Compassionate use of remdesivir in children with severe covid-19

David L. Goldman, Margaret L. Aldrich, Stefan H.F. Hagmann, Alasdair Bamford, Andres Camacho-Gonzalez, Giuseppe Lapadula, Philip Lee, Paolo Bonfanti, Christoph C. Carter, Yang Zhao, Laura Telep, Cheryl Pikora, Sarjita Naik, Neal Marshall, Ioannis Katsarolis, Moupali Das, Adam DeZure, Polly Desai, Huyen Cao, Anand P. ChokkalingamAnu Osinusi, Diana M. Brainard, Ana Méndez-Echevarría

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: Remdesivir shortens time to recovery in adults with severe coronavirus disease 2019 (COVID-19), but its efficacy and safety in children are unknown. We describe outcomes in children with severe COVID-19 treated with remdesivir. METHODS: Seventy-seven hospitalized patients ,18 years old with confirmed severe acute respiratory syndrome coronavirus 2 infection received remdesivir through a compassionateuse program between March 21 and April 22, 2020. The intended remdesivir treatment course was 10 days (200 mg on day 1 and 100 mg daily subsequently for children $40 kg and 5 mg/kg on day 1 and 2.5 mg/kg daily subsequently for children ,40 kg, given intravenously). Clinical data through 28 days of follow-up were collected. RESULTS: Median age was 14 years (interquartile range 7-16, range ,2 months to 17 years). Seventy-nine percent of patients had $1 comorbid condition. At baseline, 90% of children required supplemental oxygen and 51% required invasive ventilation. By day 28 of follow-up, 88% of patients had a decreased oxygen-support requirement, 83% recovered, and 73% were discharged. Among children requiring invasive ventilation at baseline, 90% were extubated, 80% recovered, and 67% were discharged. There were 4 deaths, of which 3 were attributed to COVID-19. Remdesivir was well tolerated, with a low incidence of serious adverse events (16%). Most adverse events were related to COVID-19 or comorbid conditions. Laboratory abnormalities, including elevations in transaminase levels, were common; 61% were grades 1 or 2. CONCLUSIONS: Among 77 children treated with remdesivir for severe COVID-19, most recovered and the rate of serious adverse events was low.

Original languageEnglish (US)
Article numbere2020047803
JournalPediatrics
Volume147
Issue number5
DOIs
StatePublished - May 1 2021

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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