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Background. Since the onset of the coronavirus disease 2019 (COVID-19) epidemic until January 1, 2024, more than 5.5 million confirmed cases of COVID-19 have been detected in Ukraine according to official data, approximately 6 % of them among children under 18 years old. Aim: to improve the management of newborns based on studies of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with different course. Materials and methods. Eleven newborns (7 boys and 4 girls) diagnosed with SARS-CoV-2 confirmed by polymerase chain reaction were observed. Disease progression, results of laboratory and instrumental studies were analyzed. Results. An analysis of clinical data and the results of laboratory and instrumental investigations are presented, as well as treatment outcomes in newborns with confirmed COVID-19. It was found that in all cases, children were infected from mothers with SARS-CoV-2. The frequency of clinical symptoms is provided, revealing discrepancies between respiratory symptoms and changes identified on lung ultrasound. Most children exhibited anemia, elevated D-dimer levels in the blood, yet experienced a mild course of the disease. The average duration of illness prior to hospitalization was 3.70 ± 1.48 days, with a hospital stay of 4.01 ± 1.22 days. An exception was in case of patient N., characterized by a severe condition necessitating prolonged oxygen therapy, mechanical ventilation, and administration of remdesivir. This particular case is detailed in the article. Conclusions. In most infants under one month of age observed in this study, the course of ­COVID-19 caused by SARS-CoV-2 was characterized by symptoms such as lethargy, hyperthermia, nasal congestion, diarrhea, and changes detected only through laboratory and instrumental stu­dies: anemia, abnormalities in the coagulation system, and increased lung parenchymal density. Ho­wever, the disease course in infants of this age can also be very severe, with lung parenchymal involvement, pneumonia, COVID-19-associated coagulopathy, complicated by generalized bacterial infection, as presented in the clinical case.

Порушення формування кишкової мікробіоти в передчасно народжених немовлят підвищує ймовірність виникнення некротизуючого ентероколіту (НЕК) і пізнього неонатального сепсису (ПНС). Застосування пробіотиків може знижувати відповідний ризик. Мета - оцінити клінічну ефективність Lactobacillus reuteri DSM 17938 у зниженні частоти НЕК і ПНС, загальної смертності в немовлят із терміном гестації (ТГ) ≤32 тиж, а також вплив цього пробіотика на формування мікробіоти травного каналу. Матеріали та методи. До відкритого рандомізованого дослідження залучено 100 немовлят із ТГ ≤32 тиж, масою тіла при народженні ≤1500 г. У групі пробіотика 50 дітям до досягнення постменструального віку (ПМВ) 36 тиж призначено Lactobacillus reuteri DSM 17938 у дозі 108 КУО/добу з ентеральним харчуванням (ЕХ), а у групі порівняння 50 дітям - стандартне лікування. Основними критеріями ефективності були частота НЕК, ПНС і загальна смертність. Як додаткові критерії ефективності використано вік дітей на момент досягнення повного об’єму ЕХ, кількість епізодів зниженої толерантності до ЕХ, тривалість антибактеріальної терапії, масу тіла у ПМВ 36 тиж і тривалість госпіталізації. Результати. Застосування Lactobacillus reuteri DSM 17938 у дозі 108 КУО/добу не знижувало ні частоти НЕК і ПНС, ні загальної смертності. Однак це втручання достовірно скорочувало тривалість загальної госпіталізації в немовлят із ТГ ≥28 тиж (56,0 (46,0-71,0) діб проти 65,0 (60,0-87,9) діб; р=0,03), а також асоціювалося зі швидшим досягненням повного об’єму ЕХ (23,0 (16,0-37,0) доби проти 30,0 (18,0-37,0) діб; р=0,26), та зменшенням кількості епізодів зниженої толерантності до ЕХ у немовлят із ТГ

