Changes in the course of acute respiratory infections in primary school children against the background of stress disorders under the conditions of full-scale war in Ukraine

The full-scale war in Ukraine induces prolonged toxic stress, leading to the somatization of distress in primary school-aged children and modifying the course of acute respiratory infections (ARI). Aim - to determine the impact of stress disorders on the course of ARI in children aged 6-10 years by assessing the relationship between infection frequency, symptom severity, and psycho-emotional state. Materials and methods. A multicenter study included 125 children divided into groups based on the frequency of ARI episodes (episodic and recurrent). The severity of ARI was assessed using the Wisconsin Upper Respiratory Symptom Survey and the Bronchitis Severity Scale; stress disorders were evaluated using the questionnaire developed by the Public Health Center of the Ministry of Health of Ukraine. Statistical analysis was performed using the Mann-Whitney U-test with the Benjamini-Hochberg correction for multiple comparisons (Padi}) and Spearman’s correlation analysis (r). Results. A high prevalence of psychosomatic manifestations was established in children amid the war. No statistically significant differences were found between the groups regarding ARI frequency (Padj>0.05), indicating the universality of stress-associated disorders. Concurrently, moderate ARI course was associated with increased psychosomatic symptoms: more intense abdominal pain, headache, sleep disturbances, and appetite/feeding disorders (Padj≤0,001). Correlation analysis revealed direct correlation links between clinical ARI symptoms and psychological markers, specifically: sputum production and abdominal pain (r=0.330), productive cough and sleep disorders (r=0.305), as well as cough severity and the level of distrust (r=0.305). Conclusions. Chronic war-related stress diminishes differences between groups based on the frequency of respiratory episodes; however, ARI severity correlates directly with the depth of psycho-emotional disturbances. This substantiates the need for integrated approaches to the management of children, combining the treatment of the infectious process with psychological support. The authors declare no conflict of interest.