I. Horbachevsky Ternopil National Medical University

Background. The main factor that ensures the health and harmonious development of a child, both in the early stages and in the later periods of his life, is rational nutrition. The widespread prevalence of food-dependent forms of pathology among children, insufficient awareness of doctors and parents, as well as violations in the organization of nutrition of young children determine the relevance of this work and the need for a comprehensive analysis of the actual nutrition of children aged 1 to 2 years for its improvement. Purpose – to purpose of the work is to establish the nutritional characteristics of children aged from 1 to 2 years in order to optimize their diets. Materials and Methods. 42 healthy children aged 1 to 2 years who lived in Odesa district took part in the study. In work were used such methods: clinical and anamnestic; dietary; anthropometric – height, weight; sociological – questionnaires; statistical. Results. The patterns of food organization and consumption of the main macronutrients by children aged 1 to 2 years are formulated, which are characterized by adequate consumption of basic food products, with the exception of excessive consumption of cheese, fruit juices and hard cheese and insufficient use of enriched industrial products. It is shown that excessive amounts of food, inadequate nutrition in the form of multiple snacks and sometimes night feedings, as well as unreasonable use of products not intended for children aged 1 to 2 years, are significant violations of the organization of nutrition of children of this age group. It was established that the diets of children aged 1 to 2 years are unbalanced in terms of the content of proteins, fats, and carbohydrates. Identified violations of the nutrition structure of young children, its imbalance in terms of macronutrient composition dictate the need for regular control by pediatricians and family doctors over the organization of nutrition for children of this age period. Conclusions. The nutrition structure of children aged 1 to 2 years is characterized by an imbalance of rations in terms of proteins, fats, and carbohydrates, which is due to violations of the feeding regime, overeating, and early transition to the «family» food-table. Young children consume excessive amounts of protein and fat compared to recommended physiological norms and insufficient amounts of carbohydrates according to their age.

Background. Post-war recovery in Ukraine necessitates rapid economic and social development, including in the healthcare sector. The quality of life and active participation in society are highly dependent on robust health, especially for citizens affected by physical and psychological trauma due to the russian aggression. Purpose – to explore the potential for exporting medical services from Ukraine and attracting international patients. Materials and Methods. Review of the literature on the development of global medical services and healthcare markets; analysis of statistical data on the state and capabilities of Ukraine’s healthcare sector; study of best practices from other countries in the field of medical tourism; assessment of economic indicators and their correlation with the growth of international medical services. Results. The study reveals that Ukraine has significant potential to develop its international medical services sector. This potential is driven by the high qualifications of Ukrainian doctors, the relatively low cost of medical services, and the availability of advanced medical technologies in some hospitals. Promoting international medical services can attract foreign investment, enhance the quality of healthcare, and generate substantial economic benefits. The influx of international patients would generate export revenues, contributing to the state budget and balancing the national payment system. However, challenges such as infrastructure improvements, international accreditation, and effective marketing need to be addressed to fully realize this potential. Conclusions. Developing international medical services in Ukraine can significantly enhance the national economy and healthcare system. Strategic focus on this sector can yield benefits like improved healthcare quality, increased foreign investment, and significant economic returns. Addressing challenges and leveraging the country’s strengths in healthcare are essential for success.

Diabetic foot ulcers (DFUs) and infections are common complications that frequently result in reduced quality of life and even morbidity for patients with diabetes. This paper highlights significant findings in DFU treatments and emerging advanced technologies for monitoring ulceration in patients with diabetes. The management of DFUs requires a multidisciplinary approach that involves patient education. It is well-established that poor glycemic control significantly contributes to diabetic foot ulcer complications, presenting global challenges in quality of life, economics, and resource allocation, affecting approximately half a billion people and potentially leading to lower limb amputation or mortality. Therefore, effective DFU management necessitates a multidisciplinary approach that includes patient education. However, current clinical guidelines for DFU treatment are not performing effectively, resulting in unnecessary increases in financial and emotional burden on patients. Researchers have experimented with advanced technologies and methods, including traditional approaches, to address complications related to DFU healing. This paper also presents the evolution of patents in the field of DFU medication and advanced diagnostic methods, showcasing relevant innovations that may benefit a wide range of researchers.

