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Rampedi PN, Ogunrombi MO, Adeleke OA. Leading Paediatric Infectious Diseases-Current Trends, Gaps, and Future Prospects in Oral Pharmacotherapeutic Interventions. Pharmaceutics 2024; 16:712. [PMID: 38931836 PMCID: PMC11206886 DOI: 10.3390/pharmaceutics16060712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
Paediatric infectious diseases contribute significantly to global health challenges. Conventional therapeutic interventions are not always suitable for children, as they are regularly accompanied with long-standing disadvantages that negatively impact efficacy, thus necessitating the need for effective and child-friendly pharmacotherapeutic interventions. Recent advancements in drug delivery technologies, particularly oral formulations, have shown tremendous progress in enhancing the effectiveness of paediatric medicines. Generally, these delivery methods target, and address challenges associated with palatability, dosing accuracy, stability, bioavailability, patient compliance, and caregiver convenience, which are important factors that can influence successful treatment outcomes in children. Some of the emerging trends include moving away from creating liquid delivery systems to developing oral solid formulations, with the most explored being orodispersible tablets, multiparticulate dosage forms using film-coating technologies, and chewable drug products. Other ongoing innovations include gastro-retentive, 3D-printed, nipple-shield, milk-based, and nanoparticulate (e.g., lipid-, polymeric-based templates) drug delivery systems, possessing the potential to improve therapeutic effectiveness, age appropriateness, pharmacokinetics, and safety profiles as they relate to the paediatric population. This manuscript therefore highlights the evolving landscape of oral pharmacotherapeutic interventions for leading paediatric infectious diseases, crediting the role of innovative drug delivery technologies. By focusing on the current trends, pointing out gaps, and identifying future possibilities, this review aims to contribute towards ongoing efforts directed at improving paediatric health outcomes associated with the management of these infectious ailments through accessible and efficacious drug treatments.
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Affiliation(s)
- Penelope N. Rampedi
- Department of Clinical Pharmacology and Therapeutics, School of Medicine, Sefako Makgatho Health Science University, Pretoria 0208, South Africa; (P.N.R.); (M.O.O.)
| | - Modupe O. Ogunrombi
- Department of Clinical Pharmacology and Therapeutics, School of Medicine, Sefako Makgatho Health Science University, Pretoria 0208, South Africa; (P.N.R.); (M.O.O.)
| | - Oluwatoyin A. Adeleke
- Preclinical Laboratory for Drug Delivery Innovations, College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
- School of Biomedical Engineering, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 3J5, Canada
- School of Pharmacy, Sefako Makgatho Health Science University, Pretoria 0208, South Africa
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Brady DK, Gurijala AR, Huang L, Hussain AA, Lingan AL, Pembridge OG, Ratangee BA, Sealy TT, Vallone KT, Clements TP. A guide to COVID-19 antiviral therapeutics: a summary and perspective of the antiviral weapons against SARS-CoV-2 infection. FEBS J 2024; 291:1632-1662. [PMID: 36266238 PMCID: PMC9874604 DOI: 10.1111/febs.16662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/11/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
Antiviral therapies are integral in the fight against SARS-CoV-2 (i.e. severe acute respiratory syndrome coronavirus 2), the causative agent of COVID-19. Antiviral therapeutics can be divided into categories based on how they combat the virus, including viral entry into the host cell, viral replication, protein trafficking, post-translational processing, and immune response regulation. Drugs that target how the virus enters the cell include: Evusheld, REGEN-COV, bamlanivimab and etesevimab, bebtelovimab, sotrovimab, Arbidol, nitazoxanide, and chloroquine. Drugs that prevent the virus from replicating include: Paxlovid, remdesivir, molnupiravir, favipiravir, ribavirin, and Kaletra. Drugs that interfere with protein trafficking and post-translational processing include nitazoxanide and ivermectin. Lastly, drugs that target immune response regulation include interferons and the use of anti-inflammatory drugs such as dexamethasone. Antiviral therapies offer an alternative solution for those unable or unwilling to be vaccinated and are a vital weapon in the battle against the global pandemic. Learning more about these therapies helps raise awareness in the general population about the options available to them with respect to aiding in the reduction of the severity of COVID-19 infection. In this 'A Guide To' article, we provide an in-depth insight into the development of antiviral therapeutics against SARS-CoV-2 and their ability to help fight COVID-19.
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Affiliation(s)
- Drugan K. Brady
- Department of Biological SciencesVanderbilt UniversityNashvilleTNUSA
| | - Aashi R. Gurijala
- Department of Biological SciencesVanderbilt UniversityNashvilleTNUSA
| | - Liyu Huang
- Department of Biological SciencesVanderbilt UniversityNashvilleTNUSA
| | - Ali A. Hussain
- Department of Biological SciencesVanderbilt UniversityNashvilleTNUSA
| | - Audrey L. Lingan
- Department of Biological SciencesVanderbilt UniversityNashvilleTNUSA
| | | | - Brina A. Ratangee
- Department of Biological SciencesVanderbilt UniversityNashvilleTNUSA
| | - Tristan T. Sealy
- Department of Biological SciencesVanderbilt UniversityNashvilleTNUSA
| | - Kyle T. Vallone
- Department of Biological SciencesVanderbilt UniversityNashvilleTNUSA
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Raghav PK, Mann Z, Ahluwalia SK, Rajalingam R. Potential treatments of COVID-19: Drug repurposing and therapeutic interventions. J Pharmacol Sci 2023; 152:1-21. [PMID: 37059487 PMCID: PMC9930377 DOI: 10.1016/j.jphs.2023.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 01/31/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The infection is caused when Spike-protein (S-protein) present on the surface of SARS-CoV-2 interacts with human cell surface receptor, Angiotensin-converting enzyme 2 (ACE2). This binding facilitates SARS-CoV-2 genome entry into the human cells, which in turn causes infection. Since the beginning of the pandemic, many different therapies have been developed to combat COVID-19, including treatment and prevention. This review is focused on the currently adapted and certain other potential therapies for COVID-19 treatment, which include drug repurposing, vaccines and drug-free therapies. The efficacy of various treatment options is constantly being tested through clinical trials and in vivo studies before they are made medically available to the public.
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Affiliation(s)
- Pawan Kumar Raghav
- Immunogenetics and Transplantation Laboratory, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
| | | | - Simran Kaur Ahluwalia
- Amity Institute of Biotechnology, Amity University, Sector-125, Noida, Uttar Pradesh, India
| | - Raja Rajalingam
- Immunogenetics and Transplantation Laboratory, Department of Surgery, University of California San Francisco, San Francisco, CA, USA
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Kale A, Shelke V, Dagar N, Anders HJ, Gaikwad AB. How to use COVID-19 antiviral drugs in patients with chronic kidney disease. Front Pharmacol 2023; 14:1053814. [PMID: 36843922 PMCID: PMC9947246 DOI: 10.3389/fphar.2023.1053814] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
Antiviral drugs such as Remdesivir (Veklury), Nirmatrelvir with Ritonavir (Paxlovid), Azvudine, and Molnupiravir (Lagevrio) can reduce the risk for severe and fatal Coronavirus Disease (COVID)-19. Although chronic kidney disease is a highly prevalent risk factor for severe and fatal COVID-19, most clinical trials with these drugs excluded patients with impaired kidney function. Advanced CKD is associated with a state of secondary immunodeficiency (SIDKD), which increases the susceptibility to severe COVID-19, COVID-19 complications, and the risk of hospitalization and mortality among COVID-19 patients. The risk to develop COVID-19 related acute kidney injury is higher in patients with precedent CKD. Selecting appropriate therapies for COVID-19 patients with impaired kidney function is a challenge for healthcare professionals. Here, we discuss the pharmacokinetics and pharmacodynamics of COVID-19-related antiviral drugs with a focus on their potential use and dosing in COVID-19 patients with different stages of CKD. Additionally, we describe the adverse effects and precautions to be taken into account when using these antivirals in COVID-19 patients with CKD. Lastly, we also discuss about the use of monoclonal antibodies in COVID-19 patients with kidney disease and related complications.
