). In almost 1/3 of patients, the infection course had no clinical manifestations. 18,2% of children at the disease onset had increased body temperature, while only 3,5% of children had hyperthermia above 390 C. Cough was registered in 50,8% of cases. Rhinitis/rhinopharyngitis developed only in every 4th child. Symptoms pathognomonic for COVID-19, such as loss of smell (anosmia) and taste (ageusia), were recorded only in 17% of cases. 41,3% of patients received treatment in a hospital, and among them children under 3 years of age predominated. Conclusion: in children in the RF, the new coronavirus infection COVID-19 is generally favorable.

The second decade of the 21st century has brought us a new coronavirus infection, SARS-CoV-2, which affects not only animals (livestock, companion animals, birds), but also people, causing severe disease in them (COVID-19) with various clinical variants: from upper respiratory tract lesions to sepsis and thromboembolism. Coronaviruses are known to suppress the production of IFN-I. Therefore, administration of IFN-I is a promising strategy for early treatment and prevention of COVID-19. In the Russian Federation, treatment of COVID-19 in children is performed in accordance with the recommendations of the Ministry of Health of Russia and depends on the clinical form of the disease. Mild and moderate forms of the disease, observed in the majority of children, are treated according to the protocols for managing ARVI, bronchitis, bronchiolitis, and pneumonia in children. However, the fact that non-severe COVID-19 shares clinical manifestations with other infections caused by respiratory viruses and herpesviruses (including cytomegalovirus, HHV6A/B, and Epstein-Barr virus), as well as recently increased proportion of mixed viral infections necessitate (until the etiological diagnosis is confirmed) the administration of drugs recommended for the treatment of seasonal ARVI (including intranasal forms of IFN-α, etc.). Such therapeutic tactics often ensures faster improvement and symptom elimination. We report a case of mixed respiratory infection caused by two viruses (SARS-CoV-2 and Epstein–Barr virus) in a child. Early treatment with recombinant interferon-α2b with taurine resulted in fever alleviation and normalization of child’s condition by the moment of transfer to a specialized department. Key words: SARS-CoV-2, COVID-19, children, treatment, interferon.

Humanity has recently encountered an infection caused by a new strain of human coronavirus (SARS-CoV-2). This infection is characterized by a variety of clinical symptoms with lesions not only to the respiratory tract, but also to other organs, lack of causal therapy, and high mortality rate. Wide spread of COVID-19 contributes to the development of this disease in children. Objective. To identify clinical and epidemiological characteristics of new coronavirus infection in children in the Russian Federation (RF). Materials and methods. We performed a retrospective analysis of all confirmed COVID-19 cases among children in the RF between January and June 2020. Information on patients (age, gender, place of residence, reason and date of examination, and clinical form of the disease) was taken from the database containing reports of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing according to from No. 970 ‘Information on cases of infectious diseases in people with suspected coronavirus infection’ for January–June 2020. The results were processed by generally accepted statistical methods with the calculation of the Fisher s-criterion. Differences were considered significant at p <0.05. Results. A total of 47,712 cases of COVID-19 were registered in children during the first 6 months of 2020 in the Russian Federation, which accounted for 8.4% of all COVID-19 cases. Children of all ages are affected with boys having the disease slightly more often than girls (52.2% vs. 47.8%, p > 0.05). The majority of hospitalized children were younger than 3 years of age. The proportion of pneumonia among children treated in inpatient departments was 4.4% and two-thirds of them were older than 3 years (p < 0.001). Upper respiratory tract infections were diagnosed in 83% of children. Almost one-fifth of children (18.2%) had hyperthermia at the disease onset, although high-grade fever (>39°С) was detected only in 2.6% of children. Half of the patients (50.8%) had cough. Only one in four children developed rhinitis/rhinopharyngitis. Symptoms that are pathognomonic for COVID-19, such as loss of smell (anosmia) and taste (ageusia), were registered in 17% of cases only. Conclusion. Children with new coronavirus infection usually have mild disease. Key words: children, coronavirus, COVID-19