Diabetes is a multifunctional chronic disease that affects both the central and/or peripheral nervous systems. This study assessed whether nicotinamide (NAm) or conjugate of nicotinic acid with gamma-aminobutyric acid (N-GABA) could be potential neuroprotective agents against type 1 diabetes (T1D)-induced nervous system impairments in rats. After six weeks of T1D, induced by streptozotocin, nonlinear male Wistar rats were treated for two weeks with NAm (100 mg/kg, i. p.) or N-GABA (55 mg/kg, i. p.). Expression levels of myelin basic protein (MBP) were analyzed by immunoblotting. Polyol pathway parameters of the sciatic nerves were assessed spectrophotometrically, and their structure was examined histologically. NAm had no effect on blood glucose or body weight in T1D, while N-GABA reduced glucose by 1.5-fold. N-GABA also increased MBP expression by 1.48-fold, enhancing neuronal myelination, while NAm showed no such effect. Activation of the polyol pathway was observed in the T1D sciatic nerves. Both compounds decreased sorbitol content and aldose reductase activity, thereby alleviating changes similar to primary degeneration in the sciatic nerves and preventing peripheral neuropathy development. These results demonstrate that NAm and, more notably, N-GABA may exert neuroprotective effects against T1D-induced nervous system impairments by increasing MBP expression levels, improving myelination processes in the brain, inhibiting the polyol pathway, and partially restoring morphometric parameters in the sciatic nerves. This suggests their potential therapeutic efficacy as promising agents for the prevention of T1D-induced nervous system alterations.

Introduction Neonatal stress significantly affects the early adaptation, maturation and long-term development of preterm infants. The objective of the study To investigate the effect of skin-to-skin contact (SSC) on stress level in preterm infants. Materials and methods The research was a prospective study. Stress indicators (cortisol, melatonin) were measured before the SSC began (pre-intervention level) and after this intervention (post-intervention). Results The study included 150 preterm infants in the NICU with gestational age (GA) ≤36 weeks. Pre-intervention salivary cortisol level was higher in extremely and very preterm neonates compared to moderate and late preterm newborns (p = 0.028), in children with low Apgar scores (p = 0.041), in those who were on mechanical ventilation (p = 0.005), and suffered neonatal sepsis (p = 0.005). Pre-intervention melatonin level was lower in children with low Apgar scores (p = 0.032). Salivary cortisol levels were significantly decreased after SSC in preterm infants [pre-intervention: 0.294 (0.111; 0.854) μg/dL vs. post-intervention: 0.127 (0.070; 0.229) μg/dL, p < 0.001], and urinary melatonin levels were significantly increased after SSC [pre-intervention: 4.01 (2.48; 6.34) ng/mL vs. post-intervention: 5.48 (3.39; 9.17) ng/mL, p < 0.001]. A greater reduction in cortisol levels after skin-to-skin contact was revealed in infants with a lower gestational age (p = 0.022), in boys compared to girls (p = 0.012), in infants with respiratory distress syndrome (p = 0.048), in those who had mechanical ventilation compared to non-ventilated neonates (p = 0.008), and in infants with seizures (p = 0.036). The melatonin levels increased more intensively in infants with low Apgar scores (p = 0.002), and in those with late-onset sepsis (p = 0.006). Conclusion The reduction in cortisol levels and the increase in melatonin levels provided strong evidence that SSC ameliorated the NICU-related stress in preterm infants. We found higher indicators of stress and more dramatic responses to SSC in reducing indicators of stress in infants with lower GA than in infants with higher GA, indicating that SSC may be even more important for lower GA infants. The infants who need SSC the most should not be denied the care they need to reduce the stress they experience from being born too soon and continuing their gestational development in the stressful environment of the NICU.

Background The comorbidity of chronic pancreatitis (CP) in patients with osteoarthritis (OA) is insufficiently studied, and the reciprocal impact of these conditions remains poorly understood. This study aimed to investigate potential predictors for the development of CP in OA patients, as well as associated complications. Methods A cohort of 181 patients was categorized into four groups: a control group (n=30), patients with OA (n=68), patients with CP (n=31), and patients with OA and comorbid CP (n=52). All four groups had no statistical differences in age and gender. The study utilized the WOMAC index, Visual Analog Scale (VAS), Lequesne index, biochemical assays, and advanced statistical methods to assess joint status in OA patients with comorbid CP. It explored potential predictors of comorbidity development and associated complications. Results The study revealed that concurrent CP in OA exacerbates progression and contributes to malnutrition. Body Mass Index (BMI) emerged as a potential predictor for CP comorbidity development in OA patients. Factors such as the WOMAC total score, fecal elastase-1, C-reactive protein (CRP), ferritin, retinol, tocopherol, 25-hydroxyvitamin D3, and BMI were found to influence the development of comorbidity of CP in OA. Additionally, Gastrointestinal Symptom Rating Scale-Diarrhea Syndrome (GSRS-DS), Gastrointestinal Symptom Rating Scale-Constipation Syndrome (GSRS-CS), Qualitative Assessment of the Symptoms and Impact of Pancreatic Exocrine Insufficiency Domain A (PEI-Q-A), retinol, tocopherol, and iron were identified as potential predictors comorbidity CP with exocrine pancreatic insufficiency in OA patients. Conclusion The presence of CP in OA patients exacerbates disease progression and complications, necessitating further investigation.

