STRESS LEVEL IN SCHOOL-AGE CHILDREN WITH COVID-19

Authors

  • H. А. Pavlyshyn I. Horbachevsky Ternopil National Medical University
  • O. I. Panchenko I. Horbachevsky Ternopil National Medical University

DOI:

https://doi.org/10.11603/1811-2471.2023.v.i4.14306

Keywords:

children, COVID-19, stress, cortisol

Abstract

SUMMARY. The aim – to find out the level of stress in school-aged children with different courses of COVID-19 by determining their level of free salivary cortisol.

Material and Methods. Totally 90 children aged 6 to 18 years were examined: 60 patients with manifestations of laboratory-confirmed SARS-CoV-2 infection and 30 children without signs of the disease (control group). The level of free salivary cortisol was assessed in all children of this study. According to the severity of the disease, 3 groups were formed: the first – 20 children with a mild course of COVID-19, the second group – 31 patients with a moderate to severe course of the disease, the third – 9 children with severe COVID-19. Quantitative determination of the level of free cortisol in saliva was carried out by enzyme-linked immunosorbent assay (Cortisol Saliva Elisa, TECAN, Hamburg, Germany). The result was evaluated in micrograms/deciliter (μg/dL). Statistical analysis was carried out using the "Stat Plus" program. The result was considered statistically significant at p<0.05.

Results. The mean age of all children was (11.47±to 3.80) years. There was no significant difference between sex (c2=4.97; p=0.174) and age (p=0.490) in the study groups. The mean level of free salivary cortisol in children of the control group was 0.158 [0.088; 0.365] μg/dL, in children with manifestations of SARS-CoV-2 infection – 0.740 [0.313; 1.024] μg/dL (p<0.001). There was no significant difference in cortisol values between male and female patients (p=0.355). A significant increase in the level of this indicator was associated with the severity of the disease (H=27.30, P<0.001). There is a positive medium-strength correlation between the level of free cortisol and ESR (r=0.47, p<0.001), CRP (r=0.42, p<0.001), glycemic level (r=0.47, p=0.004), procalcitonin (r=0.31, p=0.044) duration of hyperthermia (r=0.39, p=0.006), duration of treatment (r=0.42, p=0.002).

Conclusions. Pediatric patients with COVID-19 have a higher level of stress, which reliably depends on the course of this disease. In children with manifestations of COVID-19, significantly higher levels of free salivary cortisol were observed compared to the control group, which indicates a higher level of stress in this group of patients. A significant increase in free cortisol levels is associated with an increase in pro-inflammatory markers (ESR, CRP, procalcitonin), as well as the duration of treatment and the duration of hyperthermia, indicating an increase in the severity of the disease. Cortisol in combination with other markers may be useful as a prognostic marker of disease outcome. Determination of cortisol levels in patients with COVID-19 may lead to new directions in the treatment of this disease.

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Published

2023-12-19

How to Cite

Pavlyshyn H. А., & Panchenko, O. I. (2023). STRESS LEVEL IN SCHOOL-AGE CHILDREN WITH COVID-19. Achievements of Clinical and Experimental Medicine, (4), 119–124. https://doi.org/10.11603/1811-2471.2023.v.i4.14306

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Section

Оригінальні дослідження