Articles, Issue 2/2022

Treatment of Children with COVID-19: a Review of the Literature and Current Recommendations

Posted on by admin

S. Ali, L. Chochkova, I. Ivanov


Abstract

The COVID-19 pandemic is still in full swing, and an increase in the childhood morbidity was noticed in the last two waves.. Over the past two years, significant progress has been made in our understanding of disease pathogenesis, and manyt herapeutic strategies havebeen developed, using old and well-known drugs, as well as new ones and biologicals. A number of basic and clinical research studies are still ongoing. Yet, there is no unified protocol for the treatment of COVID-19, both in adults and children. The proposed work is an attempt to systematize the treatment options for pediatric patients by summarizing applicable drugs,the irindications, doses and thecommonest side effects according to the current medical literature.

Key words:COVID-19, treatment recommendations, children

To access this content, you must purchase Годишен абонамент.

Bibliography

  1. World Health Organization. WHO Coronavirus (COVID-19) Dashboard. Available at:https://covid19.who.int/. Accessed on 10.01.2022.
  2. Jones J. Epidemiology Task Force, CDC COVID-19 Public Health Response. Epidemiology of COVID-19 in Children Aged 5 – 11 years.ACIP Meeting November 2, 2021.Available at:https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-11-2-3/03-Covid-Jefferson-508.pdf. Accessedon11.01.2022.
  3. National Institutes of Health.COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19).Treatment Guidelines.Available at:https://www.covid19treatmentguidelines.nih.gov/. Accessed on30.11.2021.
  4. Zachariah P. COVID-19 in Children. Infect Dis Clin North Am. 2022;36(1):1-14.
  5. Howard-Jones AR, Burgner DP, Crawford NW, Goeman E, Gray PE, Hsu P, Kuek S, McMullan BJ, Tosif S, Wurzel D, Bowen AC, Danchin M, Koirala A, Sharma K, Yeoh DK, Britton PN. COVID-19 in children. II: Pathogenesis, disease spectrum and management. J Paediatr Child Health. 2022;58(1):46-53.
  6. NICE COVID-19 rapid guidelines. PharmacoEcon Outcomes News. 2021;877(1):33.doi: 10.1007/s40274-021-7682-3. Epub 2021 May 1. PMID: 33948079; PMCID: PMC8085796.
  7. Venturini E, Montagnani C, Garazzino Set al. Treatment of children with COVID-19: update of the Italian Society of Pediatric Infectious Diseases position paper. Ital J Pediatr47, 199 (2021). https://doi.org/10.1186/s13052-021-01132-2
  8. Children’s Hospital of the King’s Daughters. CHKD Treatment Guideline for COVID-19 in Children; 2020.Available at: https://www.chkd.org/uploadedFiles/Documents/COVID-19/CHKD%20COVID%2019%20treatment%20guideline.pdf. Accessedon 30.11.2021.
  9. WHO.Therapeutics and COVID-19: living guideline. Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-therapeutics-2021.3Accessed on 30.11.2021.
  10. Министерство на здравеопазването на Република България, Интерактивен справочник за Ковид-19. Достъпно на: https://www.mh.government.bg/bg/covid-19/interactiven-spravochnik-lechenie-covid-19/. Посетено 28.12 2021
  11. Younis NK, Zareef RO, Fakhri G, et al. COVID-19: potentialtherapeuticsforpediatricpatients. PharmacolRep. 2021 Dec;73(6):1520-1538. doi: 10.1007/s43440-021-00316-1. Epub 2021 Aug 30. PMID: 34458951; PMCID: PMC8403523.
  12. O’HoroJC. COVID-19 Critical care. Elsevier WebPages.Availableat: https://www.elsevier.com/__data/assets/pdf_file/0003/1017966/COVID-19-critical-care-CO-2021-05-06.pdf. Accessedon11.01.2022.
  13. EMA. Veklury: EPAR- product information. Available at: https://www.ema.europa.eu/en/documents/product-information/veklury-epar-product-information_en.pdf Accessed on20.01.2022.
