mesЭкстремальная биомедицинаExtreme Medicine3033-89643033-8972Centre for Strategic Planning of the Federal Medical and Biological Agency10.47183/mes.2021.017mes-131Research ArticleОБЗОР ИНФЕКЦИОННЫЕ БОЛЕЗНИREVIEW INFECTIOUS DISEASESCOVID-19-ассоциированный педиатрический мультисистемный воспалительный синдромPediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infectionЛобзинЮ. В.LobzinYu. V.

Санкт-Петербург

Saint Petersburg

УсковА. Н.UskovA. N.

Санкт-Петербург

Saint Petersburg

СкрипченкоН. В.SkripchenkoN. V.

Санкт-Петербург

Saint Petersburg

ВильницА. А.VilnitsA. A.

Алла Ароновна Вильниц

 ул. профессора Попова, д. 9, г. Санкт-Петербург, 197022

Alla A. Vilnits

Professora Popova, 9, Saint Petersburg, 197022

vilnitz@mail.ruБехтереваМ. К.BekhterevaM. K.

Санкт-Петербург

Saint Petersburg

БабаченкоИ. В.BabachenkoI. V.

Санкт-Петербург

Saint Petersburg

Детский научно-клинический центр инфекционных болезней Федерального медико-биологического агентства; Северо-Западный государственный медицинский университет имени И. И. Мечникова; Военно-медицинская академия имени С. М. КироваРоссияPediatric Research and Clinical Center for Infectious Diseases of FMBA; Mechnikov North-West State Medical University; Kirov Military Medical AcademyRussian FederationДетский научно-клинический центр инфекционных болезней Федерального медико-биологического агентстваРоссияPediatric Research and Clinical Center for Infectious Diseases of FMBARussian FederationДетский научно-клинический центр инфекционных болезней Федерального медико-биологического агентства; Санкт-Петербургский государственный педиатрический медицинский университетРоссияPediatric Research and Clinical Center for Infectious Diseases of FMBA; Saint Petersburg State Pediatric Medical UniversityRussian Federation2021251020242321319Copyright © Лобзин Ю.В., Усков А.Н., Скрипченко Н.В., Вильниц А.А., Бехтерева М.К., Бабаченко И.В., 20242024Лобзин Ю.В., Усков А.Н., Скрипченко Н.В., Вильниц А.А., Бехтерева М.К., Бабаченко И.В.Lobzin Y.V., Uskov A.N., Skripchenko N.V., Vilnits A.A., Bekhtereva M.K., Babachenko I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.extrememedicine.ru/jour/article/view/131

Несмотря на невысокую заболеваемость и летальность, относительно легкое течение COVID-19 в педиатрической популяции, в последнее время у детей после перенесенной коронавирусной инфекции или контакта с инфицированным выросло число случаев развития состояния, по клинической картине схожего с болезнью Кавасаки, которое получило название педиатрический мультисистемный воспалительный синдром, ассоциированный с COVID-19 (ПМВС). В обзоре представлены современные взгляды на возможный патогенез данного состояния, диагностику и лечение, а также данные по клинико-инструментальной картине и тактике ведения ПМВС у детей и подростков, госпитализированных в отделение интенсивной терапии Детского научно-клинического центра инфекционных болезней. Изложены основные проблемы своевременной диагностики и прогнозирования исходов ПМВС у детей.

Despite the low incidence, low mortality and relatively mild symptoms of COVID-19 in children, there has been a rise in pediatric patients who develop a condition resembling Kawasaki disease after COVID-19 or contact with individuals infected with SARS-CoV-2. This condition is known as the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS). This review introduces the reader to the hypotheses of PIMS-TS pathogenesis, provides information about its diagnosis and treatment, presents clinical and laboratory data and describes treatments strategies used in children and adolescents hospitalized to the intensive care unit of the Pediatric Research and Clinical Center for Infectious Diseases. Besides, the review outlines the main diagnostic and prognostic challenges of PIMS-TS.

