THE NATURE OF THE COURSE OF THE NEW CORONAVIRUS INFECTION (COVID-19) IN CHILDREN WITH CYSTIC FIBROSIS (CLINICAL CASES)

Abstract

A new coronavirus infection (COVID-19) was first reported in late 2019 in Wuhan (China). In March 2020, the World Health Organization (WHO) announced a pandemic. The incidence in children aged 0 to 17 years accounts for 10 to 20% of cases worldwide. COVID-19 in children and adolescents is more often asymptomatic or as a mild form of acute respiratory infection, which is probably due to the low incidence of chronic diseases in children, a lower prevalence of cells with ACE2, which SARS-CoV-2 uses to infect. Alveolar type II cells are the main targets for this virus, resulting in the development of diffuse alveolar damage. The presence of various concomitant pathology can aggravate the course of viral infections to the development of acute respiratory failure and death. In particular, children with pathology of the bronchopulmonary system, such as chronic obstructive pulmonary disease and interstitial lung diseases, are at maximum risk of infection. However, based on literature sources, there is a hypothesis that in many patients with impaired immune mechanisms, the presence of chronic lung diseases, COVID-19 may proceed relatively favorably and with a lower risk of complications. Due to the fact that the acute course of COVID-19 is characterized by the appearance of fever, catarrhal syndrome and damage to the lung tissue, the primary differential diagnosis in patients with pathology of the bronchopulmonary system has certain difficulties, since these clinical manifestations are primarily regarded as an exacerbation of a chronic process. In this regard, we analyzed cases of acute COVID-19 in 2 girls aged 16 and 5 with cystic fibrosis, and identified clinical and laboratory factors affecting both the severity of COVID-19 disease and cystic fibrosis.