COVID-19 treatment in children

Panda, Prateek Kumar; Sharawat, Indar Kumar; Vivekanand, N; Bhakat, Rahul

doi:10.4103/jfmpc.jfmpc_2583_20

Cited by 20 publications

(19 citation statements)

References 83 publications

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“…Most children have milder COVID-19 than adults do, and a small percentage of children require treatment, so few meta-analyses on pediatric treatment have been reported. A systematic review and meta-analysis on the treatment of COVID-19 in children showed that anti-inflammatory agents such as corticosteroids and antivirals such as RDV are the most promising for severe cases of pediatric COVID-19 [ 37 ]. In addition, WHO and various guidelines based on large RCTs and systematic reviews suggest that in addition to RDV, corticosteroids, IVIG, tocilizumab, anakinra, infliximab, aspirin, and heparin, other drugs cannot be recommended in cases of COVID-19 in children of any severity [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Use of Remdesivir in children with COVID-19: report of an Italian multicenter study

Romani,

Roversi,

Bernardi

et al. 2024

Ital J Pediatr

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Background COVID-19 is generally milder in children than in adults, however severe infection has been described in some patients. Few data are available on use of Remdesivir (RDV) in children, as most clinical trials focused on adult patients. We report a multicenter study conducted in 10 Italian Hospitals to investigate the safety of RDV in children affected by COVID-19. Methods We collected the clinical data of children with COVID-19 treated with RDV between March 2020 and February 2022 in 10 Italian hospitals. Clinical data were compared according to a duration of RDV therapy more or less than 5 days. Linear regression model was used to determine the association of significant variables from the bivariate analysis to the duration of RDV therapy. Results A total of 50 patients were included, with a median age of 12.8 years. Many patients had at least one comorbidity (78%), mostly obesity. Symptoms were fever (88%), cough (74%) and dyspnea (68%). Most patients were diagnosed with pneumonia of either viral and/or bacterial etiology. Blood test showed leukopenia in 66% and increased C-reactive protein (CRP) levels in 63% of cases. Thirty-six patients received RDV for 5 days, nine patients up to 10 days. Most children who received RDV longer were admitted to the PICU (67%). Treatment with RDV was well tolerated with rare side effects: bradycardia was recorded in 6% of cases, solved in less than 24 h after discontinuation. A mild elevation of transaminases was observed in 26% of cases, however for the 8%, it was still detected before the RDV administration. Therefore, in these cases, we could not establish if it was caused by COVID-19, RDV o both. Patients who received RDV for more than 5 days waited longer for its administration after pneumonia diagnosis. The presence of comorbidities and the duration of O2 administration significantly correlated with the duration of RDV therapy at the linear regression analysis. Conclusion Our experience indicates that RDV against SARS-CoV-2 is safe and well-tolerated in pediatric populations at high risk of developing severe COVID-19. Our data suggest that delaying RDV therapy after diagnosis of pneumonia may be associated with a longer duration of antiviral therapy, especially in patients with comorbidities.

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Section: Discussionmentioning

confidence: 99%

Use of Remdesivir in children with COVID-19: report of an Italian multicenter study

Romani,

Roversi,

Bernardi

et al. 2024

Ital J Pediatr

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“…The average LOS for those who used steroids was 4.9 days, while those who did not use steroids stayed for 6.5 days. A meta-analysis was done regarding the use of antivirals in treatment regimens of COVID-19 in the pediatric age group, and it showed that antivirals were administered in 15.3% of children, and remdesivir was the most often used antiviral medicine in 6.2% of included children, with no major side effects [ 25 ]. Recent studies have indicated that remdesivir should be used only in severe situations, even in adults.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing the Length of Hospital Stay Among Pediatric COVID-19 Patients at Queen Rania Al Abdullah Hospital for Children: A Cross-Sectional Study