  14. Horby P, Lim WS, Emberson JR, et al. RECOVERY Collaborative Group.DexamethasoneinHospitalizedPatientswith Covid-19. N Engl J Med. 2021 Feb 25;384(8):693-704. doi: 10.1056/NEJMoa2021436. Epub 2020 Jul 17.
  15. Wang J, Tang Y, Ma Y, et al. Efficacy and safety of antibiotic agents in children with COVID-19: a rapid review. Ann Transl Med. 2020;8(10):619. doi:10.21037/atm-20-3300
  16. Министерство на Здравеопазването на Република България. Заповед № РД-01-835/13.10.2021г.Достъпно на: https://www.mh.government.bg/media/filer_public/2021/10/13/zapoved_chl10_zlpkhm_rosh.pdfПосетено 30.11.2021.
  17. EMA.Ronapreve: EPAR- product information. Available at: https://www.ema.europa.eu/en/documents/product-information/ronapreve-epar-product-information_en.pdf.Accessed on 30.11.2021.
  18. Whitworth H, Sartain SE, Kumar R, et al. Rate of thrombosis in children and adolescents hospitalized with COVID-19 or MIS-C. Blood. 2021 Jul 15;138(2):190-198. doi: 10.1182/blood.2020010218. PMID: 33895804; PMCID: PMC8079262.
  19. Mahajerin A, Branchford BR, Amankwah EK, et al. Hospital-associated venous thromboembolism in pediatrics: a systematic review and meta-analysis of risk factors and risk-assessment models. Haematologica. 2015 Aug;100(8):1045-50.
  20. Goldenberg NA, Sochet A, Albisetti M, et al. Pediatric/Neonatal Hemostasis and Thrombosis Subcommittee of the ISTH SSC. Consensus-based clinical recommendations and research priorities for anticoagulant thromboprophylaxis in children hospitalized for COVID-19-related illness. J ThrombHaemost. 2020 Nov;18(11):3099-3105.
  21. Moores LK еt al.: Prevention, Diagnosis, and Treatment of VTE in Patients With Coronavirus Disease 2019: CHEST Guideline and Expert Panel Report. Chest. 2020 Sep;158(3):1143-1163. doi: 10.1016/j.chest.2020.05.559. Epub 2020 Jun 2. PMID: 32502594; PMCID: PMC7265858.
  22. UNC Children’s COVID-19 Guidelines Avalaible at: https://www.med.unc.edu/pediatrics/cccp/wp-content/uploads/sites/1156/2021/07/Peds-COVID-19-Inpatient-Treatment-Guideline-8.19.21.pdf. Accessed on 09.03.2022.
  23. Sharathkumar AA, Faustino EVS, Takemoto CM. How we approach thrombosis risk in children with COVID-19 infection and MIS-C. Pediatr Blood Cancer. 2021;68(7):e29049. doi:10.1002/pbc.
  24. Medscape drugs and diseases information.Enoxaparin.Available at: https://reference.medscape.com/drug/lovenox-enoxaparin-342174.Accessedon11.01.2022.
  25. Dabbous MK, Sakr FR, Malaeb DN. Anticoagulant therapy in pediatrics. J Basic Clin Pharm. 2014;5(2):27-33. doi:10.4103/0976-0105.134947.
  26. FDA news release- FDAApprovesFirstOralBloodThinningMedicationforChildren. Availableat: https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-blood-thinning-medication-children.Accessedon11.01.2022.
  27. National Library of Medicine, Clinical trials.gov registry. COVID-19 AnticoagulationinChildren – Thromboprophlaxis (COVAC-TP) Trial. Availableat: https://clinicaltrials.gov/ct2/show/NCT04354155 Accessed on11.01.2022.
  28. Tran VL, Parsons S, Varela CR. The Trilogy of SARS-CoV-2 in Pediatrics (Part 3): Thrombosis, Anticoagulant, and Antiplatelet Considerations. J PediatrPharmacolTher. 2021;26(6):565-576. doi:10.5863/1551-6776-26.6.565
  29. Alhazzani Wet al: Surviving Sepsis Campaign guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19).  Crit Care Med. 2021.ePub, March 27, 2020.
  30. Alhazzani Wet al: Surviving Sepsis Campaign Guidelines on the Management of Adults With Coronavirus Disease 2019 (COVID-19) in the ICU: First Update. Crit Care Med. 2021.ePub, February 2021.

Address for correspondence:

Clinic of Pediatrics, University Hospital “St. George” Plovdiv
Department of Pediatrics and Medical Genetics, MU – Plovdiv
15A, “Vasil Aprilov”, Blvd.
4000, Plovdiv, Bulgaria
e-mail: ivanovist@gmail.com