Antiviral Treatment in Pediatric COVID-19 Patients

Öz

There is no clear protocol for the treatment of COVID-19 in children. Also, like adults, not every child with a positive nasopharyngeal polymerase chain reaction (PCR) test is an indication for treatment. The treatment is decided according to the children's underlying risk factors, complaints, findings of physical examination and laboratory values. Possible side effects of drugs should also be considered when making a treatment decision. Supportive treatment is the main treatment protocol in children. The necessity of antiviral treatment should be decided in the light of the literature by determining the conditions such as disease severity, clinical course, presence of underlying disease.

Anahtar Kelimeler

• Antiviral
• COVID-19
• treatment

Çocuklarda COVID-19 Tedavisinde Antiviral İlaçlar

Öz

Çocuklarda COVID-19 tedavisi ile ilgili kabul edilmiş net bir protokol yoktur. Aynı zamanda erişkinler gibi nazofarengeal polimeraz zincir reaksiyon (PCR) testi pozitif her çocuk da tedavi endikasyonu oluşturmamaktadır. Çocukların altta yatan risk faktörleri, şikayetleri, fizik muayene bulguları ve laboratuvar değerlerine göre tedaviye karar verilmektedir. İlaçların gelişebilecek istenmeyen etkileri de tedaviye karar vermede önemlidir. Çocuklarda ana tedavi protokolünü destek tedavisi oluşturmaktadır. Antiviral tedavi gerekliliğine hastalık ciddiyeti, klinik seyir ve önceden mevcut risk faktörlerinin varlığı gibi durumlar belirlenerek literatür eşliğinde karar verilmelidir.

Anahtar Kelimeler

• Antiviral
• COVID-19
• tedavi

Kaynakça

1. Sankar J, Dhochak N, Kabra SK, Lodha R. COVID-19 in Children: Clinical Approach and Management. Indian J Pediatr. 2020 Jun;87(6):433-442. doi: 10.1007/s12098-020-03292-1.
2. https://www.cdc.gov/coronavirus/2019-ncov/hcp/pediatric-hcp.html.
3. Jean SS, Lee PI, Hsuehd PR. Treatment options for COVID-19: The reality and challenges. J Microbiol Immunol Infect. 2020 Jun; 53(3): 436–443. Published online 2020 Apr 4. doi: 10.1016/j.jmii.2020.03.034.
4. FDA emergency use authorization for remdesivir. Available at: https://www.fda.gov/media/137564/download. Accessed August 22, 2020.
5. Chiotos K, Hayes M, Kimberlin DW, Jones SB, James SH , Pinninti SG et all. Multicenter Interim Guidance on Use of Antivirals for Children With Coronavirus Disease 2019/Severe Acute Respiratory Syndrome Coronavirus 2. Journal of the Pediatric Infectious Diseases Society, 2021;10(1):34–48, https://doi.org/10.1093/jpids/piaa115.
6. US Food and Drug Asministration. Remdesivir by Gilead Sciences: FDA Warns of newly discovered potential drug interaction that may reduce effectiveness of treatment. Availableat:https://www.fda.gov/safety/medical-product-safety-information/remdesivir-gilead-sciences-fda-warns-newly-discovered-potential-drug-interaction-may-reduce (Accessed on June 15, 2020).
7. Fact sheet for healthcare providers: Emergency use authorization (EUA) of baricitinib. https://www.fda.gov/media/143823/download (Accessed on November 20, 2020).
8. Kalil AC, Patterson TF, Mehta AK, et al. Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19. N Engl J Med 2021; 384:795.

9. Al-Bari MA. Chloroquine analogues in drug discovery: new directions of uses, mechanisms of actions and toxic manifestations from malaria to multifarious diseases. J Antimicrob Chemother 2015; 70:1608.
10. US Food and Drug Administration (FDA). FDA News Release. Coronavirus (COVID-19) update: FDA revokes emergency use authorization for chloroquine and hydroxychloroquine www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-revokes-emergency-use-authorization-chloroquine-and (Accessed on June 15, 2020).
11. Schoergenhofer C, Jilma B, Stimpfl T, et al. Pharmacokinetics of Lopinavir and Ritonavir in Patients Hospitalized With Coronavirus Disease 2019 (COVID-19). Ann Intern Med 2020; 173:670.
12. RECOVERY Collaborative Group. Lopinavir-ritonavir in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet 2020.
13. Ivashchenko AA, Dmitriev KA, Vostokova NV, et al. AVIFAVIR for Treatment of Patients with Moderate COVID-19: Interim Results of a Phase II/III Multicenter Randomized Clinical Trial. Clin Infect Dis 2020.
14. Cai Q, Yang M, Liu D, et al. Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study. Engineering 2020.