воспалительный мультисистемный синдромкоронавирусная инфекцияCOVID-19SARS-CoV-2детиmultisystem inflammatory syndromecoronavirus infectionCOVID-19SARS-CoV-2childrenReferencesWHO Coronavirus (COVID-19) Dashboard. 2021 Apr (cited 2021 Apr 07). Available from: https://covid19.who.int/ .WHO Coronavirus (COVID-19) Dashboard. 2021 Apr (cited 2021 Apr 07). Available from: https://covid19.who.int/ .Ludvigsson J.F. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020; 109: 1088–95. PMID: 32202343 DOI: 10.1111/apa.15270.Ludvigsson J.F. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020; 109: 1088–95. PMID: 32202343 DOI: 10.1111/apa.15270.Ding Y., Yan H., Guo W. Clinical Characteristics of Children with COVID-19: A Meta-Analysis. Front Pediatr 2020; 8: 431. PMID: 32719759 DOI: 10.3389/fped.2020.00431.Ding Y., Yan H., Guo W. Clinical Characteristics of Children with COVID-19: A Meta-Analysis. Front Pediatr 2020; 8: 431. PMID: 32719759 DOI: 10.3389/fped.2020.00431.Guo C.X., He L., Yin J.Y., Meng X.G., Tan W., Yang G.P., et al. Epidemiological and clinical features of pediatric COVID-19. BMC Med 2020; 18: 250. PMID: 32762696 DOI:10.1186/s12916-020-01719-2.Guo C.X., He L., Yin J.Y., Meng X.G., Tan W., Yang G.P., et al. Epidemiological and clinical features of pediatric COVID-19. BMC Med 2020; 18: 250. PMID: 32762696 DOI: 10.1186/s12916-020-01719-2.Усков А.Н., Лобзин Ю.В., Рычкова С.В., Бабаченко И.В., Федоров В.В., Улуханова Л.У. и др. Течение новой коронавирусной инфекции у детей: некоторые аспекты мониторинга заболеваемости и анализа летальности. Журнал инфектологии. 2020; 12 (3): 12–20. DOI: 10.22625/2072-6732-2020-12-3-12-20.Uskov A.N., Lobzin Ju.V., Rychkova S.V., Babachenko I.V., Fedorov V.V., Uluhanova L.U. i dr. Techenie novoj koronavirusnoj infekcii u detej: nekotorye aspekty monitoringa zabolevaemosti i analiza letal'nosti. Zhurnal infektologii. 2020; 12 (3): 12–20. DOI: 10.22625/2072-6732-2020-12-3-12-20. Russian.Leidman E., Duca L.M., Omura J.D., Proia K., Stephens J.W., Sauber-Schatz E.K. COVID-19 Trends Among Persons Aged 0—24 Years — United States, March 1-December 12, 2020. MMWR Morb Mortal Wkly Rep. 2021; 70 (3): 88–94. DOI: 10.15585/mmwr.mm7003e1. PMID: 33476314; PMCID: PMC7821770.Leidman E., Duca L.M., Omura J.D., Proia K., Stephens J.W., Sauber-Schatz E.K. COVID-19 Trends Among Persons Aged 0—24 Years — United States, March 1-December 12, 2020. MMWR Morb Mortal Wkly Rep. 2021; 70 (3): 88–94. DOI: 10.15585/mmwr.mm7003e1. PMID: 33476314; PMCID: PMC7821770.Jones V.G., Mills M., Suarez D., Hogan C.A., Yeh D., Segal J.B., et al. COVID-19 and Kawasaki Disease: Novel Virus and Novel Case. Hosp Pediatr. 2020; 10 (6): 537–40. DOI: 10.1542/hpeds.2020-0123. Epub 2020 Apr 7. PMID: 32265235.Jones V.G., Mills M., Suarez D., Hogan C.A., Yeh D., Segal J.B., et al. COVID-19 and Kawasaki Disease: Novel Virus and Novel Case. Hosp Pediatr. 2020; 10 (6): 537–40. DOI: 10.1542/hpeds.2020-0123. Epub 2020 Apr 7. PMID: 32265235.Davies P., Evans C., Kanthimathinathan H.K., Lillie J., Brierley J., Waters G., et al. Intensive care admissions of children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the UK: a multicentre observational study. Lancet Child Adolesc Health. 