Background: Designing novel biologically active compounds with anti-inflammatory properties based on condensed quinazolines is a significant area of interest in modern medicinal chemistry. In the present study, we describe the development of promising new bioactive molecules through the bioisosteric replacement of a carbon atom with a sulfur atom in anti-inflammatory agents, specifically 3-methyl-2-oxo-2H-[1,2,4]triazino[2,3-c]quinazolin-6-yl)butanoate. Methods: Design and synthetic studies have led to the series of previously unknown substituted 2-[((3-R-2-oxo-2H-[1,2,4]triazino[2,3-c]quinazolin-6-yl)methyl)thio]carboxylic acids and their esters. These compounds were synthesized by reacting 6-chloroalkyl-3-R-2H-[1,2,4]triazino[2,3-c]quinazolin-2-ones with sulfanylalkyl carboxylic acids and their functional derivatives. The purity and structure of the obtained compounds were confirmed using a set of physicochemical methods, including elemental analysis, HPLC-MS, and 1 H NMR spectroscopy. Molecular modeling, predicted toxicity, drug-likeness, and pharmacokinetics data were used to select compounds for evaluation of their effects on acute aseptic inflammation (carrageenan-induced paw edema test) and on markers of the inflammatory process. Results: The compound 2-((1-(3-methyl-2-oxo-2H-[1,2,4]triazino[2,3-c]quinazolin-6-yl)ethyl)thio)acetic acid (com-pound 2e) was identified as the most active anti-inflammatory agent (AA = 53.41%), demonstrating significant inhibition of both paw edema development and the generation of pro-inflammatory cy-tokines and mediators. Conclusions: Results from docking studies and analysis of "structure-affinity" correlations revealed that these compounds are promising candidates for further modification and detailed investigation of their anti-inflammatory activity

Leptospirosis is an emerging illness presenting a broad range of clinical manifestations, ranging from asymptomatic or mild cases to severe and fatal outcomes. Early detection is crucial for effective treatment; however, similar clinical presentations in various febrile illnesses or co-infections, along with challenges in laboratory diagnostics, can lead to misdiagnosis and severe consequences. Identifying clinical predictors for severe forms of the disease is essential in mitigating complications and reducing mortality. Consequently, we conducted a retrospective case-control study to identify clinical markers indicative of severe disease in leptospirosis patients from the Transcarpathian region. The study focused on patients admitted with clinically suspected leptospirosis, involving a total of 51 diagnosed cases, with 13 resulting in severe outcomes and death. Categorical variables were analyzed using χ², revealing a mean patient age of 50 years, predominantly male (n = 36, 70.5%). Oliguria emerged as a significant independent factor associated with mortality (odds ratio [OR], 13.5; 95% confidence interval [CI], 2.56–71.12; p = 0.001). Additionally, our analysis uncovered a noteworthy increase in leptospirosis notification rates in Transcarpathian compared to Ukraine, with 150 cases out of the total 433 in Ukraine. The highest notification rates were observed in Mukachevo District and Perechyn District. These findings highlight the importance of early recognition of key clinical markers, such as oliguria, which are critical for predicting severe outcomes in leptospirosis patients. The higher notification rates in Transcarpathian regions also underscore the need for enhanced surveillance, targeted public health interventions, and timely treatment to reduce mortality in endemic areas.