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Affiliation(s)
- Ajinath Kale
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, India
| | - Vishwadeep Shelke
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, India
| | - Neha Dagar
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, India
| | - Hans-Joachim Anders
- Division of Nephrology, Department of Internal Medicine IV, Hospital of the Ludwig Maximilians University Munich, Munich, Germany
| | - Anil Bhanudas Gaikwad
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, India,*Correspondence: Anil Bhanudas Gaikwad,
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Hashemian H, Mansouri SS, Badeli HR, Esmaili E, Asgharzadeh M, Shahraki T, Ghasemabadi NA, Falahatkar R, Mashouf P, Jafari A. Pediatrics Infected with COVID-19: A Case Series Study on Pediatrics Hospitalized in a Referral Pediatric Hospital. Int J Pediatr 2021; 2021:1135503. [PMID: 34917154 PMCID: PMC8670982 DOI: 10.1155/2021/1135503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/23/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION COVID-19 infection which is a novel pneumonia associated with coronavirus suddenly broke out in the world. The aim of this study is to analyze and summarize the clinical characteristics of pediatric patients who were hospitalized in a referral pediatric hospital because of COVID-19 infection. MATERIALS AND METHODS Twenty-one COVID-19 infection cases confirmed by clinical and laboratory findings who were hospitalized in our center from 20 February to 19 April 2020 were included. Demography information, clinical, laboratory, and radiological findings, and treatment strategies of patients were evaluated. RESULTS The mean age was 91.5 ± 68.38 months (1-225), and there were 12 (57.1%) boys and 9 (42.9%) girls. Fever ≥ 38°C was detected in 11 (52.4%) patients. Eleven (52.3%) patients had tachypnea, and 4 (19%) of them developed tachycardia. Nine CT scans (42.85%) demonstrated a halo sign, and patchy infiltration was seen in CT scan of 7 patients (33.33%). Furthermore, bilateral crazy-paving pattern was seen in CT scan of nine (42.85%) patients. We prescribed chloroquine in 8 (38.1%), oseltamivir in 8 (38.1%), Kaletra in 6 (28.6%), and Ribavirin in 1 (4.8%) of patients. Finally, four (19.04%) patients expired which one of them suffered from ARDS. CONCLUSIONS We found out that boys might develop more severe cases of COVID-19, and this could be more common in school age. Manifestations might be milder than adults, and the most severe cases might be associated with underlying diseases. Also, the effectiveness of drugs in the treatment of this disease needs further study.
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Affiliation(s)
- Houman Hashemian
- Pediatric Diseases Research Center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Saeid Sadat Mansouri
- Pediatric Diseases Research Center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Reza Badeli
- Pediatric Diseases Research Center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ebrahim Esmaili
- Pediatric Diseases Research Center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Majid Asgharzadeh
- Pediatric Diseases Research Center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Tamkin Shahraki
- Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Neda Aligoli Ghasemabadi
- Pediatric Diseases Research Center, 17 Shahrivar Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Reza Falahatkar
- Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Parham Mashouf
- Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Alireza Jafari
- Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Inflammatory Lung Disease Research Center, Department of Internal Medicine, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Zou H, Yang Y, Dai H, Xiong Y, Wang JQ, Lin L, Chen ZS. Recent Updates in Experimental Research and Clinical Evaluation on Drugs for COVID-19 Treatment. Front Pharmacol 2021; 12:732403. [PMID: 34880750 PMCID: PMC8646041 DOI: 10.3389/fphar.2021.732403] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/13/2021] [Indexed: 12/17/2022] Open
Abstract
Since the outbreak of corona virus disease 2019 (COVID-19) in Wuhan (China) in December 2019, the epidemic has rapidly spread to many countries around the world, posing a huge threat to global public health. In response to the pandemic, a number of clinical studies have been initiated to evaluate the effect of various treatments against COVID-19, combining medical strategies and clinical trial data from around the globe. Herein, we summarize the clinical evaluation about the drugs mentioned in this review for COVID-19 treatment. This review discusses the recent data regarding the efficacy of various treatments in COVID-19 patients, to control and prevent the outbreak.
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Affiliation(s)
| | - Yuqi Yang
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, United States
| | - Huiqiang Dai
- Cell Research Center, Shenzhen Bolun Institute of Biotechnology, Shenzhen, China
| | - Yunchuang Xiong
- Cell Research Center, Shenzhen Bolun Institute of Biotechnology, Shenzhen, China
| | - Jing-Quan Wang
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, United States
| | - Lusheng Lin
- Cell Research Center, Shenzhen Bolun Institute of Biotechnology, Shenzhen, China
| | - Zhe-Sheng Chen
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, United States
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Ayittey FK, Chiwero NB, Dhar BK, Tettey EL, Saptoro A. Epidemiology, clinical characteristics and treatment of SARS-CoV-2 infection in children: A narrative review. Int J Clin Pract 2021; 75:e15012. [PMID: 34806816 PMCID: PMC9011565 DOI: 10.1111/ijcp.15012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 12/08/2020] [Accepted: 11/19/2021] [Indexed: 12/19/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people around the world, with most cases recorded among adults. The cases reported among children have been acknowledged to be minimal in comparison to adults. Nevertheless, coronavirus disease 2019 (COVID-19) has been reported to affect children of all ages, including newborns. The symptoms among children have also been identified to be similar to those observed among adults, although paediatric patients have been noted to display a spectrum of clinical features ranging from asymptomatic to moderate symptoms. Despite ample publications on the ongoing pandemic, the literature is only replete with guidelines on treating SARS-CoV-2 infection among older people. In this narrative review, comprehensive updates on the infection in children have been discussed. The latest information on the spread of the disease among children around the world, the clinical features observed among the paediatric population, as well as recommended pharmaceutical treatments of COVID-19 among this special group of patients have been covered. Further, expert consensus statements regarding the management of this highly contagious disease among pregnant women and neonates have been discussed. It is believed that this comprehensive review will provide updated information on the epidemiology and clinical features of the ongoing pandemic among paediatric patients. Additionally, the guidelines for handling SARS-CoV-2 among pregnant women and children, as reviewed in this article, are anticipated to be useful to frontline clinicians battling this fatal disease around the globe.