2020; 4 (9): 669–77. DOI: 10.1016/S2352-4642(20)30215-7. PMID: 32653054; PMCID: PMC7347350.Davies P., Evans C., Kanthimathinathan H.K., Lillie J., Brierley J., Waters G., et al. Intensive care admissions of children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the UK: a multicentre observational study. Lancet Child Adolesc Health. 2020; 4 (9): 669–77. DOI: 10.1016/S2352-4642(20)30215-7. PMID: 32653054; PMCID: PMC7347350.Verdoni L., Mazza A., Gervasoni A., Martelli L., Ruggeri M., Ciuffreda M., et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020; 395 (10239): 1771–8. DOI: 10.1016/S0140-6736(20)31103-X. PMID: 32410760; PMCID: PMC7220177.Verdoni L., Mazza A., Gervasoni A., Martelli L., Ruggeri M., Ciuffreda M., et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020; 395 (10239): 1771–8. DOI: 10.1016/S0140-6736(20)31103-X. PMID: 32410760; PMCID: PMC7220177.Rowley A.H. Understanding SARS-CoV-2-related multisystem inflammatory syndrome in children. Nat Rev Immunol. 2020; 20 (8): 453–4. DOI: 10.1038/s41577-020-0367-5. PMID: 32546853; PMCID: PMC7296515.Rowley A.H. Understanding SARS-CoV-2-related multisystem inflammatory syndrome in children. Nat Rev Immunol. 2020; 20 (8): 453–4. DOI: 10.1038/s41577-020-0367-5. PMID: 32546853; PMCID: PMC7296515.Evans C., Davies P. SARS-CoV-2 paediatric inflammatory syndrome. Paediatr Child Health (Oxford). 2021; 31 (3): 110–5. DOI: 10.1016/j.paed.2020.12.003. PMID: 33391390; PMCID: PMC7762804.Evans C., Davies P. SARS-CoV-2 paediatric inflammatory syndrome. Paediatr Child Health (Oxford). 2021; 31 (3): 110–5. DOI: 10.1016/j.paed.2020.12.003. PMID: 33391390; PMCID: PMC7762804.Dolhnikoff M., Ferreira Ferranti J., de Almeida Monteiro R.A., Duarte-Neto A.N., Soares Gomes-Gouvêa M., Viu Degaspare N., et al. SARS-CoV-2 in cardiac tissue of a child with COVID-19-related multisystem inflammatory syndrome. Lancet Child Adolesc Health. 2020; 4 (10): 790–4. DOI: 10.1016/S2352-4642(20)30257-1. PMID: 32828177; PMCID: PMC7440866.Dolhnikoff M., Ferreira Ferranti J., de Almeida Monteiro R.A., Duarte-Neto A.N., Soares Gomes-Gouvêa M., Viu Degaspare N., et al. SARS-CoV-2 in cardiac tissue of a child with COVID-19-related multisystem inflammatory syndrome. Lancet Child Adolesc Health. 2020; 4 (10): 790–4. DOI: 10.1016/S2352-4642(20)30257-1. PMID: 32828177; PMCID: PMC7440866.Брегель Л.В., Костик М.М., Фелль Л.З., Ефремова О.С., Соболева М.К., Крупская Т.С. и др. Болезнь Кавасаки и мультисистемный воспалительный синдром при инфекции COVID-19 у детей. Педиатрия им. Г. Н. Сперанского. 2020; 99 (6): 209–19. DOI: 10.24110/0031-403X-2020-99-6-209-219.Bregel L.V., Kostik M.M., Fell L.Z., Efremova O.S., Soboleva M.K., Krupskaja T.S. i dr. Bolezn' Kavasaki i mul'tisistemnyj vospalitel'nyj sindrom pri infekcii COVID-19 u detej. Pediatrija im. G. N. Speranskogo. 