Al-Khlaifat¹,

Quraan²,

Nimri³

et al. 2023

Cureus

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BackgroundCOVID-19 caused by SARS-CoV-2 is a worldwide epidemic. Children are less commonly infected and have less severe symptoms than adults. However, they are at risk for COVID-19-associated severe sickness and hospitalization. The duration of stay is a major driver of effective health treatment during hospitalization; thus, it is only logical to attempt to comprehend the factors influencing the length of stay (LOS) for these patients, particularly in light of the ongoing pandemic caused by the new SARS-CoV-2 virus. As predictors of hospital LOS, several variables, including age, gender, disease severity, hospital mortality, insurance type, and hospital location, have been discovered. In our study, we focused on the severity of the patient's condition, the presence of comorbidities, and the necessary therapeutic regimen to predict the duration of stay. This study aimed to answer the following questions: If a patient has comorbidity and has COVID-19 requiring hospital treatment, will the patient's comorbidity elongate the duration of stay at the hospital for further management in the pediatric age group? What are the risk factors that play a significant role in the hospital stay duration in pediatrics? MethodologyWe gathered data from 100 hospitalized children aged up to 14 years who tested positive for COVID-19, which was not specific to variants of SARS-CoV-2, over 24 months (February 2020-February 2022) at Queen Rania Al Abdullah Hospital for Children, one of the Health Care Accreditation Council accredited facilities. Clinical symptoms, signs, oxygen demand, imaging study results, laboratory data, and usage of corticosteroid and antiviral medication were all taken from patients' medical records. There were no limitations in taking the sample of patients. All patients in the duration mentioned were included. ResultsClinical data of 100 COVID-19-positive pediatric patients were analyzed; 52% of the patients had associated chronic illnesses, while 48% were medically free. The longest duration of LOS was 28 days, the shortest was one day, the median was eight days, and five days was the most frequent among patients owing to 21% of patients, using mean descriptive statistics. We compared LOS to having or not having comorbidities. The mean LOS of patients with the comorbid disease was 6.15 days, with a maximum of 28 days, while for patients without chronic illnesses, the mean was 4.81 days with a maximum of 14 days. The significance was 0.07. Our results also showed a significant correlation between using steroids and LOS, as it had an advantageous effect by decreasing it with a significance value of 0.04. Having abnormal findings on chest computed tomography (CT) scan was also associated with increased LOS with a significant value of 0.00. ConclusionsAccording to our research, there was no direct association between comorbidity and hospital LOS, which is counterintuitive, as it was influenced by multiplayers of variables such as using steroids, which decreased the LOS, and abnormal findings on chest CT, which re...

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“…En nuestro estudio, 40,4% de los pacientes pediátricos con COVID-19 recibieron corticoides intrahospitalariamente, incluyendo el 28,1% de los casos asinhttps://doi.org/10.17843/rpmesp.2023.401.12326 tomáticos. Sin embargo, una revisión sistemática en niños encontró que la mayoría de casos asintomáticos no recibió tratamiento alguno (8) . Nuestros hallazgos al respecto requieren futuras indagaciones, pues es posible que parte de estos participantes hayan requerido recibir corticoides debido a condiciones concomitantes.…”

Section: Discussionunclassified

Uso de medicamentos en pacientes pediátricos con COVID-19 hospitalizados en un hospital de referencia de Lima, Perú

Luna-Vilchez

Mejia

Ortiz-Benique

et al. 2023

Rev Peru Med Exp Salud Publica

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El objetivo del estudio fue describir el uso de medicamentos en pacientes pediátricos con COVID-19 hospitalizados en el Instituto Nacional de Salud del Niño – San Borja (INSN-SB) de Lima, Perú, entre marzo del 2020 y marzo del 2022. Por ello, realizamos un estudio observacional descriptivo y evaluamos el uso de seis medicamentos: corticoides, ceftriaxona, azitromicina, inmunoglobulina, hidroxicloroquina e ivermectina. Finalmente, comparamos los resultados entre subpoblaciones definidas según la ola de la pandemia por COVID-19. Incluimos 421 pacientes pediátricos. Al 40,4% se le indicó corticoides, 35,6%ceftriaxona, 12,1% azitromicina, 3,6% inmunoglobulina, 2,4% hidroxicloroquina y 0,5% ivermectina. El uso de ceftriaxona y azitromicina fue menos frecuente durante la tercera ola. El uso de hidroxicloroquina fue casi exclusivo de la primera ola. El uso de inmunoglobulina solo se observó en pacientes con síndrome inflamatorio multisistémico pediátrico. La indicación de los medicamentos evaluados fue en generalmenor en la tercera ola.

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COVID-19 treatment in children

Cited by 20 publications

References 83 publications

Use of Remdesivir in children with COVID-19: report of an Italian multicenter study

Use of Remdesivir in children with COVID-19: report of an Italian multicenter study

Factors Influencing the Length of Hospital Stay Among Pediatric COVID-19 Patients at Queen Rania Al Abdullah Hospital for Children: A Cross-Sectional Study

Uso de medicamentos en pacientes pediátricos con COVID-19 hospitalizados en un hospital de referencia de Lima, Perú

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