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Affiliation(s)
- Foster Kofi Ayittey
- Department of Chemical and Energy EngineeringCurtin Malaysia Research InstituteCurtin University MalaysiaMiriSarawakMalaysia
| | | | - Bablu Kumar Dhar
- Department of International Trade and EconomicsYantai UniversityYantaiShandongChina
| | | | - Agus Saptoro
- Department of Chemical and Energy EngineeringCurtin Malaysia Research InstituteCurtin University MalaysiaMiriSarawakMalaysia
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Mahmood MM, Jafarli I, Al-Barazanchi AF, Mosa NM, Al-Ameen ZGY, Alkhanchi T. What you need to know about children's COVID-19: a systematic review. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:1080-1090. [PMID: 34753538 DOI: 10.7499/j.issn.1008-8830.2106122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The aim of the systematic review is to describe clinical features of coronavirus disease 2019 (COVID-19) in children with a focus on the possible reasons why children are less susceptible to COVID-19 and whether their immune response works better than adults. The three research questions below were determined. (1) Why do pediatric COVID-19 cases have milder clinical symptoms than adults? (2) What are clinical manifestations, diagnosis, and treatment of COVID-19 in children? (3) How long lasts viral shedding after recovery? We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Abstracts of Reviews of Effects, as well as foreign literature with English translations. Extra information and data have been collected from Google Scholar and the American Society for Microbiology. Information on patients' age, comorbidities, methods of treatment, and effects on mortality and morbidity were extracted. It is concluded that children are less susceptible to COVID-19 than adults and that the symptoms in children are less severe than in adults. A low incidence of COVID-19 in children and milder disease than in adults might be attributed to many theories and reasons; however, the mechanisms involved are not fully understood.
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Affiliation(s)
- Majid Mohammed Mahmood
- Unit of Zoonotic Diseases, College of Veterinary Medicine, University of Baghdad, Iraq, Baghdad, Iraq
| | - Ilhama Jafarli
- Pediatric Surgery Department, Cardiff and Vale University Hospital, Heath Park. CF14 4XW, Cardiff, Wales, UK
| | - Aras Fathi Al-Barazanchi
- Department of Pediatrics, Pediatric Hospital, Halabja, Halabja Road, Sulimanyha, Postal code 46018, Kurdistan Region of Iraq
| | - Nadhim Mohammed Mosa
- Department of Radiology Techniques, Al-Qalam University College, Nawroz City, Erbil, Postal code 44001, Iraq
| | - Zenab Ghanim Younus Al-Ameen
- Division of Pharmaceuticals, Al-Adel Health Sector, Al-Kharkh Health Center, Ministry of Health, Baghdad, Postal code 10006, Iraq
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Saeed H, Osama H, Madney YM, Harb HS, Abdelrahman MA, Ehrhardt C, Abdelrahim MEA. COVID-19; current situation and recommended interventions. Int J Clin Pract 2021; 75:e13886. [PMID: 33278855 PMCID: PMC7883281 DOI: 10.1111/ijcp.13886] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 11/01/2020] [Accepted: 11/30/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The new coronavirus (SARS-COV-2) that emerged at the end of 2019 was stated in China and infected millions of people around the world, with the highest spread rate amongst humans compared with other coronaviruses. This paper aimed to review and analyse the published studies about COVID-19 diagnosis, prevention, and treatment. METHOD The reviewed studies were clinical trials, in-vivo, in-vitro, guidelines, reports from the world health organization (WHO), and the centre for disease control and prevention (CDC) in addition to systemic reviews. All data extracted and analysed to stand on the latest updates and recommendations for fighting this severe attack of COVID-19. RESULTS Most important antiviral therapy of COVID-19 clinical trials is still running without clear results, but a few trials have indicated the role of numerous drugs in the treatment of COVID-19. Specific recommendations for aerosol therapy should be followed for the management of COVID-19. CONCLUSION Nature of COVID-19 is still not very clear, however, management of the condition is similar to the previous attacks of coronaviruses.
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Affiliation(s)
- Haitham Saeed
- Clinical Pharmacy DepartmentFaculty of PharmacyBeni‐Suef UniversityBeni‐SuefEgypt
| | - Hasnaa Osama
- Clinical Pharmacy DepartmentFaculty of PharmacyBeni‐Suef UniversityBeni‐SuefEgypt
| | - Yasmin M. Madney
- Clinical Pharmacy DepartmentFaculty of PharmacyBeni‐Suef UniversityBeni‐SuefEgypt
| | - Hadeer S. Harb
- Clinical Pharmacy DepartmentFaculty of PharmacyBeni‐Suef UniversityBeni‐SuefEgypt
| | - Mona A. Abdelrahman
- Clinical Pharmacy DepartmentFaculty of PharmacyBeni‐Suef UniversityBeni‐SuefEgypt
| | - Carsten Ehrhardt
- School of Pharmacy and Pharmaceutical SciencesTrinity College DublinDublin 2Ireland
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A literature review of 2019 novel coronavirus (SARS-CoV2) infection in neonates and children. Pediatr Res 2021; 89:1101-1108. [PMID: 32679582 DOI: 10.1038/s41390-020-1065-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/18/2020] [Accepted: 06/29/2020] [Indexed: 01/08/2023]
Abstract
At the time of writing, there are already millions of documented infections worldwide by the novel coronavirus 2019 (2019-nCoV or severe acute respiratory syndrome coronavirus 2 (SARS-CoV2)), with hundreds of thousands of deaths. The great majority of fatal events have been recorded in adults older than 70 years; of them, a large proportion had comorbidities. Since data regarding the epidemiologic and clinical characteristics in neonates and children developing coronavirus disease 2019 (COVID-19) are scarce and originate mainly from one country (China), we reviewed all the current literature from 1 December 2019 to 7 May 2020 to provide useful information about SARS-CoV2 viral biology, epidemiology, diagnosis, clinical features, treatment, prevention, and hospital organization for clinicians dealing with this selected population. IMPACT: Children usually develop a mild form of COVID-19, rarely requiring high-intensity medical treatment in pediatric intensive care unit. Vertical transmission is unlikely, but not completely excluded. Children with confirmed or suspected COVID-19 must be isolated and healthcare workers should wear appropriate protective equipment. Some clinical features (higher incidence of fever, vomiting and diarrhea, and a longer incubation period) are more common in children than in adults, as well as some radiologic aspects (more patchy shadow opacities on CT scan images than ground-glass opacities). Supportive and symptomatic treatments (oxygen therapy and antibiotics for preventing/treating bacterial coinfections) are recommended in these patients.
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Sarman A, Tuncay S. Principles of approach to suspected or infected patients related Covid-19 in newborn intensive care unit and pediatric intensive care unit. Perspect Psychiatr Care 2021; 57:957-964. [PMID: 33184910 DOI: 10.1111/ppc.12643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/08/2020] [Accepted: 09/30/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE In this study, it was aimed to evaluate physical and mental health (MH) effects of children and their parents in newborn intensive care unit and pediatric intensive care unit due to Covid-19. CONCLUSIONS Children are less likely to develop severe illness than adults. It may benefit from medical and psychological/behavioral interventions. Prevent negative MH outcomes for babies/children/caregivers affected by Covid-19. PRACTICE IMPLICATIONS It is useful to clarify the clinical course of children (treatment, care procedures, psychosocial effects, etc.). The establishment of mental health expert nursing teams, psychological counseling (synchronous telemedicine services for support purposes, telepsychiatry for parents, etc.) may have helped prevent negative mental health of Covid-19 outcomes. Continuous updating of medical staff's knowledge and skills for the prevention of Covid-19 is expected to slow the spread of the disease.
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Affiliation(s)
- Abdullah Sarman
- Department of Medical Services and Techniques, Vocational School of Health Services, Bingol University, Bingol, Turkey
| | - Suat Tuncay
- Department of Pediatric Nursing, Bingol University, Bingol, Turkey
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12
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Parsons S, Tran VL. The Trilogy of SARS-CoV-2 in Pediatrics (Part 1): Acute COVID-19 in Special Populations. J Pediatr Pharmacol Ther 2021; 26:220-239. [PMID: 33833623 DOI: 10.5863/1551-6776-26.3.220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 01/27/2021] [Indexed: 12/18/2022]
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.