2020; 99 (6): 209–19. DOI: 10.24110/0031-403X-2020-99-6-209-219. Russian.Ravelli A., Minoia F., Davì S., Horne A., Bovis F., Pistorio A., et al. 2016 Classification Criteria for Macrophage Activation Syndrome Complicating Systemic Juvenile Idiopathic Arthritis: A European League Against Rheumatism/American College of Rheumatology/ Paediatric Rheumatology International Trials Organisation Collaborative Initiative. Ann Rheum Dis. 2016;75(3):481–9. DOI: 10.1136/annrheumdis-2015-208982. PMID: 26865703.Ravelli A., Minoia F., Davì S., Horne A., Bovis F., Pistorio A., et al. 2016 Classification Criteria for Macrophage Activation Syndrome Complicating Systemic Juvenile Idiopathic Arthritis: A European League Against Rheumatism/American College of Rheumatology / Paediatric Rheumatology International Trials Organisation Collaborative Initiative. Ann Rheum Dis. 2016;75(3):481–9. DOI: 10.1136/annrheumdis-2015-208982. PMID: 26865703.Toubiana J., Poirault C., Corsia A., Bajolle F., Fourgeaud J., Angoulvant F., et al. Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ. 2020; 369: m2094. DOI: 10.1136/bmj.m2094. PMID: 32493739; PMCID: PMC7500538.Toubiana J., Poirault C., Corsia A., Bajolle F., Fourgeaud J., Angoulvant F., et al. Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ. 2020; 369: m2094. DOI: 10.1136/bmj.m2094. PMID: 32493739; PMCID: PMC7500538.Consiglio C., Cotugno N., Sardh F., et al. The immunology of multisystem inflammatory syndrome in children with COVID-19. 2020; 12; 183 (4): 968–81.e7. DOI: 10.1016/j.cell.2020.09.016. PMID: 32966765; PMCID: PMC7474869.Consiglio C., Cotugno N., Sardh F., et al. The immunology of multisystem inflammatory syndrome in children with COVID-19. 2020; 12; 183 (4): 968–81.e7. DOI: 10.1016/j.cell.2020.09.016. PMID: 32966765; PMCID: PMC7474869.Gruber C.N., Patel R.S., Trachtman R., Lepow L., Amanat F., Krammer F., et al. Mapping Systemic Inflammation and Antibody Responses in Multisystem Inflammatory Syndrome in Children (MIS-C). Cell. 2020; 183 (4): 982–95.e14. DOI: 10.1016/j.cell.2020.09.034. PMID: 32991843; PMCID: PMC7489877.Gruber C.N., Patel R.S., Trachtman R., Lepow L., Amanat F., Krammer F., et al. Mapping Systemic Inflammation and Antibody Responses in Multisystem Inflammatory Syndrome in Children (MIS-C). Cell. 2020; 183 (4): 982–95.e14. DOI: 10.1016/j.cell.2020.09.034. PMID: 32991843; PMCID: PMC7489877.Hoste L., Van Paemel R., Haerynck F.. Multisystem inflammatory syndrome in children related to COVID-19: a systematic review. Eur J Pediatr. 2021; 18: 1–16. DOI: 10.1007/s00431-021-03993-5. PMID: 33599835; PMCID: PMC7890544.Hoste L., Van Paemel R., Haerynck F. Multisystem inflammatory syndrome in children related to COVID-19: a systematic review. Eur J Pediatr. 2021; 18: 1–16. DOI: 10.1007/s00431-021-03993-5. PMID: 33599835; PMCID: PMC7890544.Yasuhara J., Watanabe K., Takagi H., Sumitomo N., Kuno T. COVID-19 and multisystem inflammatory syndrome in children: A systematic review and meta-analysis. Pediatr Pulmonol. 2021; 11: 10.1002/ppul.25245. DOI: 10.1002/ppul.25245. PMID: 33428826; PMCID: PMC801339.Yasuhara J., Watanabe K., Takagi H., Sumitomo N., Kuno T. COVID-19 and multisystem inflammatory syndrome in children: A systematic review and meta-analysis. Pediatr Pulmonol. 2021; 11: 10.1002/ppul.25245. DOI: 10.1002/ppul.25245. PMID: 33428826; PMCID: PMC801339.Tang Y., Li W., Baskota M., Zhou Q., Fu Z., Luo Z., et al. Multisystem inflammatory syndrome in children during the coronavirus disease 2019 (COVID-19) pandemic: a systematic review of published case studies. Transl Pediatr. 