tetano
Editor, Senior Moderator
Health Sci Rep
. 2023 Dec 14;6(12):e1698.
doi: 10.1002/hsr2.1698. eCollection 2023 Dec. Remdesivir therapy for severe pediatric COVID-19 in Singapore: A single-center retrospective observational cohort study
Valerie Xue Fen Seah[SUP] 1 [/SUP], Rina Yue Ling Ong[SUP] 1 [/SUP], Kai Qian Kam[SUP] 2 3 4 5 [/SUP], Koh Cheng Thoon[SUP] 2 3 4 5 [/SUP], Natalie Woon Hui Tan[SUP] 2 3 4 5 [/SUP], Jiahui Li[SUP] 2 3 4 5 [/SUP], Karen Donceras Nadua[SUP] 2 3 4 5 [/SUP], Chia Yin Chong[SUP] 2 3 4 5 [/SUP], Chee Fu Yung[SUP] 2 4 5 [/SUP]
Affiliations
Background and aims: There is a paucity of information on remdesivir (RDV) use in severe pediatric coronavirus disease 2019 (COVID-19). We aimed to explore the effectiveness of RDV as the cumulative proportion of pediatric COVID-19 patients deescalated from Day 5 of high dependency or intensive care unit (HD/ICU).
Methods: All children ≤18 years admitted to Singapore's largest pediatric hospital from January 1, 2020 to March 18, 2022 were reviewed retrospectively. Patients were included if they were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on reverse transcriptase polymerase chain reaction, required oxygen, and HD/ICU care. The characteristics and outcomes of those who received RDV or not (no-RDV) were compared.
Results: We reviewed 15 children with a median age of 2.5 years (interquartile range [IQR]: 0.8-11.0), of which 7 (46.7%) received RDV. There was no difference in cumulative proportion of children deescalated from Day 5 of HD/ICU care in the RDV versus the no-RDV group (5/7, 70% vs. 7/8, 87.5%, p = 0.57). The RDV versus no-RDV group had higher disease severity, that is, WHO Ordinal Scale scores (median 6, IQR: 5-7 vs. 5, IQR: 4-5, p = 0.03), higher procalcitonin levels (ug/L) (median 4.31, IQR: 0.8-24.2 vs. 0.12, IQR: 0.09-0.26, p = 0.02), and longer HD/ICU care days (median 5, IQR: 4-9, vs. 1, IQR: 1-4, p = 0.01). There was no significant difference in hospitalization days. There were no adverse events directly attributable to RDV. None died from COVID-19 infection.
Conclusion: Our observational analysis was unable to detect any clear benefit of RDV in terms of reducing duration in HD/ICU. RDV was well-tolerated in children with severe COVID-19.
Keywords: SARS‐CoV‐2; children; pediatric; remdesivir; severe COVID‐19.
. 2023 Dec 14;6(12):e1698.
doi: 10.1002/hsr2.1698. eCollection 2023 Dec. Remdesivir therapy for severe pediatric COVID-19 in Singapore: A single-center retrospective observational cohort study
Valerie Xue Fen Seah[SUP] 1 [/SUP], Rina Yue Ling Ong[SUP] 1 [/SUP], Kai Qian Kam[SUP] 2 3 4 5 [/SUP], Koh Cheng Thoon[SUP] 2 3 4 5 [/SUP], Natalie Woon Hui Tan[SUP] 2 3 4 5 [/SUP], Jiahui Li[SUP] 2 3 4 5 [/SUP], Karen Donceras Nadua[SUP] 2 3 4 5 [/SUP], Chia Yin Chong[SUP] 2 3 4 5 [/SUP], Chee Fu Yung[SUP] 2 4 5 [/SUP]
Affiliations
- PMID: 38098972
- PMCID: PMC10719654
- DOI: 10.1002/hsr2.1698
Background and aims: There is a paucity of information on remdesivir (RDV) use in severe pediatric coronavirus disease 2019 (COVID-19). We aimed to explore the effectiveness of RDV as the cumulative proportion of pediatric COVID-19 patients deescalated from Day 5 of high dependency or intensive care unit (HD/ICU).
Methods: All children ≤18 years admitted to Singapore's largest pediatric hospital from January 1, 2020 to March 18, 2022 were reviewed retrospectively. Patients were included if they were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on reverse transcriptase polymerase chain reaction, required oxygen, and HD/ICU care. The characteristics and outcomes of those who received RDV or not (no-RDV) were compared.
Results: We reviewed 15 children with a median age of 2.5 years (interquartile range [IQR]: 0.8-11.0), of which 7 (46.7%) received RDV. There was no difference in cumulative proportion of children deescalated from Day 5 of HD/ICU care in the RDV versus the no-RDV group (5/7, 70% vs. 7/8, 87.5%, p = 0.57). The RDV versus no-RDV group had higher disease severity, that is, WHO Ordinal Scale scores (median 6, IQR: 5-7 vs. 5, IQR: 4-5, p = 0.03), higher procalcitonin levels (ug/L) (median 4.31, IQR: 0.8-24.2 vs. 0.12, IQR: 0.09-0.26, p = 0.02), and longer HD/ICU care days (median 5, IQR: 4-9, vs. 1, IQR: 1-4, p = 0.01). There was no significant difference in hospitalization days. There were no adverse events directly attributable to RDV. None died from COVID-19 infection.
Conclusion: Our observational analysis was unable to detect any clear benefit of RDV in terms of reducing duration in HD/ICU. RDV was well-tolerated in children with severe COVID-19.
Keywords: SARS‐CoV‐2; children; pediatric; remdesivir; severe COVID‐19.