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.
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