2021; 10 (1): 121–35. DOI: 10.21037/tp-20-188. PMID: 33633944; PMCID: PMC7882293.Tang Y., Li W., Baskota M., Zhou Q., Fu Z., Luo Z., et al. Multisystem inflammatory syndrome in children during the coronavirus disease 2019 (COVID-19) pandemic: a systematic review of published case studies. Transl Pediatr. 2021; 10 (1): 121–35. DOI: 10.21037/tp-20-188. PMID: 33633944; PMCID: PMC7882293.Daskalakis D. Health Alert# 13: pediatric multi-system inflammatory syndrome potentially associated with COVID-19 // NYC Health [Internet]. 2020 May [cited 2021 Apr 07]. Available from: https://www1.nyc.gov/assets/doh/downloads/pdf/han/alert/2020/covid-19-pediatric-multi-system-inflammatorysyndrome.pdf.Daskalakis D. Health Alert# 13: pediatric multi-system inflammatory syndrome potentially associated with COVID-19 // NYC Health [Internet]. 2020 May [cited 2021 Apr 07]. Available from: https://www1.nyc.gov/assets/doh/downloads/pdf/han/alert/2020/covid-19-pediatric-multi-system-inflammatorysyndrome.pdf.Ahmed M., Advani S., Moreira A., Zoretic S., Martinez J., Chorath K., et al. Multisystem inflammatory syndrome in children: A systematic review. EClinicalMedicine. 2020; 26: 100527. DOI: 10.1016/j.eclinm.2020.100527. PMID: 32923992; PMCID: PMC7473262.Ahmed M., Advani S., Moreira A., Zoretic S., Martinez J., Chorath K., et al. Multisystem inflammatory syndrome in children: A systematic review. EClinicalMedicine. 2020; 26: 100527. DOI: 10.1016/j.eclinm.2020.100527. PMID: 32923992; PMCID: PMC7473262.Jindal A.K., Pilania R.K., Prithvi A., Guleria S., Singh S. Kawasaki disease: characteristics, diagnosis, and unusual presentations. Expert Rev Clin Immunol. 2019; 15 (10): 1089–104. DOI: 10.1080/1744666X.2019.1659726. PMID: 31456443.Jindal A.K., Pilania R.K., Prithvi A., Guleria S., Singh S. Kawasaki disease: characteristics, diagnosis, and unusual presentations. Expert Rev Clin Immunol. 2019; 15 (10): 1089–104. DOI: 10.1080/1744666X.2019.1659726. PMID: 31456443.Whittaker E., Bamford A., Kenny J., Kaforou M., Jones C.E., Shah P., et al. PIMS-TS Study Group and EUCLIDS and PERFORM Consortia. Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2. JAMA. 2020; 324 (3): 259–69. DOI: 10.1001/jama.2020.10369. PMID: 32511692; PMCID: PMC7281356.Whittaker E., Bamford A., Kenny J., Kaforou M., Jones C.E., Shah P., et al. PIMS-TS Study Group and EUCLIDS and PERFORM Consortia. Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2. JAMA. 2020; 324 (3): 259–69. DOI: 10.1001/jama.2020.10369. PMID: 32511692; PMCID: PMC7281356.Wu L., O'Kane A.M., Peng H., Bi Y., Motriuk-Smith D., Ren J. SARS-CoV-2 and cardiovascular complications: From molecular mechanisms to pharmaceutical management. Biochem Pharmacol. 2020; 178: 114114. DOI: 10.1016/j.bcp.2020.114114. PMID: 32579957; PMCID: PMC7306106.Wu L., O'Kane A.M., Peng H., Bi Y., Motriuk-Smith D., Ren J. SARS-CoV-2 and cardiovascular complications: From molecular mechanisms to pharmaceutical management. Biochem Pharmacol. 2020; 178: 114114. DOI: 10.1016/j.bcp.2020.114114. PMID: 32579957; PMCID: PMC7306106.Royal College of Paediatric and Child Health. Guidance: paediatric multisystem inflammatory syndrome temporally associated with COVID-19. 