The trilogy of sars-cov-2 in pediatrics (Part 1): Acute covid-19 in special populations

Abstract

With the emergence of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) virus, the pandemic has resulted in a severe respiratory disease known as COVID-19. Data and literature are limited in the evaluation, treatment, and considerations for pediatric patients including special populations (e.g., neonates, children, immunocompromised patients, and those with sickle cell disease). There exists a need for a comprehensive review of pediatric proven and disproven treatments as therapies continue to emerge. This article evaluates the pharmacologic treatment and prevention therapies used in pediatric patients to date, including emergency use authorizations, as well as rationales for pharmacotherapies not routinely used to treat acute COVID-19 infection. It is important to note this review article is current as of January 25, 2021, given the rapid evolvement of the pandemic. ABBREVIATIONS ACE2, angiotensin-converting enzyme 2, ALT, alanine aminotransferase, AST, aspartate transaminase, BMI, body mass index, CDC, Centers for Disease Control and Prevention, ECMO, extracorporeal membrane oxygenation, eGFR, estimated glomerular filtration rate, EMA, European Medicines Agency, EUA, emergency use authorization, FDA, US Food and Drug Administration, HIV, human immunodeficiency virus, ICU, intensive care unit, IFN, interferon, IDSA, Infectious Diseases Society of America, IgG, immunoglobulin G, IL, interleukin, IV, intravenous, JAK, Janus kinase, MIS-C, multisystem inflammatory syndrome in children, mRNA, messenger RNA, NAAT, nucleic acid amplification test, NIH, National Institutes of Health, NS, normal saline, PCR, polymerase chain reaction, QTc, corrected ECG interval from the QRS complex to the end of the T wave, RNA, ribonucleic acid, SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, SCD, sickle cell disease, TNF-β, tumor necrosis factor beta, WHO, World Health Organization.