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Alcindor ML, Alcindor F, Richard KE, Ajay G, Denis AM, Dickson DM, Lawal E, Alcindor MA, Allen D. COVID-19 Management in Pediatrics. J Nurse Pract 2021; 17:528-535. [PMID: 33723483 PMCID: PMC7942142 DOI: 10.1016/j.nurpra.2021.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is a deadly global pandemic, with scientific efforts improving our understanding of this novel coronavirus. No proven disease-specific therapies exist, although 2 vaccines have been recently approved by the United States Food and Drug Administration under emergency use authorization, and several others are in development or phase III clinical trial testing. COVID-19 presents in greater severity in the medically fragile, obese, elderly, and socially disadvantaged, and children in general are less affected. All children are at risk, but those with comorbidities and neonates are more susceptible. The multisystem inflammatory syndrome is a severe version which can present in any child with a recent COVID-19 infection. The face of the pandemic has been changing in the last few months, with recent increasing cases, virus mutations, and onset of vaccination. This article provides COVID-19 management for children and adolescents and implications for nursing and advanced practice providers.
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Alam A, Sudarwati S, Hakim DDL, Mahdiani S. Case Report: Severe COVID-19 and Dengue in an Indonesian Infant. Am J Trop Med Hyg 2021; 104:1456-1460. [PMID: 33626019 PMCID: PMC8045663 DOI: 10.4269/ajtmh.20-1244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/09/2021] [Indexed: 12/23/2022] Open
Abstract
We report a case of a 10-month infant with dual severe infection of COVID-19 and dengue fever who was admitted to the hospital with an influenza-like illness. The patient experienced severe conditions of COVID-19 and dengue fever with shock followed by disseminated intravascular coagulation. The standard of COVID-19 care was given coupled with fluid resuscitation and blood transfusion. The pitfalls of this case are how to differentiate the clinical manifestation of dengue fever in a patient with confirmed COVID-19; the difficulty to monitor the dengue course of illness of the patient in the COVID-19 isolation room; and to differentiate the severe dengue from the multisystem inflammatory syndrome-C when the patient was in critical condition. The infant recovered without sequale, but the management of new probable cases must be improved more thoroughly, especially during dengue peak period in tropical and developing countries such as Indonesia.
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Affiliation(s)
- Anggraini Alam
- 1Department of Child Health Hasan Sadikin General Hospital, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
| | - Sri Sudarwati
- 1Department of Child Health Hasan Sadikin General Hospital, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia.,2Limijati Hospital, Bandung, Indonesia
| | - Dzulfikar Djalil Lukmanul Hakim
- 1Department of Child Health Hasan Sadikin General Hospital, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia.,2Limijati Hospital, Bandung, Indonesia
| | - Sally Mahdiani
- 2Limijati Hospital, Bandung, Indonesia.,3Department of Ear Nose and Throat Hasan Sadikin General Hospital, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
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15
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SARMAN A, TUNCAY S, SARMAN E. Çocuklarda Covid-19’un Tanılanmasında Hemşirelik Yaklaşımı: Sistematik Bir İnceleme. ACTA MEDICA ALANYA 2021. [DOI: 10.30565/medalanya.843403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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16
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Merino-Navarro D, Díaz-Periánez C. [Prevention and treatment of COVID-19 in the pediatric population from the family and community perspective]. ENFERMERIA CLINICA 2021; 31:S29-S34. [PMID: 32425488 PMCID: PMC7229975 DOI: 10.1016/j.enfcli.2020.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 12/23/2022]
Abstract
Based on the report on the situation of COVID-19 in Spain, dated April 3, 2020, the confirmed cases amount to 117,710, of which 343 are under 14 years of age (< 1%). It is essential to know the specificity of this process in the child population, as well the specific recommendations for proper prevention and care of children during the COVID-19 pandemic. The paper aim is to analyze the scientific evidence on the specific recommendations for pediatric care in cases of COVID-19 from the family and community settings.The main recommendations and preventive measures in primary health care settings and at home have been selected and analyzed from an integrative approach that includes the biopsychosocial aspects of the child during confinement.The importance of caring for children in the face of the disease lies above all in ensuring the correct measures for the prevention of contagion due to the condition of acting as possible carriers during an incubation period of up to 21 days. The recommendation is that children actively participate in routine preventive actions to contain the spread of the disease. At the household level, isolation is an important challenge for families where there are manifestations of uncertainty, fear and helplessness in the face of changes and among the recommendations are establishing routines and order through schedules of activities and leisure together with hygiene measures.Given the rapidity with which the COVID-19 pandemic has occurred, there is little evidence at the moment. Research on prevention and treatment in the pediatric age needs to be developed to improve the available recommendations.
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Affiliation(s)
- Dolores Merino-Navarro
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Huelva, Huelva, España.
| | - Cristina Díaz-Periánez
- Doctorado en Ciencias de la Salud, Departamento de Enfermería, Facultad de Enfermería, Universidad de Huelva, Huelva, España
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17
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Cardenas MC, Bustos SS, Enninga EAL, Mofenson L, Chakraborty R. Characterising and managing paediatric SARSCoV-2 infection: Learning about the virus in a global classroom. Acta Paediatr 2021; 110:409-422. [PMID: 33175403 DOI: 10.1111/apa.15662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/26/2020] [Accepted: 11/06/2020] [Indexed: 01/08/2023]
Abstract
AIM This study is a comprehensive review with the purpose of collecting the most relevant data in several sections including current treatment guidelines in the paediatric population. METHODS Literature was systematically searched in different databases. Results were limited to 2019+ and English, French and Spanish language. RESULTS Children can exhibit mild and less severe COVID-19 disease than adults and also have asymptomatic carriage of SARS-CoV-2, while severe disease is more frequently noted during infancy (<1 year). SARS-CoV-2 binds the angiotensin-converting enzyme 2 (ACE-2) receptor; age-, racial-, and gender-specific differences in ACE-2 expression need to be elucidated in order to explain the differential clinical profiles between children and adults. Multisystem inflammatory syndrome in children (MIS-C) is an important condition to recognise in children. The decision to use antiviral or immunomodulatory therapy in a child or adolescent should be individualised based on the clinical scenario. Remdesivir is the only FDA-approved therapy available for children older than 12 years old who require hospitalisation for COVID-19. CONCLUSION Further studies are urgently required to address prevention and treatment in at-risk and infected children, especially with underlying comorbidities. The chapter on the overall impact of COVID-19 in children has not yet been written. Nevertheless, SARS-CoV-2 has now joined a long list of human pandemics, which may forever change the world's history.
