Seriakova I. Clinical and laboratory markers of to the nervous system damage in children with COVID-19.

This dissertation is devoted to the problem of the development of the nervous system damage in children with coronavirus infection (COVID-19). The medical and social significance of the problem is emphasized by the prevalence of COVID-19 and its various organs` and systems` complications. Damage to the nervous system because of COVID-19 occupies a leading place in the structure of the complicated course in adults and children. Considering the long course of the pandemic and the development of numerous complications due to COVID-19, the implementation of diagnostic approaches is urgent for the timely detection of probable lesions of the nervous system. The purpose of the research is to increase the effectiveness of diagnosis of nervous system damage and complicated course of coronavirus infection in children based on the study of biomarkers and analysis of the clinical indicators. The objectives of the research are the follows: 1. To study the peculiarities of the clinical picture of coronavirus infection in children. 2. To determine complications of the nervous system due to COVID-19. 3. To conduct the research on the level of neurobiomarkers (neuron-specific enolase (NSE), S100 protein) and a marker of vascular endothelium damage (E-selectin) in the blood serum of children with coronavirus infection. 4. To investigate the prognostic value of the level of biomarkers regarding the complicated course of the disease and development of the symptoms of nervous system damage in children with COVID-19. 5. To assess the role of the endothelium in the structure of nervous system damage in children with COVID-19 by determining the relationship of E-selectin with markers of nervous system damage (NSE and S100). In general, the study included 945 children aged 1 month to 18 years with a laboratory-confirmed diagnosis of COVID-19 by the PCR method who underwent inpatient treatment at the "Kyiv city children's clinical infectious disease hospital" in Kyiv, Ukraine. Among them, to conduct a cohort, observational, retrospective study, we determined the level of NSE, S100 and E-selectin markers in 88 patients in a complex of general clinical examinations in blood serum. Informed consent of parents and children was obtained. The design of this study was approved by the Commission on Bioethical Expertise and Scientific Research Ethics of Bogomolets National Medical University.