Infant With SARS-CoV-2 Infection Causing Severe Lung Disease Treated With Remdesivir

Area of Science:

• Pediatrics
• Infectious Diseases
• Critical Care Medicine

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is reported as rare and less severe in infants compared to adults.
• Limited data exists on severe SARS-CoV-2 disease presentation and treatment in neonates and young infants.

Purpose of the Study:

• To describe a case of severe SARS-CoV-2 infection in an ex-premature infant.
• To report the first use of remdesivir in a young child for SARS-CoV-2 treatment.
• To highlight an expedited compassionate use approval process for a novel antiviral in a pediatric patient.

Main Methods:

• Case report of an ex-premature infant with severe SARS-CoV-2 infection.
• Clinical management and treatment with remdesivir.
• Expedited approval process involving a multidisciplinary team and bioethics committee.

Main Results:

• The infant presented with severe acute respiratory syndrome.
• Treatment with remdesivir was successfully administered under compassionate use.
• The case demonstrates that SARS-CoV-2 can cause severe pulmonary disease in young infants, mirroring adult disease progression.

Conclusions:

• Young infants, including ex-premature infants, can develop severe, life-threatening pulmonary disease from SARS-CoV-2 infection.
• Remdesivir can be considered for treating severe SARS-CoV-2 in young children, with appropriate ethical and clinical oversight.
• An expedited approval process is feasible for compassionate use of novel antiviral therapies in critically ill pediatric patients.