Asthenic syndrome and features of cerebral blood flow in respiratory infections in children

Abstract

The problem of diagnosing asthenic syndrome (AS) after infectious diseases does not lose its relevance. The aim of the study was to analyze the relationship between cerebral blood flow disorders and the development of asthenic disorders in children after acute respiratory viral infections, as well as to develop a model for predicting the development of asthenic syndrome in children during the period of COVID-19 convalescence. Materials and methods. 203 children aged 7 to 17 years were examined. The 1st group consisted of 147 children who had COVID-19; the second group consisted of 30 chil- dren who had a rhinovirus infection; 26 healthy children made up the control group. All children were assessed at baseline and after 30 days: the frequency and severity of AS on the L.D. Malkova scale, transcranial duplex scanning (TDS) of cerebral vessels with the determination of the reactivity index (IR). Results. A higher incidence of AS was found in group 1 compared with group 2 (p<0.001), both at baseline (96.6% and 23.3%) and after 1 month (91.9% and 23.3%) with a decrease in IR, which this indicated tension and exhaustion of autoregulatory mechanisms. When studying the frequency of IR violations, the same patterns were revealed. Conclusion. The course of viral infections caused by SARS-CoV-2 and rhinovirus in children is characterized by a similarity of clinical manifestations, however, the development and degree of asthenic and somatovegetative syndromes depend on the etiology of the pathogen, its tropicity to the nervous tissue and vascular endothelial cells. The established relationship between the presence of asthenic disorders and indicators of cerebrovascular blood flow in children during convalescence 1 month after coronavirus infection makes it possible to predict the risk of developing asthenic disorders at the early stages of the pathological process using a highly effective model with an accuracy of 95,9%.