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Update on COVID-19 Therapy in Pediatric Age

Susanna Esposito1, Giovanni Autore1, Alberto Argentiero1

  • 1Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

Pharmaceuticals (Basel, Switzerland)
|December 23, 2022
PubMed

Insights

Pediatric COVID-19 cases and severe outcomes have increased, necessitating effective treatments. While some antivirals are authorized for children, specific data for neonates and young children are crucial for safe and appropriate management.

Area of Science:

  • Pediatric Infectious Diseases
  • Pharmacology
  • Epidemiology

Background:

  • The COVID-19 pandemic's evolution, including vaccination and variant emergence, has altered pediatric disease epidemiology.
  • Increased prevalence, severe cases, and long-COVID have been observed in children, particularly younger ones.

Purpose of the Study:

  • To review available COVID-19 treatments for pediatric patients.
  • To identify treatments authorized for early life stages and existing therapeutic limitations in pediatrics.

Main Methods:

  • Literature analysis of approved/authorized antivirals for COVID-19 treatment.
  • Evaluation of treatment applicability and limitations based on age and clinical characteristics.

Main Results:

  • Molnupiravir (MPV) is contraindicated in pediatric patients due to bone growth risks.
  • Remdesivir (RVD) is approved for all pediatric ages except neonates; Paxlovid and bebtelovimab have age-related usage considerations.
  • Limited pharmacokinetic and clinical data exist for neonates and young children, hindering optimal treatment selection.

Conclusions:

  • Current COVID-19 antiviral therapies for children have age-specific limitations.
  • Urgent research is needed on pediatric-specific pharmacokinetic and clinical data to guide safe and effective treatment strategies for all pediatric age groups, including neonates.

Keywords:
COVID-19antiviral therapybebtelovimabmolnupiravirnirmatrelvir/ritonavirremdesivir

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