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Affiliation(s)
- Maria C. Cardenas
- Division of Pediatric Infectious Diseases Department of Mayo Clinic Rochester Minnesota USA
| | - Samyd S. Bustos
- Department of Surgery Mayo Clinic Rochester Minnesota USA
- Center for Regenerative Medicine Mayo Clinic Rochester Minnesota USA
| | | | - Lynne Mofenson
- Elizabeth Glaser Pediatric AIDS Foundation Washington District of Columbia USA
| | - Rana Chakraborty
- Division of Pediatric Infectious Diseases Department of Mayo Clinic Rochester Minnesota USA
- Department of Obstetrics and Gynecology Mayo Clinic Rochester Minnesota USA
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18
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Sabatino J, Moscatelli S, Rustamova Y, Kotlar I, Avesani M, Brida M, Gök G, Borrelli N, Marchenko O, Calvieri C, Czerwińska-Jelonkiewicz K, Moharem-Elgamal S, Grapsa J, Kemaloğlu Öz T. Women's perspective on the COVID-19 pandemic: Walking into a post-peak phase. Int J Cardiol 2021; 323:29-33. [PMID: 32800917 PMCID: PMC7423508 DOI: 10.1016/j.ijcard.2020.08.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/03/2020] [Accepted: 08/07/2020] [Indexed: 01/08/2023]
Abstract
The pandemic of Novel Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has provoked hundreds of thousands of deaths, resulting in catastrophe for humans. Although some insights have been garnered in studies on women, children and young adults infected with COVID-19, these often remain fragmented in literature. Therefore, we discussed the impact of COVID-19 pandemic on women, children and young patients, particularly those with underlying cardiovascular comorbidities or congenital heart disease. Furthermore, we gathered and distilled the existing body of literature that describes their cardiovascular complications and the recommended actions in favour of those patients toward the post-peak pandemic period. Although many questions still require answers, this article is sought to help the practicing clinician in the understanding and management of the threatening disease in special populations.
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Affiliation(s)
- Jolanda Sabatino
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy.
| | - Sara Moscatelli
- Clinic of Cardiovascular Diseases, University of Genoa, Genoa, Italy
| | - Yasmin Rustamova
- Department of Internal Medicine 1/Cardiology, Azerbaijan Medical University, Baku, Azerbaijan
| | - Irina Kotlar
- University Clinic of Cardiology, Skopje, Macedonia
| | - Martina Avesani
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Margarita Brida
- Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, United Kingdom; Division of Adult Congenital Heart Disease, Department of Cardiovascular Medicine, University Hospital Centre, Zagreb, Croatia
| | - Gülay Gök
- Department of Cardiology, Medipol University Hospital, Istanbul, Turkey
| | - Nunzia Borrelli
- Paediatric Cardiology Department, Bambino Gesù Children Hospital, Rome, Italy
| | - Oksana Marchenko
- Ukrainian Children's Cardiac Center, Clinic for adults, Kyiv, Ukraine; Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
| | - Camilla Calvieri
- Paediatric Cardiology Department, Bambino Gesù Children Hospital, Rome, Italy; Department of Internal Medicine, Anesthesiology and Cardiovascular Sciences, "La Sapienza" University of Rome, Italy
| | - Katarzyna Czerwińska-Jelonkiewicz
- Andrzej Frycz Modrzewski Krakow University, Kraków, Poland; Intensive Therapy Unit, Harefield Hospital, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom
| | - Sarah Moharem-Elgamal
- Cardiology Department, Bristol Heart Institute-, Bristol, United Kingdom; Cardiology Department, National Heart Institute, Giza, Egypt
| | - Julia Grapsa
- Cardiology Department, Guys and St Thomas Hospitals NHS Trust, London, United Kingdom
| | - Tugba Kemaloğlu Öz
- Liv Hospital Ulus, Cardiology Department, Istanbul, Turkey; Istinye University, Faculty of medicine, Istanbul, Turkey.
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19
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Ha JF. COVID-19 in Children: A Narrative Review. Curr Pediatr Rev 2021; 17:212-219. [PMID: 34042036 DOI: 10.2174/1573396317666210526155313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/31/2020] [Accepted: 03/06/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic is caused by the third known zoonotic coronavirus. It is a disease that does not spare any age group. The scientific community has been inundated with information since January. This review aims to summarise pertinent information related to COVID-19 in children. METHODS A literature search was conducted in 2020 on the PubMed, MEDLINE, and Embase databases, with the keyword "COVID 19" and "children". A bibliographic search of articles included was also undertaken. The abstracts were scanned to assess their appropriateness to be included in this narrative review. This was updated on the 11th April, 2020. RESULTS The aetiology, transmission, incubation, pathophysiology, clinical features and complications, and management are discussed. CONCLUSION Our understanding of COVID-19 is evolving as more reports are published. The growth of SARS-CoV2 is limited in children and they are often asymptomatic. The disease course is also milder. Continued research to understand its effect on children is important to help us manage the disease in these vulnerable populations in a timely fashion.
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Affiliation(s)
- Jennifer F Ha
- Department of Paediatrics Otolaryngology-Head & Neck Surgery, Perth Children's Hospital, 15 Hospital Avenue, Nedlands 6009, Western Australia, Australia
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20
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Afshar Z, Babazadeh A, Javanian M, Barary M, Rekha V, Ebrahimpour S. A comprehensive review of COVID-19 treatment. ACTA FACULTATIS MEDICAE NAISSENSIS 2021. [DOI: 10.5937/afmnai38-26326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus strain that caused coronavirus disease 2019 (COVID-19). This novel coronavirus is an emerging global health threat. It caused approximately 140 million confirmed cases, with about 3 million deaths worldwide until April 18, 2021. Although there are two approved medications for this disease, remdesivir and dexamethasone, numerous studies are underway to investigate more therapeutic options. However, so far, most treatments have been supportive, and the clinical efficacy of the suggested drugs is still under consideration. The purpose of this review is to summarize the ongoing treatments, such as several antivirals, convalescent plasma transfusion, and adjunctive medications, with the intent of serving as a clinical guide for the physician and a resource for further evaluations in various clinical trials.
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21
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Ibrahim Fouad G. A proposed insight into the anti-viral potential of metallic nanoparticles against novel coronavirus disease-19 (COVID-19). BULLETIN OF THE NATIONAL RESEARCH CENTRE 2021; 45:36. [PMID: 33564223 PMCID: PMC7863044 DOI: 10.1186/s42269-021-00487-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/06/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Over the last ten months since December 2019, the world has faced infectious emerging novel coronavirus disease-2019 (COVID-19) outbreaks that had a massive global impact affecting over 185 countries. MAIN BODY Emerging novel COVID-19 is a global health emergency on a pandemic scale that represents a terror to human health through its ability to escape anti-viral measures. Such viral infections impose a great socioeconomic burden, besides global health challenges. This imposes a pressing need for the development of anti-viral therapeutic agents and diagnostic tools that demonstrate multifunctional, target-specific, and non-toxic properties. Nanotheranostics is regarded as a promising approach for the management of different viral infections. Nanotheranostics facilitates targeted drug-delivery of anti-viral therapeutics as well as contributing to the development of diagnostic systems. Multifunctional metallic nanoparticles (NPs) have emerged as innovative theranostic agents that enable sustainable treatment and effective diagnosis. Here we have reviewed current advances in the use of theranostic metallic NPs to fight against COVID-19, and discussed the application as well as limitations associated with nanotechnology-based theranostic approaches. CONCLUSION This review verified the potential use of some metal-based NPs as anti-viral nanotheranostic agents. Metal-based NPs could act as carriers that enable the sustainable and targeted delivery of active anti-viral molecules, or as diagnostic agents that allow rapid and sensitive diagnosis of viral infections.