The gut microbiome, body weight, and related comorbidities are intricately linked through a complex interaction of microbial, genetic, environmental, and psychological factors. Alterations in gut microbiota can contribute to the development of weight disorders and depressive symptoms, with the potential for these relationships to be bidirectional. Effective management of these interconnected conditions often involves a combination of lifestyle modifications and psychological support. Medical interventions, including treatments for obesity, antidiabetic drugs, antidepressants, antibiotics, and probiotics, can have beneficial and detrimental effects on gut microbiota and mental health. Further research is needed to better understand their impact on gut microbiome and mental health in the context of obesity.

Nowadays, there is a need to expand the bank of spectrophotometric methods for the determination of perindopril in dosage forms for the purposes of routine pharmaceutical analysis, which would be simple, express, «green» and inexpensive. In the present work, perindopril in tablets was quantified via a direct simple, «green», and non-extracting spectrophotometric approach based on the formation of ion-pair complexes with sulphophtalein dyes. The absorbances of the colored reaction products were registered at 405 nm (bromocresol green, BCG), 397 nm (bromocresol purple, BCP, and bromothymol blue, BTB) and 598 nm (bromophenol blue, BPB). To achieve the highest intensity of absorbance, optimum conditions were established by the screening of many experimental factors such as optimal concentration and volume of dyes, and the time consumed for the reaction. Beer’s law was obeyed in the ranges of 0.44–3.96 µg/mL (BCG), 3.00–7.00 µg/mL (BCP), 4.00–12.00 µg/mL (BTB) and 0.44–3.52 µg/mL (BPB). All four methods were validated in accordance with ICH guidelines, confirming specificity and linearity, accuracy and precision, limits of detection and quantification, robustness. These validated methods provide a reliable and green approach for the quantitative analysis of perindopril in tablets, contributing to safer and more sustainable laboratory practices in pharmaceutical analysis.

Herein we report a case of Lyme borreliosis in a pediatric patient, highlighting the diagnostic challenges associated with this condition. An 11-year-old girl was admitted with high fever, headaches, abdominal pain, and a progressing rash. Initial symptoms included small rashes that vanished with antihistamine treatment, but maculopapular rashes later emerged on the trunk and limbs, prompting further investigation. Differential diagnosis included toxic erythema, Stevens-Johnson syndrome, and Lyme borreliosis. Despite no reported tick bite and initial doubt due to the season, Lyme borreliosis was confirmed by serologic testing, diagnosing the patient with early disseminated Lyme disease. The diagnostic complexity was increased by the rash’s atypical presentation – large, homogeneous papular rashes. This case emphasizes the necessity for physicians to adeptly gather detailed histories and employ thorough, up-to-date diagnostic methods. Effective correlation of clinical findings with laboratory results and ongoing patient observation proved critical for an accurate diagnosis. This report underscores the importance of recognizing atypical presentations of Lyme borreliosis in children and the need for careful differential diagnosis.

Acute ischemia can cause a sudden decrease in limb perfusion, threatening its viability. The restoration of blood supply causes complex damage to previously ischemic tissues as well as to the tissues distant from the area of ischemia, which is defined as ischemia-reperfusion injury. This condition gets significantly worse under conditions of acute blood loss. The development of new approaches for the prognosis of morphological changes in the soft tissues of the limbs and further clinical research on their correction is also relevant for civilian and military medicine, especially in martial law conditions. The objective of the study was to establish an association between the degree of structural changes in the rat hind-limb skeletal muscles and systemic changes in the indicators of lipid peroxidation and antioxidant defense in ischemia-reperfusion injury against the background of acute blood loss to make prognosis for morphological disorders using neural network clustering. Materials and Methods. We carried out a histological and morphometric study of skeletal muscles and measured the parameters of lipid peroxidation (content of diene conjugates, triene conjugates, TBA-reactive substances) and antioxidant defense (superoxide dismutase and catalase activity) in blood serum of 30 mature white male rats. Simulation of acute ischemia was performed by applying SWAT rubber tourniquets 5-6 mm wide on the hind limbs of rats at the level of the inguinal fold for 2 hours under thiopental sodium anesthesia. Reperfusion was induced by restoring blood circulation in the limbs of the animals after removing the tourniquet. Acute blood loss was simulated by transection of the femoral vein. To analyze the relationship between the identified structural 522 © 2024 by the author(s). This work is licensed under Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ How to сite / Як цитувати статтю: Selskyy P, Televiak A, Lutsyk V, Franchuk V, Sverstiuk A, Voloshyn V, Furdela M. Prognosis of limb muscular structural disorders after tourniquet application based on the changes in lipid peroxidation indicators using neural network clustering. East Ukr Med J. 2024;12(3):522-532

