Importance of herpes viruses in children with post-COVID conditions
DOI: 10.32364/2618-8430-2023-6-1-39-44
M.S. Savenkova1,2, I.A. Sotnikov2, A.A. Afanasieva1,2, Ya.V. Afanasieva3, R.V. Dushkin4
1Pirogov Russian National Research Medical University, Moscow, Russian Federation
2Morozov Children's City Clinical Hospital, Moscow, Russian Federation
3All-Russian Public Organization “Russian Academy of Engineering”, Moscow, Russian Federation
4LLC “Agency of Artificial Intelligence,” Moscow, Russian Federation
Aim: to assess the prevalence of detection of confirmed herpes virus infections (HVI) in children who had a previous COVID-19 infection, characterize specific clinical manifestations of the disease under the new conditions (post-COVID syndrome), and to provide a rationale for the administration of drug therapy.
Patients and Methods: of 456 patients who received medical consultations from September 2021 to July 2022, the authors selected 72 (15.8%) children (42 boys and 30 girls) who had a previous SARS-CoV-2 infection confirmed by serological tests or polymerase chain reaction and in whom herpes viruses were found during serological evaluation.
Results: most of the children (81.4%) visited the polyclinic within the first six months after the COVID-19 infection. Epstein-Barr virus (EBV) was the most prevalent finding among herpesviruses detected in children with post-COVID-19 sequela — it was detected in 44 (61.1%) cases. Human herpesvirus (HHV) 6 and cytomegalovirus (CMV) were less common in this group and found in 41 (56.9%) and 30 (41.7%) children, respectively. HHV-1 and HHV-2 were detected more rarely — in 11 (15.3%) children. Monoinfection was diagnosed in 41 (56.9%) cases and a combination of viruses was found in 31 children, in 22 (71.0%) of them it comprised two viruses, in 6 (19.3%) — three viruses, and in 3 (9.7%) — four viruses. The presence of herpesvirus infections underpinned the main reasons why parents of the ill children were seeking for outpatient care, in particular: a prolonged subfebrile condition (18.0%), fatigue and sleep disorders (27.7%), rashes (16.6%), lymphadenopathy (16.7%), ENT diseases (33.3%), more frequently occurring respiratory diseases (33.3%), and the increase in seizure activity in children with epilepsy (8.3%). In addition to herpes viruses, pathogenic agents were detected in 18% of patients, including intracellular pathogens, which were found in 13.9% of 72 children. Taking into consideration the obtained results and established clinical diagnoses, the authors conducted a review and provided a rationale for the administered drug therapy, including medications for herpes treatment.
Conclusion: a prior COVID-19 infection induces immunosuppression and, as a result, the activation of herpesvirus infections as long-term effects of COVID-19 (post-COVID conditions). The presence of mixed viral and bacterial pathogens is an indication for administering antivirals, immunomodulators, antibacterial agents, and probiotics.
Keywords: post-COVID conditions, herpesvirus infections, children, clinical symptoms, treatment.
For citation: Savenkova M.S., Sotnikov I.A., Afanasieva A.A. et al. Importance of herpes viruses in children with post-COVID conditions. Russian Journal of Woman and Child Health. 2023;6(1):39–44 (in Russ.). DOI: 10.32364/2618-8430-2023-6-1-39-44.
About the authors:
Marina S. Savenkova — Dr. Sc. (Med.), Professor of the Department of Clinical Functional Diagnostics of the Faculty of Additional Professional Education, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117997, Russian Federation; pediatrician, Consultative and Diagnostic Center "Morozov Children's City Clinical Hospital"; 1/9, 4th Dobryninsky proezd, Moscow, 119049, Russian Federation; ORCID iD 0000-0002-1648-8683.
Ilya A. Sotnikov — C. Sc. (Med.), Head of Consultative and Diagnostic Center "Morozov Children's City Clinical Hospital"; 1/9, 4th Dobryninsky proezd, Moscow, 119049, Russian Federation.
Aida A. Afanasieva — C. Sc. (Med.), assistant of the Department of Clinical Functional Diagnostics of the Faculty of Additional Professional Education, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117997, Russian Federation; ORCID iD 0000-0001-5328-4877.
