CO-INFECTION WITH COVID-19 AND GENETIC DIVERSITY OF SARS-COV-2 IN CHILDREN

Main Article Content

Authors

D. Kamalova

National Biotechnology Center, Kurgalzhynskoye road, Astana, 010000, Kazakhstan
Eurasian National University named after L.N. Gumilyov , 2 Satbaev st., Astana, 010000, Kazakhstan

M. Makibayeva

Department of pediatric diseases with courses in cardio-rheumatology and gastroenterology, Astana Medical University, Beybitshilik street 49a, Astana, 010000, Kazakhstan

A. Amirgazin

National Biotechnology Center, Kurgalzhynskoye road, Astana, 010000, Kazakhstan.

S. Abdrakhmanova

Department of pediatric diseases with courses in cardio-rheumatology and gastroenterology, Astana Medical University, Beybitshilik street 49a, Astana, 010000, Kazakhstan

I. Sytnik

National Biotechnology Center, Kurgalzhynskoye road, Astana, 010000, Kazakhstan

A. Tuleubaeva

Department of pediatric diseases with courses in cardio-rheumatology and gastroenterology, Astana Medical University, Beybitshilik street 49a, Astana, 010000, Kazakhstan

E Ramankulov

National Biotechnology Center, Kurgalzhynskoye road, Astana, 010000, Kazakhstan

A. Shevtsov

National Biotechnology Center, Kurgalzhynskoye road, Astana, 010000, Kazakhstan

Abstract

In the pediatric population, coronavirus infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is more commonly observed in asymptomatic and moderately symptomatic cases. However, when COVID-19 coexists with other infections, it can result in a more severe disease progression. Various subtypes of the SARS-CoV-2 virus are associated with different clinical presentations, with certain subtypes exhibiting a predominance of specific symptoms or manifestations. Clinical manifestations of COVID-19 in children, both during the acute phase of the disease and in the post-COVID-19 period, are not fully understood and different compared to adults. This article presents four clinical cases in which PCR-confirmed COVID-19 was observed in combination with infections caused by viruses such as Ebstein-Barr, varicella, and rotavirus. The severity of the disease in these cases was attributed to symptoms related to intoxication, as well as skin and intestinal syndromes. To understand important genomic signatures of SARS-CoV-2 virus circulating in the area, the genome-wide sequencing was performed for the SARS-CoV-2 samples isolated from nasopharyngeal swabs collected from four patients. Based on the genotyping results, all four samples were found belonging to the SARS-CoV-2 virus Omicron lineage. Three months after the initial testing, follow-up evaluations of the children indicated a higher likelihood of complete recovery. However, some underlying disease manifestations, including anemia and atopic dermatitis, persisted despite the resolution of COVID-19 symptoms.

Keywords

COVID-19, SARS-COV-2, PCR, children, dermatological manifestations, post-COV syndrome, pyrosequencing

Article Details

References

Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin // Nature. – 2020. 579(7798): - p. 1–4.

da Rosa Mesquita, R., Francelino Silva Junior, L. C., Santos Santana, F. M., Farias de Oliveira, T., Campos Alcântara, R., Monteiro Arnozo, G., Freire de Souza, C. D. Clinical manifestations of COVID-19 in the general population: systematic review // Wiener klinische Wochenschrift. -2021. 133(7-8), - p. 377-382.

Butowt, R.; Bilinska, K. SARS-cov-2: Olfaction, Brain Infection, and the Urgent Need for Clinical Samples Allowing Earlier Virus Detection. ACS Chem. Neurosci. – 2020. – Vol. 11. - p. 1200–1203.

Baj, J., Karakuła-Juchnowicz, H., Teresiński, G., Buszewicz, G., Ciesielka, M., Sitarz, R., ... & Maciejewski, R. COVID-19: specific and non-specific clinical manifestations and symptoms: the current state of knowledge // Journal of clinical medicine. – 2020. – Vol. 9(6). - p. 1753.

Bansal, M. Cardiovascular disease and COVID-19 // Diabetes Metab. Syndr. Clin. Res. Rev. – 2020. – Vol. 14. - p. 247–250.

Zhu, H.; Rhee, J.-W.; Cheng, P.; Waliany, S.; Chang, A.; Witteles, R.M.; Maecker, H.; Davis, M.M.; Nguyen, P.K.; Wu, S.M. Cardiovascular Complications in Patients with COVID-19: Consequences of Viral Toxicities and Host Immune Response // Curr. Cardiol. Rep. – 2020. – Vol. 22. - p. 1–9.

Martora F, Fabbrocini G, Nappa P, Megna M. Impact of the COVID-19 pandemic on hospital admissions of patients with rare diseases: an experience of a Southern Italy referral center // Int J Dermatol. – 2022. – Vol. 61(7). Doi: 10.1111/ijd.16236. Epub 2022 May 10. PMID: 35538737; PMCID: PMC9347904.

Klejtman T. Skin and COVID-19 // J Med Vasc. -2020, – Vol. 45(4). –p. 175-176. Doi: 10.1016/j.jdmv.2020.06.001. PMID: 32571556; PMCID: PMC7304393.