Background/Objectives. The comorbidity of osteoarthritis and type 2 diabetes mellitus poses a complex clinical challenge, complicating patient management due to overlapping pathophysiological mechanisms. This research aims to analyze the exacerbation of clinical symptoms and biochemical markers in patients with OA and T2DM compared to those with OA alone. Methods. We employed various assessment methods to evaluate inflammation, oxidative stress, and glycemic control in both cohorts. This study includes the administration of alpha-lipoic acid (ALA) to patients with comorbid OA and T2DM, monitoring its effects on joint function, inflammatory markers, oxidative stress levels, and glycemic control. Results. The findings indicate that T2DM significantly worsens clinical symptoms and biochemical markers in OA patients. Those with both conditions exhibited elevated indicators of inflammation and oxidative stress compared to OA-only patients. Additionally, correlations among metabolic, psychological, and inflammatory factors were identified. Body mass index emerged as a potential predictor for the deterioration of evaluated parameters. The analysis revealed that ALA administration led to statistically significant improvements in WOMAC pain scores, the Lequesne Algofunctional Index, and the AIMS-P compared to the control group. Conclusions. Further research into ALA’s effects on OA progression in patients with comorbidities is essential for developing personalized treatment approaches.

The increase in female reproductive disorders, such as polycystic ovary syndrome, endometriosis, and diminished ovarian reserve that lead to subfertility and infertility, has encouraged researchers to search and discover their underlying causes and risk factors. One of the crucial factors that may influence the increasing number of reproductive issues is environmental pollution, particularly exposure to man-made endocrine-disrupting chemicals (EDCs). EDCs can interfere with the ovarian microenvironment, impacting not only granulosa cell function but also other surrounding ovarian cells and follicular fluid (FF), which all play essential roles for oocyte development, maturation, and overall reproductive function. FF surrounds developing oocytes within an ovarian follicle and represents a dynamic milieu. EDCs are usually found in biological fluids, and FF is therefore of interest in this respect. This narrative review examines the current knowledge on specific classes of EDCs, including industrial chemicals, pesticides, and plasticizers, and their known effects on hormonal signaling pathways, gene expression, mitochondrial function, oxidative stress induction, and inflammation in FF. We describe the impact of EDCs on the development of reproductive disorders, oocyte quality, menstrual cycle regulation, and their effect on assisted reproductive technique outcomes. The potential transgenerational effects of EDCs on offspring through animal and first-human studies has been considered also. While significant progress has been made, the current understanding of EDCs’ effects on ovarian function, particularly in humans, remains limited, underscoring the need for further research to clarify actions and effects of EDCs in the ovary.

Lysosomal storage diseases (LSDs) encompass a group of rare inherited metabolic disorders characterized by the accumulation of undegraded substrates within lysosomes, leading to multisystemic manifestations, including profound neurological involvement. This article provides a concise overview of the neurological manifestations of LSDs, with a focus on central nervous system (CNS) involvement and treatment strategies. While the paper intricacies of each LSD subtype and its associated CNS manifestations, it aims to provide a summary of the essential findings and implications. The neurological manifestations of LSDs encompass a spectrum of symptoms, including cognitive impairment, motor dysfunction, seizures, and sensory deficits, which significantly impact patients’ quality of life and pose therapeutic challenges. Current treatment strategies primarily aim to alleviate symptoms and slow disease progression, with limited success in reversing established neurological damage. Enzyme replacement therapy, substrate reduction therapy, and emerging gene therapies hold promise for addressing CNS involvement in LSDs. However, challenges such as blood-brain barrier penetration and long-term efficacy remain. In addition to discussing treatment modalities, this article highlights the importance of early diagnosis, multidisciplinary care, and patient advocacy in optimizing outcomes for individuals affected by LSDs. Ethical considerations are also addressed, including equitable access to emerging treatments and integrating personalized medicine approaches. Overall, this article underscores the complex interplay between genetics, neuroscience, and clinical care in understanding and managing the neurological manifestations of LSDs while emphasizing the need for continued research and collaboration to advance therapeutic interventions and improve patient outcomes.

