The clinical course of acute upper respiratory infection in children: results of a cohort study
Information on the dynamics of resolution of clinical symptoms in children with acute respiratory viral infections (ARVI) can better treat children and reduce the frequency of repeat visits to the doctor.
Treating children with acute respiratory viral infections (ARVI) on an outpatient basis when parents are caring for a sick child has been proposed as one of the measures to reduce the burden on medical facilities. However, adults who observe a child can see a doctor again and expect antibiotics to be prescribed if they do not have a clear idea of how quickly symptoms of the disease will resolve and how long they will last. of the disease, or if the dynamics of SARS in their child does not respect the planned dates. In this regard, CCButler and colleagues (Great Britain) have attempted to describe the dynamics of clinical symptoms in children with acute respiratory viral infections seeking medical help to help practitioners better predict course of the disease.
A secondary analysis of a cohort from a randomized controlled trial was carried out, the aim of which was to compare the effectiveness of local intranasal therapy with sodium cromoglycate and physiological saline. The study involved children aged 6 months to 12 years with upper respiratory tract infections of likely viral etiology, who sought medical help from general practitioners. The study did not include children who received antibiotic therapy. Since the clinical and statistical results of the treatment were the same, when performing a cohort study, all patients were considered as one group.
Of the 290 children participating in the study, 47% were boys, the average age of the children was 5.2 ± 3.39 years and the average duration of the disease at the time of treatment was 3.3 ± 2 , 18 days. The parents of each patient completed a diary in which the dynamics of symptoms were recorded until the 14th day of illness. The journal contained 18 points to assess the symptoms of acute respiratory infections and influenza (CARIFS). The total number of points on this scale varies from 0 to 54, and the higher the sum of the points, the more pronounced the severity of the disease. Children with less than 5 points were considered to be recovered.
On the 4th day of the study, 101 children (56%) had persistent manifestations of infection, on the 7th day - in 49 children (26%) and on the 14th day - in 10 (6%).
Thus, more than half of the children suspected of acute respiratory viral infections remained sick on day 4 from the time they consulted a doctor, a quarter remained sick on day 7 (i.e. 10 days after infection) and every twenty years after 2 weeks. Despite this, doctors often tell parents that the child's condition should improve within a few days. Providing parents with the correct information will allow them to take better care of their children and reduce the frequency of repeat visits to the doctor.