Introduction. Excessive intestinal inflammation in preterm infants is one of the key factors in the development of necrotizing enterocolitis (NEC), early- (EOS) and late-onset neonatal sepsis (LOS). Purpose - to evaluate the connection between fecal calprotectin (FC), enteral use of lactoferrin (LF), and the occurrence of NEC, EOS, and LOS in preterm infants. Materials and methods. FC was measured in 26 newborns with gestational age (GA) ≤32 weeks and birth weight ≤1500 g. Feces were collected twice: in the first 7 days of life and at the postmenstrual age (PMA) of 36 weeks. The main group included 15 infants with either EOS, LOS or NEC. The remaining 11 infants formed the comparison group. Eleven infants received LF (4 in the main group and 7 in the comparison group), which was randomly administered in the first 3 days of life. Results. FC in the first 7 days of life was higher in the main group (р>0.05). At the PMA of 36 weeks, FC decreased in the main group and increased in the comparison group (p>0.05). FC in the first week of life was higher in infants with EOS compared to newborns without the diseases (p=0.03), followed by a decrease at the PMA of 36 weeks (p=0.04). There was no significant difference in FC levels depending on the development of LOS or NEC. FC levels increased in all infants who received LF and decreased in babies who did not receive LF (p>0.05). Conclusions. The occurrence of EOS is associated with a significant increase in FC which subsequently decrease by the PMA of 36 weeks. FC in the first week of life are not associated with the development of NEC or LOS. Enteral use of LF at a dose of 100 mg/day is associated with an increase in FC levels (p>0.05). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Гемодинамічно значуща відкрита артеріальна протока (гзВАП) є поширеним ускладненням у значно недоношених немовлят, які народилися з гестаційним віком менше 32 тиж. Водночас, на сьогодні немає єдиних критеріїв визначення дійсної гемодинамічноъ значущості ВАП і загальновизнаної тактики надання допомоги таким дітям. Мета — оцінити прогностичну цінність рівнів амінотермінального сегмента натрійуретичного пептиду В-типу (NT-proBNP) у сироватці крові значно недоношених новонароджених щодо гемодинамічної значущості ВАП. Матеріали та методи. До клінічного рандомізованого дослідження залучено 52 недоношені дитини з терміном гестації 1,5 мм. Із них 27 (52%) дітям призначено ібупрофен або парацетамол із перших 3 діб життя. Очікувальну тактику застосовано у 25 (48%) новонароджених. Усім пацієнтам щодня проведено ехокардіографічне обстеження та двічі визначено вміст NT-proBNP у сироватці крові в перші 10 діб після народження. За підсумками ехокардіографічного та клінічного моніторингу ретроспективно сформовано дві групи немовлят: у 22 (42%) з них діагностовано гзВАП, а у 30 (58%) — гемодинамічно незначущу ВАП. Результати. Відсоткова кількість дітей, які отримали фармакологічне лікування з приводу ВАП, істотно не різнилася по групах (p>0,05). Сироваткові концентрації NT-proBNP у середньому віці 2 і 8 діб були вірогідно вищими в немовлят зі гзВАП (p12000 пг/мл дає змогу вірогідно прогнозувати формування гзВАП. Дослідження виконано відповідно до принципів Гельсінської Декларації. Протокол дослідження ухвалено Локальним етичним комітетом зазначеної в роботі установи. На проведення досліджень отримано інформовану згоду батьків дітей. Автори заявляють про відсутність конфлікту інтересів.

Malnutrition (undernutrition) and related faltering growth in young children are common medical problems, which in developed countries are mainly associated with underlying diseases, chronic conditions, injuries, burns, and surgeries. Malnutrition and faltering growth can also be of a “non-organic” origin and arise due to behavioral, socioeconomic, and environmental factors. To date, there are no generally accepted definitions of malnutrition and faltering growth in children, which complicates the diagnosis and study of the epidemiology of these conditions. Under such circumstances, it is advisable to use the diagnostic criteria of the World Health Organization and leading international professional associations. Know­ledge of risk factors and preconditions for malnutrition, as well as the corresponding nutritional needs allows timely adjusting the diet, especially of sick children, through the use of special milk formulas with a high content of energy, protein and micronutrients. These food products have proven clinical effectiveness, are available on the Ukrainian market, and are recommended not only for prevention but also for the treatment of children with faltering growth.

