Коронавирусная инфекция COVID-19 у детей: обзор литературы

Введение. В конце 2019 г. новый подтип коронавируса, названный коронавирусом тяжелого острого респираторного синдрома 2 (SARS-CoV-2), быстро распространился по миру, вызвав глобальную пандемию. Изначально доля подтвержденных случаев среди детей была относительно небольшой, и считалось, что они заражаются редко. Последующие наблюдения показали, что у детей и подростков инфекция протекает либо бессимптомно, либо сопровождается минимальной клинической симптоматикой, в связи с чем истинная заболеваемость недооценивается из-за низкого уровня тестирования.

Цель исследования — обобщить и систематизировать результаты исследований, посвященных распространенности, диагностике, клинической картине, вакцинации и лечению детей с новой коронавирусной инфекцией COVID-19.

Материалы и методы. В PubMed проведен поиск статей, опубликованных до 15 января 2022 г., с использованием комбинаций следующих слов: COVID-19, SARS-CoV-2, дети, педиатрия, подростки, младенцы и школа. Мы прочитали аннотации к 101 статье и отобрали 78 статей на основе их актуальности для обсуждаемых тем. Также мы проанализировали 3 статьи о вакцинации детей. Всего в обзор включено 89 статей.

Результаты. Частота положительных результатов тестирования на SARS-CoV-2 на протяжении всего пика пандемии у детей была низкой по сравнению со взрослыми, в том числе у тех, у кого была острая респираторная инфекция. Дети не только реже заражаются вирусом, но и переносят инфекцию легче, чем взрослые. Уровень летальности у детей с COVID-19 составлял < 0,5%. У большинства детей заражение протекает либо бессимптомно, либо сопровождается стертой клинической картиной. Вакцинация детей и подростков рекомендуется в основном для достижения коллективного иммунитета во всех возрастных группах. Однако отсутствуют убедительные данные о длительности иммунного ответа, уровне необходимого защитного титра антител, а также об отдаленных побочных эффектах вакцинации в связи с недостаточным сроком наблюдения и неопределенностью критериев иммунного ответа.

Заключение. По мере накопления информации о вирусной нагрузке детей и подростков, их роли в передаче вируса оптимизированы подходы к диагностике в этой возрастной группе. Эффективность лечения протестирована на пациентах, госпитализированных в стационар, и разработаны рекомендации по лечению. В настоящее время глобальные исследовательские усилия сосредоточены на защите особенно уязвимых детей, перспективах тотальной вакцинации детей, ее эффективности и безопасности. 

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