1 - Unidade de Infecciologia, Hospital D. Estefânia, Centro Hospitalar Universitário de Lisboa Central
2 - Serviço de Pediatria, Unidade Local de Saúde do Baixo Alentejo – Hospital José Joaquim Fernandes
- E-Poster na “41st Annual Meeting of the European Society for Paediatric Infectious Diseases” da “European Society for Paediatric Infectious Diseases”
Introdução: The role of Remdesivir in pediatric COVID-19 hospitalizations is still discussed. Recent evidence has shown it to be safe in children, allowing the expansion of indications to >4 weeks-old and >3 kilograms.
Objetivo: To describe our experience using remdesivir in pediatric hospitalized patients.
Métodos: Single-center, retrospective, descriptive study of pediatric patients (< 18 years-old) with COVID-19 admitted to a third level Pediatric Center in Portugal, treated with remdesivir, from May/2020 to December/2022. Demographic and clinical data were collected.
Resultados: 32 patients were included, 24 (75%) males, median age of 36 months [10-108]. Sixteen (50%) presented comorbidities, most frequently cardiac insufficiency/cardiomyopathy (n=4), asthma/recurrent wheezing (n=4), medullary aplasia (n=3), cerebral palsy (n=2) and obesity (n=2). Twenty-two (68,7%) were from late 2021/2022 and 10 (31,3%) from 2020/early 2021. Remdesivir treatment was initiated at a median 4 day [3,00-5,75] of disease onset. The most common indication was hypoxic pneumonia (n=26). Treatment duration was 5 days (n=27) or 10 days (n=5) and 19 (59,4%) were concomitantly treated with corticosteroids. The duration of admission had a median of 7,5 days [5,25-12,75]. Eight (25%) were admitted to pediatric ICU, 4 (12.5%) needed mechanical ventilation and 1 (3,1%) ECMO. Two patients died during acute illness (1 previously healthy, 1 cardiac insufficiency). Complications attributed to remdesivir occurred in 3 (9,4%) previously healthy patients (bradycardia (n=2), hepatitis (n=1)) and were self-limited.
Conclusões: Remdesivir is the only approved pediatric antiviral for SARS-CoV-2 infection, both in established severe disease and prophylaxis, appearing to be safe. In adults, if used early, it shows reduction in hospitalization risk and complications in high-risk groups. Large scale randomized controlled trials enrolling pediatric patients are still needed to measure the impact on disease progression/prevention.
Palavras Chave: Pneumonia COVID-19, remdesivir, idade pediátrica