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Affiliation(s)
- Ghadha Ibrahim Fouad
- Department of Therapeutic Chemistry, National Research Centre, 33 El-Bohouth St., Dokki, Cairo, 12622 Egypt
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22
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Mulaw Belete T. An Up-to-Date Overview of Therapeutic Agents for the Treatment of COVID-19 Disease. Clin Pharmacol 2020; 12:203-212. [PMID: 33363416 PMCID: PMC7753885 DOI: 10.2147/cpaa.s284809] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/04/2020] [Indexed: 12/15/2022] Open
Abstract
Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has a great potential to overwhelm the world healthcare systems that may lead to high morbidity and mortality. It also affects world economic development in the future. Currently, no proven effective drugs or vaccines are available for the management of COVID-19 disease. The pace of normal drug development progression is unacceptable in the context of the current pandemic. Therefore, repurposing the existing drugs that were used for the treatment of malaria, Ebola, and influenza helps rapid drug development for COVID-19. Currently, several repurposing candidate drugs are in a clinical trial including, chloroquine monoclonal antibodies, convalescent plasma, interferon, and antiviral therapies. Antiviral drugs like arbidol, remdesiv and favirnavir are the most promising due to the similarities of the viruses regarding viral entry, fusion, uncoating, and replication. This review article provides an overview of the potential therapeutic agent, which displayed better clinical treatment outcomes. Moreover, with further understanding of the SARS-CoV-2 virus, new drugs targeting specific SARS-CoV-2 viral components arise, and investigations on these novels anti-SARSCoV- 2 agents are also reviewed.
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Affiliation(s)
- Tafere Mulaw Belete
- Department of Pharmacology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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23
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COVID-19 in Children and Neonates: A Comprehensive Review Article. IRANIAN JOURNAL OF PEDIATRICS 2020. [DOI: 10.5812/ijp.108095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Context: Novel coronavirus (COVID-19) has become a new public health crisis, posing a great threat to the people all around the world. We aimed to review the articles on COVID-19 in pediatric population to help physicians and other healthcare workers understand the importance of detecting silent disease carriers in this age group and stop further transmission to other healthy individuals and manage symptomatic patients based on the latest recommendations. Methods: We searched databases including PubMed, Scopus, Google Scholar, and Medline and reviewed 70 articles from December 2019 to mid-July 2020. Relevant articles about COVID-19 in children were included. Results: According to the latest reports, 1% - 5% of infected patients were under 19 years old. Death in this age group was rare but it can occur in children with severe disease. The overall course of disease -mainly pulmonary involvement- of the infected children tend to be milder than adults. This may be related to both host factors and exposure. The lab tests and computed tomography (CT) scan findings are nonspecific and milder compared to those in older ages. The cornerstone of COVID-19 management in pediatric group is supportive care. Of note, there is not any approved specific drug for treatment of children affected by COVID-19. Conclusions: COVID-19 disease characteristics in children are not yet fully established, which poses a significant problem for pediatric medical specialists. It should be considered that most children are asymptomatic or have mild symptoms. Critical cases, although uncommon, can occur especially in children with underlying diseases.
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24
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Ghasemiyeh P, Mohammadi-Samani S. COVID-19 outbreak: Challenges in pharmacotherapy based on pharmacokinetic and pharmacodynamic aspects of drug therapy in patients with moderate to severe infection. Heart Lung 2020; 49:763-773. [PMID: 32980626 PMCID: PMC7500907 DOI: 10.1016/j.hrtlng.2020.08.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/15/2020] [Accepted: 08/26/2020] [Indexed: 01/08/2023]
Abstract
The new coronavirus (COVID-19) was first detected in Wuhan city of China in December 2019. Most patients infected with COVID-19 had clinical presentations of dry cough, fever, dyspnea, chest pain, fatigue and malaise, pneumonia, and bilateral infiltration in chest CT. Soon COVID-19 was spread around the world and became a pandemic. Now many patients around the world are suffering from this disease. Patients with predisposing diseases are highly prone to COVID-19 and manifesting severe infection especially with organ function damage such as acute respiratory distress syndrome, acute kidney injury, septic shock, ventilator-associated pneumonia, and death. Till now many drugs have been considered in the treatment of COVID-19 pneumonia, but pharmacotherapy in elderly patients and patients with pre-existing comorbidities is highly challenging. In this review, different potential drugs which have been considered in COVID-19 treatment have been discussed in detail. Also, challenges in the pharmacotherapy of COVID-19 pneumonia in patients with the underlying disease have been considered based on pharmacokinetic and pharmacodynamic aspects of these drugs.
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Affiliation(s)
- Parisa Ghasemiyeh
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran; Pharmaceutical Sciences Research Center, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soliman Mohammadi-Samani
- Pharmaceutical Sciences Research Center, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
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25
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Jaiswal S, Kumar M, Mandeep, Sunita, Singh Y, Shukla P. Systems Biology Approaches for Therapeutics Development Against COVID-19. Front Cell Infect Microbiol 2020; 10:560240. [PMID: 33194800 PMCID: PMC7655984 DOI: 10.3389/fcimb.2020.560240] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/29/2020] [Indexed: 12/13/2022] Open
Abstract
Understanding the systems biology approaches for promoting the development of new therapeutic drugs is attaining importance nowadays. The threat of COVID-19 outbreak needs to be vanished for global welfare, and every section of research is focusing on it. There is an opportunity for finding new, quick, and accurate tools for developing treatment options, including the vaccine against COVID-19. The review at this moment covers various aspects of pathogenesis and host factors for exploring the virus target and developing suitable therapeutic solutions through systems biology tools. Furthermore, this review also covers the extensive details of multiomics tools i.e., transcriptomics, proteomics, genomics, lipidomics, immunomics, and in silico computational modeling aiming towards the study of host-virus interactions in search of therapeutic targets against the COVID-19.
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Affiliation(s)
- Shweta Jaiswal
- Enzyme Technology and Protein Bioinformatics Laboratory, Department of Microbiology, Maharshi Dayanand University, Rohtak, India
| | - Mohit Kumar
- Soil Microbial Ecology and Environmental Toxicology Laboratory, Department of Zoology, University of Delhi, Delhi, India
- Department of Zoology, Hindu College, University of Delhi, Delhi, India
| | - Mandeep
- Enzyme Technology and Protein Bioinformatics Laboratory, Department of Microbiology, Maharshi Dayanand University, Rohtak, India
| | - Sunita
- Enzyme Technology and Protein Bioinformatics Laboratory, Department of Microbiology, Maharshi Dayanand University, Rohtak, India
- Bacterial Pathogenesis Laboratory, Department of Zoology, University of Delhi, Delhi, India
| | - Yogendra Singh
- Bacterial Pathogenesis Laboratory, Department of Zoology, University of Delhi, Delhi, India
| | - Pratyoosh Shukla
- Enzyme Technology and Protein Bioinformatics Laboratory, Department of Microbiology, Maharshi Dayanand University, Rohtak, India
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26
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de M Ribeiro LN, Fonseca BB. The role of pharmaceutical nanotechnology in the time of COVID-19 pandemic. Future Microbiol 2020; 15:1571-1582. [PMID: 33215525 PMCID: PMC7682556 DOI: 10.2217/fmb-2020-0118] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/20/2020] [Indexed: 12/24/2022] Open
Abstract
There is no effective therapy against COVID-19 available so far. In the last months, different drugs have been tested as potential treatments for COVID-19, exhibiting high toxicity and low efficacy. Therefore, nanotechnology can be applied to improve the therapeutic action and minimize the toxicity of loaded drugs. In this review, we summarized the drugs tested as COVID-19 treatment and the advantages of antiviral nanostructured drug-delivery systems. Such systems have demonstrated low in vitro toxicity with better in vitro antiviral activity than free drugs. We believe that this approach should inspire novel nanostructured drug-delivery systems developments to find efficient COVID-19 treatments. Here, we discuss the remaining challenges for such promising nanosystems to be approved for clinical use.