An algorithm of the rehabilitation process is created taking into account the constraints of the patient’s rehabilitation program. The identification of rehabilitation participants, the stages, and the means of the rehabilitation efficiency evaluation are presented. Two families of optimization models are generated to find patient rehabilitation programs optimal in terms of cost and weight. The first family allows for the selection of the number of interventions for experts in the multidisciplinary team, and the second family forms a multidisciplinary team for implementing the rehabilitation program. Calculations are provided for a model example where the patient’s rehabilitation program is determined by four experts of the multidisciplinary team and three codes of the International Classification of Functioning, Disability, and Health (ICF).

Influenza and other acute respiratory viral infections (ARVIs) are among the most common human diseases. In recent decades, the discovery of cytokines and their significance in the pathogenesis of diseases has led to extensive research on these compounds in various pathologies including ARVIs. The aim of the research was to study the cytokine profile in patients with ARVIs. The cases of 30 patients were investigated. Etiological diagnosis was performed by polymerase chain reaction. Different classes of cytokines in the serum were defined by the enzyme-linked immunosorbent assay (ELISA). The level of cytokines depended on the number of pathogens. The highest levels of pro-inflammatory interleukins and the lowest levels of anti-inflammatory IL-4 were observed in patients with a combination of five or more viruses compared to those with a monoinfection. Analysis of the data showed that in the acute phase, the levels of all studied pro-inflammatory cytokines – IL-2, IL-6, and TNF-α – increased by 8, 39, and 9 times, respectively, compared to those in healthy individuals. In the acute phase of ARVI, the levels of pro-inflammatory cytokines were significantly higher and depended on the severity of the disease. The imbalance of cytokines in the serum has been established in cases of ARVIs, depending on the severity of the disease.

This study aimed to analyze the compositions of flavonoids and phenolic acids in the aerial parts of two Artemisia L. species (Artemisia ludoviciana Nutt. and Artemisia campestris L.) when grown in Ukraine. High-performance liquid chromatography analysis (HPLC) detected the presence of 11 flavonoids and 10 phenolic acids in the plant materials under study. Among the phenolic acids, chlorogenic acid was the most abundant in the raw material of both species (14.503 mg/g in Artemisia ludoviciana and 4.504 mg/g in Artemisia campestris). The main flavonoids in the Artemisia ludoviciana herb decreased in the following order: flavanone-7-O-glycoside (naringin) (21.924 mg/g) > fisetin (13.068 mg/g) > kaempferol-3-b-glucoside (5.119 mg/g) > rutin (1.295 mg/g). In comparison, in Artemisia campestris raw material the order was: flavanone-7-O-glycoside (7.525 mg/g) > fisetin (2.933 mg/g) > rutin (1.355 mg/g). Since the predominant polyphenols have demonstrated valuable therapeutic potential, the data obtained could be considered for further exploration of their biological activities.

In press Попри меншу поширеність інфекції COVID-19 (COronaVIrus Disease 2019) у дітей, такі загрозливі стани як важкий перебіг SARS-CoV-2-асоційованої пневмонії та мультисистемний запальний синдром (Multisystem Inflammatory Syndrome in Children, MIS-C) становлять проблему у диференційній діагностиці, ранній госпіталізації та лікуванні. Тому метою дослідження було дослідити генетичні особливості сприйнятливості дітей до виникнення цих станів, з визначенням предикторів та факторів ризику. Генетичні фак­тори оцінювали на основі літературного пошуку, а фенотипові прояви на основі аналізу історій хвороб 119 пацієнтів інфекційного стаціонару з діагнозами COVID-19, MIS-C, грип та гостра вірусна респіраторна інфекція. За результатами дослідження виявлено диференційні діагностичні критерії для важких форм COVID-19 та MIS-C. На основі аналізу генетичних особливостей визначено фактори ризику та супутні захворювання, які обтяжують перебіг ковідної інфекції з метою створення алгоритмів амбулаторного нагляду та диспансеризації дітей з груп ризику. Таким чином діти з бронхіальною астмою, цукровим діабетом, ожирінням, вродженими імунодефіцитами та вадами серця потребують диспансерного нагляду з точки зору важких форм COVID-19. Амбулаторного нагляду протягом місяця потребують практично здорові діти, які хворіли або контактували з хворими на ковідну інфекцію з визначенням лабораторних показників крові, даних електрокардіограм та результатів ультразвукової діагностики органів черевної порожнини для ранньої діагностики MIS-C. Ключові слова: мультисистемний запальний синдром MIS-C, важка форма COVID-19, фактори ризику, генетичні особливості, диспансеризація, діагностичні критерії.