SARS-CoV-2 infection in children with malignancies: treatment with remdesivir
Authors:
J. Petrus 1; K. Dunovská 1; E. Klapková 1; B. Hosnedlová 2; M. Jakubek 2; J. Čepová 1; R. Průša 1; R. Kizek 1
Authors‘ workplace:
2. LF Univerzity Karlovy a FN Motol, Praha, Ústav lékařské chemie a klinické biochemie, Přednosta: prof. MUDr. Richard Průša, CSc.
1; 1. LF Univerzity Karlovy a VFN, Praha, Klinika pediatrie a dědičných poruch metabolismu, Přednosta: prof. MUDr. Tomáš Honzík, Ph. D.
2
Published in:
Prakt. Lék. 2022; 102(1): 6-12
Category:
Of different specialties
Overview
Aim: The aim of this work was to perform an analysis of SARS-CoV-2 infection in paediatric patients with malignancies and the treatment used, and compare it with the severity of SARS-CoV-2 infection in overall paediatric population. According to European Centre for Disease Prevention and Control (ECDC), patients with neoplasms are a high risk group. Generally, remdesivir is recommended as a treatment. It is metabolised via system of cytochromes (CYP2C8, CYP2D6, CYP3A4) and esterases into its active form – nucleoside triphosphate. As an adenosine analogue, it affects viral replication.
Methods: The research was conducted by an analysis of papers concerning paediatric cancer patients with COVID-19. The articles were sourced from scientific databases (PubMed, Web of Science) and mainly the information about cancer diagnosis, COVID-19 mortality, necessity of ICU care and antivirals used were investigated.
Results: According to the data published by WHO, COVID-19 related mortality in overall paediatric population oscillates around 0.04% and ICU admission rate around 1%. From 25 analysed articles regarding COVID-19 in paediatric oncology patients, it has resulted that the mortality in this specific group is significantly higher (3.53%), the same is applicable to ICU care necessity (9.39%). Children with haematological malignancies are most often infected with SARS-CoV-2 virus. Notably, 56.2% of paediatric oncology patients had to have their oncological therapy modified because of COVID-19. Remdesivir (under emergency use authorization) can be used in this cohort of patients as an antiviral treatment with concomitant surveillance of hepatic and renal functions.
Conclusion: Remdesivir (under emergency authorization) can be used in paediatric oncology patients if hepatic and renal functions are monitored and their medication and clinical status does not refute it. Available studies suggest that remdesivir is well tolerated in paediatric population.
Keywords:
SARS-CoV-2 – COVID-19 – children – oncology – remdesivir
Sources
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