Clinical features of COVID-19 in children with a chronic adenotonsillar disorder

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Abstract

BACKGROUND: COVID-19, caused by SARS-CoV-2, is a highly contagious infectious disease associated with a risk of severe complications. In Russia, the COVID-19 incidence has exceeded 24 million, with new strains raising the incidence in children up to 18%. The prevalence of long COVID is rising. In children, the adaptive immune system, including the lymphoepithelial ring of the throat, plays a key role in determining the severity of COVID-19. The lymphoid tissue of the Waldeyer’s ring is one of the first immune barriers against coronaviruses and other respiratory infections. The high incidence of co-infection worsens the course of the disease. A chronic adenotonsillar disease has incidence of 32%–35% in children. However, impact of this disease on the severity of COVID-19 and the incidence of co-infection in children is poorly understood.

AIM: The aim of the study was to evaluate impact of the chronic adenotonsillar disease on COVID-19 progression and the incidence of co-infections in children.

MATERIALS AND METHODS: Conducted in St. Petersburg from January 2022 to March 2023, the study included 493 children (300 with COVID-19 and 144 with chronic adenotonsillar disease). Patients were divided into four groups to evaluate impact of chronic adenotonsillar disease on COVID-19 progression. Non-parametric statistical methods were used to analyze the clinical data.

RESULTS: Children with both COVID-19 and chronic adenotonsillar disease demonstrated a more severe course of disease compared to those without chronic adenotonsillar disease. The first group showed an increased incidence of bronchitis, bacterial co-infections, longer hospitalization and disease duration, longer fever duration, and higher maximum temperature. Laboratory data showed higher white blood cell counts in patients with COVID-19 and chronic adenotonsillar disease compared to those without chronic adenotonsillar disease.

CONCLUSIONS: Chronic adenotonsillar disease significantly complicates the course of COVID-19 in children. Further research is needed to elucidate the pathophysiological mechanisms and optimize treatment strategies for children with chronic adenotonsillar disease.

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About the authors

Vladislav V. Afanasev

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: streetva@gmail.com
ORCID iD: 0009-0006-9039-6265

Postgraduate student

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015

References

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Supplementary files

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2. Fig. 1. Distribution of Patients in the Study Groups by Gender. CAP+ and CAP–: with and without Chronic Adenotonsillar Pathology; COVID-19+ and COVID-19–: with and without New Coronavirus Infection

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3. Fig. 2. Prevalence of chronic adenotonsillar pathology by age in groups with COVID-19+ and COVID-19–

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