Galván Casas C, Català A, Carretero Hernández G, Rodríguez-Jiménez P, Fernández-Nieto D, Rodríguez-Villa Lario A, Navarro Fernández I, Ruiz-Villaverde R, Falkenhain-López D, Llamas Velasco M, García-Gavín J, Baniandrés O, González-Cruz C, Morillas-Lahuerta V, Cubiró X, Figueras Nart I, Selda-Enriquez G, Romaní J, Fustà-Novell X, Melian-Olivera A, Roncero Riesco M, Burgos-Blasco P, Sola Ortigosa J, Feito Rodriguez M, García-Doval I. Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases // Br J Dermatol. – 2020. – Vol. 183(1). –p.71-77.

de Masson A, Bouaziz JD, Sulimovic L, Cassius C, Jachiet M, Ionescu MA, Rybojad M, Bagot M, Duong TA; SNDV (French National Union of Dermatologists-Venereologists). Chilblains is a common cutaneous finding during the COVID-19 pandemic: A retrospective nationwide study from France. J Am Acad Dermatol // - 2020. – Vol. 83(2). –p.667-670.

Visconti A, Bataille V, Rossi N, Kluk J, Murphy R, Puig S, Nambi R, Bowyer RCE, Murray B, Bournot A, Wolf J, Ourselin S, Steves CJ, Spector TD, Falchi M. Diagnostic value of cutaneous manifestation of SARS-cov-2 infection // Br J Dermatol. -2021 – Vol. 184(5). –p. 880-887.

Freeman EE, mcmahon DE, Lipoff JB, Rosenbach M, Kovarik C, Desai SR, Harp J, Takeshita J, French LE, Lim HW, Thiers BH, Hruza GJ, Fox LP. The spectrum of COVID-19-associated dermatologic manifestations: An international registry of 716 patients from 31 countries // J Am Acad Dermatol. – 2020. – Vol. 83(4). –p.1118-1129.

Marzano AV, Genovese G, Moltrasio C, Gaspari V, Vezzoli P, Maione V, Misciali C, Sena P, Patrizi A, Offidani A, Quaglino P, Arco R, Caproni M, Rovesti M, Bordin G, Recalcati S, Potenza C, Guarneri C, Fabbrocini G, Tomasini C, Sorci M, Lombardo M, Gisondi P, Conti A, Casazza G, Peris K, Calzavara-Pinton P, Berti E; Italian Skin COVID-19 Network of the Italian Society of Dermatology and Sexually Transmitted Diseases. The clinical spectrum of COVID-19-associated cutaneous manifestations: An Italian multicenter study of 200 adult patients // J Am Acad Dermatol. – 2021. – Vol. 84(5). –p.1356-1363.

Gianotti R, Coggi A, Boggio F, Fellegara G. Similarities in Cutaneous Histopathological Patterns between COVID-19-positive and COVID-19 High-risk Patients with Skin Dermatosis // Acta Derm Venereol. – 2020. – Vol. 19. –p.100.

Galván Casas C, Català A, Carretero Hernández G, Rodríguez-Jiménez P, Fernández-Nieto D, Rodríguez-Villa Lario A, Navarro Fernández I, Ruiz-Villaverde R, Falkenhain-López D, Llamas Velasco M, García-Gavín J, Baniandrés O, González-Cruz C, Morillas-Lahuerta V, Cubiró X, Figueras Nart I, Selda-Enriquez G, Romaní J, Fustà-Novell X, Melian-Olivera A, Roncero Riesco M, Burgos-Blasco P, Sola Ortigosa J, Feito Rodriguez M, García-Doval I. Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases // Br J Dermatol. – 2020. – Vol. 183(1).-p.71-77.

Woodruff, R. C., Campbell, A. P., Taylor, C. A., Chai, S. J., Kawasaki, B., Meek, J., ... & Havers, F. Risk factors for severe COVID-19 in children // Pediatrics. – 2022. – Vol. 149(1), e2021053418.

Brodin, P. Why is COVID-19 so mild in children? // Acta Paediatr. -2020.

Chang, T.-H.; Wu, J.-L.; Chang, L.-Y. Clinical characteristics and diagnostic challenges of pediatric COVID-19: A systematic review and meta-analysis // J. Formos. Med. Assoc. - 2020.

Matthai, J.; Shanmugam, N.; Sobhan, P. Indian Society of Pediatric Gastroenterology, Hepatology And Nutrition; Pediatric Gastroenterology Chapter Of Indian Academy Of Pediatrics // Indian Pediatr. – 2020. – Vol. 55.-p. 885–992.

Chen, H.; Guo, J.; Wang, C.; Luo, F.; Yu, X.; Zhang, W.; Li, J.; Zhao, D.; Xu, D.; Gong, Q.; et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: A retrospective review of medical records // Lancet. -2020. – Vol. 395. –p. 809–815.

Hunter, P. The return of the seasonal flu and cold: Other diseases are set to rebound as Covid‐19 restrictions ease // EMBO reports. - 2022.– Vol. 23(4), e54932.