2020 May 01 (cited 2021 Apr 07). Available from: https://www.rcpch.ac.uk/resources/guidance-paediatricmultisystem-inflammatory-syndrome-temporally-associatedcovid-19.Royal College of Paediatric and Child Health. Guidance: paediatric multisystem inflammatory syndrome temporally associated with COVID-19. 2020 May 01 (cited 2021 Apr 07). Available from: https://www.rcpch.ac.uk/resources/guidance-paediatricmultisystem-inflammatory-syndrome-temporally-associatedcovid-19.Cuomo A.M., Zucker H.A., Dreslin S. Health advisory: pediatric multi-system inflammatory syndrome potentially associated with сoronavirus disease (COVID-19) children // New York State of Opportunity. Department of Health. 2020 May 06 (cited 2021 Jan 24). Available from: https://www.health.ny.gov/press/releases/2020/docs/2020-05-06_covid19_pediatric_inflammatory_syndrome.pdf.Cuomo A.M., Zucker H.A., Dreslin S. Health advisory: pediatric multi-system inflammatory syndrome potentially associated with сoronavirus disease (COVID-19) children // New York State of Opportunity. Department of Health. 2020 May 06 (cited 2021 Jan 24). Available from: https://www.health.ny.gov/press/releases/2020/docs/2020-05-06_covid19_pediatric_inflammatory_syndrome.pdf.Лобзин Ю.В., Вильниц А.А., Костик М.М. и др. Педиатрический мультисистемный воспалительный синдром, ассоциированный с новой коронавирусной инфекцией: нерешенные проблемы. Журнал инфектологии. 2021; 13 (1): 13–20. https://doi.org/10.22625/2072-6732-2021-13-1-13-20.Lobzin Ju.V., Vilnic A.A., Kostik M.M. i dr. Pediatricheskij mul'tisistemnyj vospalitel'nyj sindrom, associirovannyj s novoj koronavirusnoj infekciej: nereshennye problemy. Zhurnal infektologii. 2021; 13 (1): 13–20. https://doi.org/10.22625/2072-6732-2021-13-1-13-20. Russian.Kawasaki T. Kawasaki disease. Proc Jpn Acad Ser B Phys Biol Sci. 2006; 82 (2): 59–71. DOI: 10.2183/pjab.82.59. PMID: 25792773; PMCID: PMC4323050. 30. Kawasaki T. Kawasaki disease. Int J Rheum Dis. 2014; 17 (5): 597–600. DOI: 10.1111/1756-185X.12408.Kawasaki T. Kawasaki disease. Proc Jpn Acad Ser B Phys Biol Sci. 2006; 82 (2): 59–71. DOI: 10.2183/pjab.82.59. PMID: 25792773; PMCID: PMC4323050.Александрович Ю.С., Алексеева Е.И., Бакрадзе М.Д. и др. Особенности клинических проявлений и лечения заболевания, вызванного новой коронавирусной инфекцией (COVID-19), у детей. Методические рекомендации. Версия 2. Педиатрическая фармакология. 2020; 17 (3): 187–212. DOI: 10.15690/pf.v17i3.2123.Kawasaki T. Kawasaki disease. Int J Rheum Dis. 2014; 17 (5): 597–600. DOI: 10.1111/1756-185X.12408.Aleksandrovich Ju.S., Alekseeva E.I., Bakradze M.D. i dr. Osobennosti klinicheskih projavlenij i lechenija zabolevanija, vyzvannogo novoj koronavirusnoj infekciej (COVID-19), u detej. Metodicheskie rekomendacii. Versija 2. Pediatricheskaja farmakologija. 2020; 17 (3): 187–212. DOI: 10.15690/pf.v17i3.2123. Russian.Aleksandrovich Ju.S., Alekseeva E.I., Bakradze M.D. i dr. Osobennosti klinicheskih projavlenij i lechenija zabolevanija, vyzvannogo novoj koronavirusnoj infekciej (COVID-19), u detej. Metodicheskie rekomendacii. Versija 2. Pediatricheskaja farmakologija. 2020; 17 (3): 187–212. DOI: 10.15690/pf.v17i3.2123. Russian.

The authors declare that there are no conflicts of interest present.