Introduction. Patent ductus arteriosus (PDA) is a common problem in preterm infants, which can cause complications and worsen the results of treatment. However, there is no unambiguous approach to the management of PDA. Objective. The aim of this study was to compare the efficacy of the pharmacological closure of the PDA with ibuprofen and paracetamol in premature newborns. Also, the effectiveness and feasibility of expectant management without pharmacological treatment has been evaluated. Materials and methods. 80 preterm infants (gestation age < 32 wks) with PDA diagnosed by echocardiography were enrolled into a retrospective study. Thirty of them received ibuprofen (ibuprofen group), 21 newborns were treated with paracetamol (paracetamol group), and 29 neonates were managed expectantly(comparison group).The first dose of both drugs was introduced in a median (IQR) age of 6 days (6 [1-21] days for ibuprofen and 6 [3-14] days for paracetamol; p>0.05). Results. The study groups were not different either in birth weight or in gestational age. The median(IQR) size of PDA was 3 [1.0-4.5] mm in the ibuprofen group, 2.5 [1.5-4] mm in the paracetamolgroup and 2.5 [1.0-4] in the comparison group(р0.05). Treatment with ibuprofen was effective in 27 (90%), and paracetamol – in 15 (71%) babies (p>0.05). Spontaneous closure of the PDA was observed in 21 (72%) infants from the comparison group. The median age of the babies at the time of PDA closure was 21 [6-78] days when treated with ibuprofen, 23 [8-71] days with paracetamol use, and 17 [7-48] days in the comparison group(p>0.05). 2 infants (7%) in the ibuprofen group and 3 infants (14%) in the paracetamolgroup (p> 0.05) required surgical intervention. There were no statistically significantdifferences either in the incidences of bronchopulmonary dysplasia (BPD), BPD/ death, intraventricular haemorrhage, necrotizing enterocolitis or in the length of stay and mortality rate between the groups (р>0.05). No complications connected to pharmacological treatment were seen. Conclusions. Paracetamol could be an effective and safe alternative to ibuprofen for pharmacological closure of the hemodynamically significant arterial ductus. The closure of the hemodynamically insignificant PDA can happen without pharmacological and/or surgical interventions in a 72% of very preterm infants.

The article presents the main results of prospective multicenter study of effectiveness of using amino acid formula in diet therapy for the infants with severe atopic dermatitis (AD) and allergy to cow's milk protein (CMP). The study was conducted in 5 centers of Ukraine and included 30 infants with severe atopic dermatitis (EASI score > 18) aged from 29 days to 11 months. 22 patients completed the study. Diet therapy considered administration of amino acid formula containing 100 % free amino acids, for 4 weeks. Evaluation of clinical effectiveness of AD and allergy to CMP diet therapy with amino acid formula was carried out on the 7th, 14th and 28th day after reaching the full daily volume of the formula. Provocative test was performed on the 28th day with extensively hydrolyzed whey protein formula followed with evaluation of immediate and late reactions. Infants with severe AD (EASI score > 18) were characterized by impairment of several organs and systems: in 68 % of cases skin symptoms were associated with the gastrointestinal signs like change in stool frequency (constipation, diarrhea), appearance of pathological admixtures in feces (mucus, blood), vomiting, and others. With administration of amino acid formula significant decrease in severity of skin (98 %) and gastro-intestinal manifestations of food allergy (82 %) were seen. Amino acid formula was well tolerated by children with severe AD and, if needed, it might be used as a therapeutic formula for an exclusive feeding of infants with severe allergies to CMP. Duration of the diet therapy should not be less than 4 weeks. High effectiveness of this formula in infants with AD was proved by parents and doctors.