Forrest, C. B., Burrows, E. K., Mejias, A., Razzaghi, H., Christakis, D., Jhaveri, R., ... & Bailey, L. C. Severity of acute COVID-19 in children< 18 years old March 2020 to December 2021 // Pediatrics. -2022. – Vol. 4. –p. 149.

Li H. Aligning sequence reads, clone sequences and assembly contigs with BWA-MEM //arxiv preprint arxiv:1303.3997. – 2013.

Danecek P. Et al. Twelve years of samtools and bcftools // Gigascience. – 2021. – – Vol. 10. – p. 2. Giab008.

Aksamentov I. Et al. Nextclade: clade assignment, mutation calling and quality control for viral genomes //Journal of Open Source Software. – 2021. – Vol. 6. –p.67.

O’Toole Á. Et al. Assignment of epidemiological lineages in an emerging pandemic using the pangolin tool //Virus evolution. – 2021. – Vol. 7(2).

De Paschale, M., & Clerici, P. (2012). Serological diagnosis of Epstein-Barr virus infection: Problems and solutions. World journal of virology, 1(1), 31.

IIša P. et al. Metagenomic analysis reveals differences in the co-occurrence and abundance of viral species in SARS-CoV-2 patients with different severity of disease //BMC Infectious Diseases. – 2022. – Т. 22. – №. 1. – С. 1-12.

García-Martínez FJ, Moreno-Artero E, Jahnke S. SARS-cov-2 and EBV coinfection // Med Clin (Engl Ed). - 2020 – Vol. 155(7). –p.319-320. Doi: 10.1016/j.medcle.2020.06.010. Epub 2020 Sep 12. PMID: 32953993; PMCID: PMC7486856.

Chen T, Song J, Liu H, Zheng H, Chen C. Positive Epstein-Barr virus detection in coronavirus disease 2019 (COVID-19) patients // Sci Rep. – 2021. – Vol. 11(1). –p.10902. Doi: 10.1038/s41598-021-90351-y. PMID: 34035353; PMCID: PMC8149409.

Соломай Т. В. И др. Реактивация инфекции, вызванной вирусом Эпштейна-Барр (Herpesviridae: Lymphocryptovirus, HHV-4), на фоне COVID-19: эпидемиологические особенности //Вопросы вирусологии. – 2021. – Т. 66. – №. 2. – С. 152-161.

Le Roux P, Millardet E, Duquenoy A, Labbé F, Vandendriessche A. Pleuropneumonia resulting from varicella and COVID-19 co-infection in a 10-month-old infant //Arch Pediatr. – 2020. – Vol. 27(8). –p. 509-510.

Изюрова Н. В. И др. Клинический случай сочетания covid-19 и ветряной оспы у подростка //российский вестник перинатологии и педиатрии. – 2022. – Т. 67. – №. 4. – С. 238

Кузьмина М. Н. И др. Клинический случай ветряной оспы, осложнённой менингоэнцефалитом и отёком головного мозга, в сочетании с новой коронавирусной инфекцией (COVID-19) у ребёнка 5 лет //Детские инфекции. – 2021. – Т. 20. – №. 2. – С. 64-67

Lopez-Trujillo E, Rodriguez Mercader S, Güerri-Fernández R, Arrieta Aldea I, Pujol RM, Martin-Ezquerra G. Varicella complicated with pneumonia in a patient infected by COVID-19: the need to rule out other viral coinfections in SARS-cov-2 patients with vesicular eruptions // Int J Dermatol. – 2021. – Vol. 60(7). –p.886-888.

Татаурщикова Н. С. И др. Иммуномодулирующая терапия в лечении пациентов с реактивацией герпесвирусной инфекции на фоне COVID-19. – 2022.

Мелехина Е.В. и др. Герпесвирусные инфекции и мультисистемный воспалительный синдром, ассоциированный с Sars-COV-2, у детей в клинических примерах. – 2022.

Морозова О. В. И др. Выявление sars-cov-2 (coronaviridae: coronavirinae: betacoronavirus: sarbecovirus) у детей с острой кишечной инфекцией в нижнем новгороде за период 2020-2021 ГГ // Вопросы вирусологии. – 2022. – Т. 67. – №. 1. – С. 69-76.

Kairov U, Amanzhanova A, Karabayev D, Rakhimova S, Aitkulova A, Samatkyzy D, Kalendar R, Kozhamkulov U, Molkenov A, Gabdulkayum A, Sarbassov D, Akilzhanova A. A high scale SARS-cov-2 profiling by its whole-genome sequencing using Oxford Nanopore Technology in Kazakhstan // Front Genet. -2022. – Vol. 13.

Drago F, Ciccarese G, Gasparini G, Cogorno L, Javor S, Toniolo A, Broccolo F. Contemporary infectious exanthems: an update // Future Microbiol. – 2017. – Vol. 12. –p.171-193.

Rongioletti F. SARS-cov, Mers-cov and COVID-19: what differences from a dermatological viewpoint? // J Eur Acad Dermatol Venereol. -2020. – Vol. 34(10). –p.581-582.