Yana V. Afanasieva — Academic advisor of the All-Russian Public Organization "Russian Academy of Engineering"; 9, bldn. 4, Gazetny per., Moscow, 125009, Russian Federation.
Roman V. Dushkin — Director for Science and Technologies, LLC "Agency of Artificial Intelligence"; 75b, bldn. 2, Dubninskaya str., Moscow, 127591, Russian Federation; ORCID iD 0000-0003-4789-0736.
Contact information: Marina S. Savenkova, e-mail: mpsavenkov@mail.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 05.12.2022.
Revised 28.12.2022.
Accepted 27.01.2023.
2. Baimukhambetova D.V., Gorina A.O., Rumyantsev M.A. et al. Post-COVID condition in adults and children. Pul'monologiya. 2021;31(5):562–570 (in Russ.). DOI: 10.18093/0869-0189-2021-31-5-562-570.
3. Recommendations for the management of patients with coronary infection COVID-19 in the acute phase and with post-COVID syndrome on an outpatient basis. Vorobiev P.A., ed. Health care Standardization Problems. 2021;7–8:3–96 (in Russ.). DOI: 10.26347/1607-2502202107-08003-096.
4. Amirov N.B., Davletshina E.I., Vasilieva A.G., Fatykhov R.G. Postcovid syndrome: multisystem "deficits". The Bulletin of Contemporary Clinical Medicine. 2021;14(6):94–104. DOI: 10.20969/VSKM.2021.14(6).94-104.
5. Solomay T.V., Semenenko T.A., Isaeva E.I. et al. COVID-19 and the risk of herpesvirus reactivation. Epidemiology and Infectious Diseases. Current Items. 2021;11(2):55–62. DOI: 10.18565/epidem.2021.11.2.55-62.
6. Vikulov G.Kh., Oradovskaya I.V. Clinical and immunological characteristics of COVID-19 associated with human herpesvirus infections: management algorithms for mixed infections. Infectious diseases. 2021;19(4):79–90 (in Russ.). DOI: 10.20953/1729-9225-2021-4-79-90.
7. Votava M., Beran J. The role of non-specific immunostimulant inosine pranobex in the treatment of SARS-CoV-2 virus infection (Electronic resource.) URL: https://www.researchgate.net/publication/341043129_The_role_of_non-specific_immunostimulant_inosine_pranobex_in_the_treatment_of_SARS-CoV-2_virus_infection (access date: 04.2020).
8. Savenkova M.S., Balakireva G.M., Kuznetsova E.S. et al. Experience of treatment with Groprinosin (inosine pranobex) for herpes virus infection in children with epilepsy and infantile cerebral palsy. Pediatrics. Consilium Medicum. 2019;4:51–57. DOI: 10.26442/26586630.2019.4.190750.
9. Mitrofanov A.V., Gasilina E.S., Kitaichik S.M. Comparative efficacy of antiviral therapy for infectious mononucleosis in children. Practical medicine. 2012;7-1(63):63.
10. Savenkova M.S., Afanaseva A.A., Balakirev G.M. et al. Clinical experience in the treatment of diseases of the respiratory tract with Groprinosin (inosine pranobex) in pediatric practice. Pediatrics (Suppl. Consilium Medicum). 2018;4:32–36 (in Russ.). DOI: 10.26442/24138460.2018.4.180112.
11. Isakov D.V., Isakov V.A., Alekseeva E.A. Immunomodulators for treatment and prevention of respiratory and herpesvirus infections. Klinicheskaya farmakologiya i terapiya. 2018;27(5):76–84 (in Russ.). DOI: 10.32756/0869-5490-2018-5-76-84.
12. Looker K.J., Magaret A.S., May M.T. Global and regional estimates of prevalent and incident Herpes simplex virus type 1 infections in 2012. PLoS One. 2015;10(10):e0140765. DOI: 10.1371/journal.pone.0140765.
13. Masihi K.N. Immunomodulatory agents for prophylaxis and therapy of infections. Int J Antimicrob Agents. 2000;14(3):181–191. DOI: 10.1016/s0924-8579(99)00161-2.
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