As Russia battles a spike in COVID-19 infections, a hospital ward in St. Petersburg is treating some of the youngest patients, from newborns to teenagers. "Many parents say: 'We thought children don’t have complications from COVID-19,'" said Yulia Ordina, the head of the infectious disease department at the St. Petersburg State Pediatric Medical University. "But unfortunately, that isn't always true."

The department has treated children with severe pneumonia, inflammatory illness, and other symptoms resulting from COVID-19. There are also patients who were already diagnosed with serious diseases when they contracted the virus, meaning they had a higher risk of complications.

Russia is seeing record numbers of COVID-19 infections, and only around a third of adults are fully vaccinated. While children are less likely than adults to become seriously ill, the pediatric ward has seen a steady influx of patients.

One-year-old Sofia is staying at the hospital together with her mother, Oksana. Early on, parents who tested negative were kept out of the ward to avoid infection. Now, vaccinated parents or those who have recovered from the virus can stay with their children.

Sofia's mother, Oksana, says the girl is afraid of doctors and cries during examinations.

Department head Ordina said older children quickly get used to seeing staff in their "spacesuits," or personal protective equipment, but the sight can be frightening for the younger ones. To make the interactions easier, she said, "We try to perform the examinations in a playful way," like turning oxygen measurements into a game.

Doctors and nurses provide extra attention and care to the patients who can't be with their parents. "I love children madly. It's hard not to get attached," said a nurse named Polina.

Staff also help with schoolwork. “We don’t have to play or teach the kids, but if you leave them alone, you’ll be dealing with smashed dishes and drawings on the walls,” said Vladimir, a nurse.

Some patients faced difficult circumstances even before becoming ill. Five siblings whose mother had lost parental rights were being raised by their grandmother. After the family contracted COVID-19, the children were admitted to the hospital. "Their grandmother died yesterday," said Veronika Gushchina, a nurse. “They might have to go to a social center or an orphanage. We haven't told them yet."

While many children with COVID-19 have mild infections or no symptoms at all, there are rare cases of a severe complication called multisystem inflammatory syndrome in children, or MIS-C. The pediatric department in St. Petersburg has treated about 30 children with the syndrome since the start of the pandemic, and guided the treatment of 40 others through remote consultations.

Five-year-old Masha developed inflammation of the liver, lungs, and kidneys. She and her mother traveled to St. Petersburg from Pskov, where local doctors were not able to treat her illness. “I don’t feel tired. The most important thing is for Masha to get better," Natalya said.

Nine-year-old Matvey Mankov also developed multisystem inflammatory syndrome, which affected his heart and lungs. He was hospitalized and placed on a ventilator. The syndrome can occur after the initial infection has subsided, and the long-term effects are not well known.

Matvey spent two months in a cardiology unit, but he has recovered from the worst of the illness. He started playing table tennis for just 10 or 15 minutes a day and is now playing competitively. "He never wants to go to the hospital again," his mother said.

Some children with pre-existing diseases wind up in the hospital after a COVID-19 infection. Diabetes is one illness that is thought to be a risk factor for complications of the virus.

For others, COVID-19 can attack at the worst possible time. Semyon Golodnikov, then 4 years old, contracted the virus in November 2020 after a bone marrow transplant intended to treat leukemia.

Oncologist Gleb Kondratyev has treated a number of cancer patients who caught COVID-19. He said the virus not only poses an increased threat to patients with weakened immune systems; it can also delay cancer treatments when time is critical.

Semyon's first bone marrow transplant failed, although it was unclear if COVID was the cause. But months later, his parents said a second transplant had succeeded, and the boy's cancer was in remission.

The families of other young patients can only hope for a full recovery as they wait for their children to return home.