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Affiliation(s)
- Lígia N de M Ribeiro
- School of Veterinary Medicine, Federal University of Uberlandia, Uberlândia, Brazil
- Institute of Biotechnology, Federal University of Uberlandia, Uberlândia, Brazil
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27
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Mehrabani S. COVID-19 Infection and Children: A Comprehensive Review. Int J Prev Med 2020; 11:157. [PMID: 33312466 PMCID: PMC7716606 DOI: 10.4103/ijpvm.ijpvm_277_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/15/2020] [Indexed: 01/07/2023] Open
Abstract
Nowadays, COVID-19 is in pandemic stage, and concerns about the infection of children are on the rise. At first, it has been believed that children are not at risk while some evidences have shown that the risk of infection is lower in children than adults. The COVID-19 children indicated milder symptoms including cough, fever, sore throat, myalgia sneezing, and fatigue than COVID-19 adults. Lymphopenia, which is prevalent in adult cases, has not been reported in pediatric patients. The COVID-19 can also occur in neonates although vertical transmission from mothers to fetuses during pregnancy is rare. Overall, the outcome is better in children than adults. Thus far, there has been neither specific treatment for eradicating the infection nor any preventative vaccine for COVID-19, Preventive measures such as frequent hand washing, social distancing and wearing face mask are the best ways.
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Affiliation(s)
- Sanaz Mehrabani
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IR Iran,Address for correspondence: Dr. Sanaz Mehrabani, Non-Communicable Pediatric Diseases Research Center, No 19, Amirkola Children's Hospital, Amirkola, Babol, Mazandaran Province, 47317-41151, IR Iran. E-mail:
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28
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Diamond R, Fischer A, Hooe B, Sewell TB, Schweickert A, Ahn D, Jamal N, Zachariah P, Cheng J, Abreu W, Giordano M. A Clinical Pathway for Hospitalized Pediatric Patients With Initial SARS-CoV-2 Infection. Hosp Pediatr 2020; 10:810-819. [PMID: 32847961 DOI: 10.1542/hpeds.2020-0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread quickly across the globe, creating unique and pressing challenges for today's physicians. Although this virus disproportionately affects adults, initial SARS-CoV-2 infection can present a significant disease burden for the pediatric population. A review of the literature yields descriptive studies in pediatric patients; however, no evidence-based or evidence-informed guidelines for the diagnosis and treatment of the hospitalized pediatric patient have been published in peer-reviewed journals. The authors, working at a quaternary care children's hospital in the national epicenter of the SARS-CoV-2 pandemic, found an urgent need to create a unified, multidisciplinary, evidence-informed set of guidelines for the diagnosis and management of coronavirus disease 2019 in children. In this article, the authors describe our institutional practices for the hospitalized pediatric patient with confirmed or suspected initial SARS-CoV-2 infection. The authors anticipate that developing evidence-informed and institution-specific guidelines will lead to improvements in care quality, efficiency, and consistency; minimization of staff risk of exposure to SARS-CoV-2; and increased provider comfort in caring for pediatric patients with SARS-CoV-2 infection.
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Affiliation(s)
- Rebekah Diamond
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York; and .,NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Avital Fischer
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York; and.,NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Benjamin Hooe
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York; and.,NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Taylor B Sewell
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York; and.,NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Adam Schweickert
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York; and.,NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Danielle Ahn
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York; and.,NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Nazreen Jamal
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York; and.,NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Philip Zachariah
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York; and.,NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Jennifer Cheng
- NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Wanda Abreu
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York; and.,NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Mirna Giordano
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York; and.,NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York
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29
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Loi M, Branchford B, Kim J, Self C, Nuss R. COVID-19 anticoagulation recommendations in children. Pediatr Blood Cancer 2020; 67:e28485. [PMID: 32558124 PMCID: PMC7323104 DOI: 10.1002/pbc.28485] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/21/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Michele Loi
- Center for Cancer and Blood DisordersDepartment of PediatricsChildren's Hospital Colorado and University of ColoradoAuroraColorado,Division of Pediatric Critical Care, Department of PediatricsChildren's Hospital Colorado and University of ColoradoAuroraColorado
| | - Brian Branchford
- Center for Cancer and Blood DisordersDepartment of PediatricsChildren's Hospital Colorado and University of ColoradoAuroraColorado
| | - John Kim
- Heart Institute, Division of Cardiology, Department of PediatricsChildren's Hospital Colorado and University of ColoradoAuroraColorado
| | - Chelsea Self
- Center for Cancer and Blood DisordersDepartment of PediatricsChildren's Hospital Colorado and University of ColoradoAuroraColorado
| | - Rachelle Nuss
- Center for Cancer and Blood DisordersDepartment of PediatricsChildren's Hospital Colorado and University of ColoradoAuroraColorado
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30
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Wati DK, Manggala AK. Overview of management of children with COVID-19. Clin Exp Pediatr 2020; 63:345-354. [PMID: 32683801 PMCID: PMC7462825 DOI: 10.3345/cep.2020.00913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/02/2020] [Accepted: 07/10/2020] [Indexed: 02/07/2023] Open
Abstract
The widespread and contagious coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has become a burden in the global health domain. The subsequent discovery of the virus features and pathogenesis, and prompt and adequate management are still lacking and remain inconclusive. Children usually present milder symptoms than adults, and management focuses on providing symptomatic and respiratory supports. Several treatment modalities, including the utilization of mechanical ventilation (MV), antivirals, immune-modulating drugs, or other agents, may present promising results in reducing the symptoms of COVID-19, particularly in severe cases. Although no randomized clinical trials have been published to date, it is interesting to explore potential modalities for treating COVID-19 in children, based on review articles, case reports, and recent guidelines.
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Affiliation(s)
- Dyah Kanya Wati
- Pediatric Emergency and Intensive Care Sanglah Public Hospital, School of Medicine, Udayana University, Denpasar, Bali, Indonesia
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31
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De Luca CD, Esposito E, Cristiani L, Mancino E, Nenna R, Cortis E, Midulla F. Covid-19 in children: A brief overview after three months experience. Paediatr Respir Rev 2020; 35:9-14. [PMID: 32593648 PMCID: PMC7833924 DOI: 10.1016/j.prrv.2020.05.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 01/08/2023]
Abstract
Severe Acute Respiratory Syndrome - Coronavirus - 2 (SARS-CoV-2) and its related Coronavirus Disease - 19 (COVID-19) has become a health emergency worldwide. The medical community has been concerned since the beginning of the outbreak about the potential impact of COVID-19 in children, especially in those with underlying chronic diseases. Fortunately, COVID-19 has been reported to be less severe in children than in adults. However, epidemiologic and clinical data are scarce. Children show unique features of SARS-CoV-2 involvement that may account for the low rate of infection and death in this age group. The purpose of this review is to summarize the most relevant evidence of COVID-19 in children highlighting similarities and differences with adults.
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Affiliation(s)
| | - Emanuele Esposito
- Department of Maternal Science, Sapienza University of Rome, Rome, Italy
| | - Luca Cristiani
- Department of Maternal Science, Sapienza University of Rome, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Science, Sapienza University of Rome, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal Science, Sapienza University of Rome, Rome, Italy
| | | | - Fabio Midulla
- Department of Maternal Science, Sapienza University of Rome, Rome, Italy.
