Use of remdesivir in children with COVID-19 infection: a quick narrative review

Main Article Content

Andrea La Tessa
Marco Antonio Motisi
Gian Luigi Marseglia
Fabio Cardinale
Amelia Licari
Sara Manti
Mariangela Tosca
Michele Miraglia Del Giudice
Maria De Filippo
Luisa Galli
Elena Chiappini

Keywords

COVID-19, Children, SARS-CoV-2, Antiviral drugs

Abstract

SARS-CoV-2 infection has a severe course in a small percentage of children. Remdesivir has shown promising results in reducing hospitalisation time in adults, but data on mortality rate are conflicting and few studies are available on its use use in antivirals in children. We performed a quick narrative review of the available literature data regarding the usage of remdesivir in children and neonates. In children, remdesivir showed good safety profile, however bradicardia events have been reported in children. Remdesivir is currently recommended by several guidelines in some subgroups of children with severe COVID-19, and should also be considered in critically ill patients, always in the context of the overall clinical picture and drug availability.

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References

1. Manti S, Licari A, Montagna L, et al. SARS-CoV-2 infection in pediatric population. Acta Biomed 2020;91:e2020003.
2. Levy ER, Blumenthal J, Chiotos K. Coronavirus disease 2019 in children. Curr Opin Infect Dis 2021. Epub ahead of print.
3. Garazzino S, Lo Vecchio A, Pierantoni L, et al. Epidemiology, clinical features and prognostic factors of pediatric SARS-CoV-2 infection: results from an italian multicenter study. Front Pediatr 2021;9:649358.
4. Humeniuk R, Mathias A, Kirby BJ, et al. Pharmacokinetic, pharmacodynamic, and drug-interaction profile of remdesivir, a SARS-CoV-2 replication inhibitor. Clin Pharmacokinet 2021;60:569-583.
5. Lutz JD, Mathias A, German P, Pikora C, Reddy S, Kirby BJ. Physiologically-based pharmacokinetic modeling of remdesivir and its metabolites to support dose selection for the treatment of pediatric patients with COVID-19. Clin Pharmacol Ther 2021;109:1116-1124.
6. Mulangu S, Dodd LE, Davey RT Jr, et al.A randomized, controlled trial of Ebola virus disease therapeutics. N Engl J Med 2019; 381:2293–303.
7. Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the treatment of Covid-19 - final report. N Engl J Med 2020;383:1813-26.
8. Goldman JD, Lye DCB, Hui DS, et al. Remdesivir for 5 or 10 days in patients with severe Covid-19. N Engl J Med 2020;383:1827-37.
9. Pan H, Peto R, Henao-Restrepo AM, et al. Repurposed antiviral drugs for Covid-19 - interim WHO solidarity trial results. N Engl J Med 2021;384:497-511.
10. Singh S, Khera D, Chugh A, Khera PS, Chugh VK. Efficacy and safety of remdesivir in COVID-19 caused by SARS-CoV-2: a systematic review and meta-analysis. BMJ Open 2021;11:e048416.
11. Goldman DL, Aldrich ML, Hagmann SHF, et al. Compassionate use of remdesivir in children with severe COVID-19. Pediatrics 2021;147:e2020047803.
12. Wardell H, Campbell JI, VanderPluym C, Dixit A. Severe acute respiratory syndrome Coronavirus 2 infection in febrile neonates. J Pediatric Infect Dis Soc 2020;9:630-5.
13. Chiotos K, Hayes M, Kimberlin DW, et al. Multicenter interim guidance on use of antivirals for children with Coronavirus disease 2019/Severe Acute Respiratory Syndrome Coronavirus 2. J Pediatric Infect Dis Soc 2021;10:34-48.
14. Charan J, Kaur RJ, Bhardwaj P, et al. Rapid review of suspected adverse drug events due to remdesivir in the WHO database; findings and implications. Expert Rev Clin Pharmacol 2021;14:95-103.
15. Gubitosa JC, Kakar P, Gerula C, Nossa H, Finkel D, Wong K, Khatri M, Ali H. Marked sinus bradycardia associated with remdesivir in COVID-19: a case and literature review. JACC Case Rep 2020;2:2260-2264.