Coronavirus infection in children: clinical and laboratory features
Objective. To determine the clinical and laboratory features of acute respiratory infection (ARI) caused by coronaviruses in children. Subjects and methods. A total of 628 children aged 3 months to 6 years, who had been admitted to the Specialized Care Department of the Infectious Diseases Hospital with a diagnosis of ARI in January 2008 to December 2009 were examined. Polymerase chain reaction was used to diagnose coronavirus infection in 50 patients; of them 40 (80%) children were found to have viral monoinfection and 10 (20%) had viral co-infection. Results. Most children with coronavirus monoinfection had predominantly an acute onset of the disease that was mild or moderate. Rising body temperatures to fever at the onset of the disease were observed in 52.5% of children. In 72.5% of children, the duration of the febrile period was 1-2 days. Children were noted to have cough (100%), rhinitis (94.8%), laryngotracheitis with grade 1 laryngeal stenosis (52.5%), and harsh breath sounds on auscultation (65%). There were gastrointestinal disorders as vomiting in 7.5% of cases and liquid stool without pathological admixtures in 10%. No cardiovascular events were seen. Hematological parameters corresponded to the course of the infectious process and showed no characteristic features. Febrile fever, moderate catarrhal signs, and intoxication symptoms, cough, and phenomena of stenosing laryngotracheitis were observed in viral co-infection caused by a combination of coronaviruses and two viruses. Conclusion. In coronavirus infection (both mono- and co-infection) in children, catarrhal syndrome was dominant in most cases. The disease is commonly accompanied by cough, fever, and phenomena of stenosing laryngitis; there may be gastrointestinal dysfunction.