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32
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Rahimkhoei V, Jabbari N, Nourani A, Sharifi S, Akbari A. Potential small-molecule drugs as available weapons to fight novel coronavirus (2019-nCoV): A review. Cell Biochem Funct 2020; 39:4-9. [PMID: 32803762 PMCID: PMC7461398 DOI: 10.1002/cbf.3576] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/08/2020] [Accepted: 06/16/2020] [Indexed: 12/19/2022]
Abstract
Since the new coronavirus known as 2019‐nCoV (severe acute respiratory syndrome coronavirus 2, SARS‐CoV‐2) has widely spread in Wuhan, China, with severe pneumonia, scientists and physicians have made remarkable efforts to use various options such as monoclonal antibodies, peptides, vaccines, small‐molecule drugs and interferon therapies to control, prevent or treatment infections of 2019‐nCoV. However, no vaccine or drug has yet been confirmed to completely treat 2019‐nCoV. In this review, we focus on the use of potential available small‐molecule drug candidates for treating infections caused by 2019‐nCoV.
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Affiliation(s)
- Vahid Rahimkhoei
- Solid Tumor Research Center, Research Institute for Cellular and Molecular Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Nassrollah Jabbari
- Solid Tumor Research Center, Research Institute for Cellular and Molecular Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Aynaz Nourani
- Department of Health Information Technology, School of Allied Medical Sciences, Urmia University of Medical Sciences, Urmia, Iran
| | - Sina Sharifi
- Disruptive Technology Laboratory, Massachusetts Eye and Ear and Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Ali Akbari
- Solid Tumor Research Center, Research Institute for Cellular and Molecular Medicine, Urmia University of Medical Sciences, Urmia, Iran
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Abstract
The first pediatric coronavirus disease 2019 (COVID-19) case was confirmed in Shenzhen, China on January 20, 2020. At the beginning of the outbreak, COVID-19 pneumonia was more common in adults than in children and adolescents, and the rate of confirmed pediatric cases was relatively lower. However, as screening tests and pathogen detection campaigns were initiated in more regions as the outbreak spread, the number of pediatric infection cases increased significantly. Currently, studies on pediatric COVID-19 are limited in the literature to case reports and case series, and a few epidemiological studies. COVID-19 has distinct characteristics in the pediatric population compared to adults; therefore, we need to better understand the characteristics of this disease in children. Discovering the characteristics of the pediatric COVID-19 disease is important for contributing to the diagnosis and treatment of the disease in this population. In this review, clinical characteristics, epidemiology, diagnosis, and management of pediatric COVID-19 pneumonia based on the recent literature are discussed. [Pediatr Ann. 2020;49(7):e319-e325.].
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34
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Ghasemiyeh P, Borhani-Haghighi A, Karimzadeh I, Mohammadi-Samani S, Vazin A, Safari A, Qureshi AI. Major Neurologic Adverse Drug Reactions, Potential Drug-Drug Interactions and Pharmacokinetic Aspects of Drugs Used in COVID-19 Patients with Stroke: A Narrative Review. Ther Clin Risk Manag 2020; 16:595-605. [PMID: 32669846 PMCID: PMC7335700 DOI: 10.2147/tcrm.s259152] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/10/2020] [Indexed: 01/20/2023] Open
Abstract
Stroke has been considered as one of the underlying diseases that increases the probability of severe infection and mortality. Meanwhile, there are ongoing reports of stroke subsequent to COVID-19 infection. In this narrative paper, we reviewed major neurologic adverse drug reactions (ADRs) and pharmacokinetics of drugs which are routinely used for COVID-19 infection and their potential drug-drug interactions (PDDIs) with common drugs used for the treatment of stroke. It is highly recommended to monitor patients on chloroquine (CQ), hydroxychloroquine (HCQ), antiviral drugs, and/or corticosteroids about initiation or progression of cardiac arrhythmias, delirium, seizure, myopathy, and/or neuropathy. In addition, PDDIs of anti-COVID-19 drugs with tissue plasminogen activator (tPA), anticoagulants, antiaggregants, statins, antihypertensive agents, and iodine-contrast agents should be considered. The most dangerous PDDIs were interaction of lopinavir/ritonavir or atazanavir with clopidogrel, prasugrel, and new oral anticoagulants (NOACs).
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Affiliation(s)
- Parisa Ghasemiyeh
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
- Pharmaceutical Sciences Research Center, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Iman Karimzadeh
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soliman Mohammadi-Samani
- Pharmaceutical Sciences Research Center, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Afsaneh Vazin
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anahid Safari
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Adnan I Qureshi
- Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO, USA
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35
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2019 Novel Coronavirus Infection in Children and Infants: Where We Are and What We Know? ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2020. [DOI: 10.5812/archcid.103785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
: Since the outbreak of coronavirus disease 2019 (COVID-19), in Wuhan, China, there were more than 10,021,401 confirmed infected cases. This infection has spread to almost all countries around the world with reported high mortality and morbidity. Infections in children and infants have been reported as well. The condition of the infected children was mostly mild. To date, there have been reported deaths in pediatrics testing positive for COVID-19 in countries such as China, Italy and America. The therapy strategy for the children who suffer coronavirus disease (COVID-19) has been based on the adult experience. The present review summarizes current knowledge of the etiology, epidemiology, clinical manifestations, transmission, diagnosis, treatment, and prevention of COVID-19 infection in children and infants.
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36
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Ciuca IM. COVID-19 in Children: An Ample Review. Risk Manag Healthc Policy 2020; 13:661-669. [PMID: 32636686 PMCID: PMC7334563 DOI: 10.2147/rmhp.s257180] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/10/2020] [Indexed: 01/08/2023] Open
Abstract
The aim of this review was to describe the current knowledge about coronavirus disease 2019 (COVID-19, which is caused by severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) in children, from epidemiological, clinical, and laboratory perspectives, including knowledge on the disease course, treatment, and prognosis. An extensive literature search was performed to identify papers on COVID-19 (SARS-CoV-2 infection) in children, published between January 1, 2020 and April 1, 2020. There were 44 relevant papers on COVID-19 in children. The results showed that COVID-19 occurs in 0.39-12.3% of children. Clinical signs and symptoms are comparable to those in adults, but milder forms and a large percentage of asymptomatic carriers are found among children. Elevated inflammatory markers are associated with complications and linked to various co-infections. Chest computed tomography (CT) scans in children revealed structural changes similar to those found in adults, with consolidations surrounded by halos being somewhat specific for children with COVID-19. The recommended treatment includes providing symptomatic therapy, with no specific drug recommendations for children. The prognosis is much better for children compared to adults. This review highlights that COVID-19 in children is similar to the disease in the adult population, but with particularities regarding clinical manifestations, laboratory test results, chest imaging, and treatment. The prognosis is much better for children compared to adults, but with the progression of the pandemic; the cases in children might change in the future.
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Affiliation(s)
- Ioana M Ciuca
- Pediatric Department, University of Medicine and Pharmacy “Victor Babes”, Pediatric Pulmonology Unit, Clinical County Hospital, Timisoara, Romania
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37
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Ferranti JF, Rodriguez IS, Motta E, Johnston C, Carvalho WBDB, Delgado AF. Beyond ventilatory support: challenges in general practice and in the treatment of critically Ill children and adolescents with SARS-CoV-2 infection. ACTA ACUST UNITED AC 2020; 66:521-527. [PMID: 32578790 DOI: 10.1590/1806-9282.66.4.521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 01/15/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2 infection) is a new challenge for all countries, and children are predisposed to acquire this disease. Some studies have demonstrated more severe diseases in adults, but critically ill pediatric patients have been described in all ages. Pulmonary involvement is the major feature, and ventilatory support is common in critical cases. Nevertheless, other very important therapeutic approaches must be considered. In this article, we reviewed extensively all recent medical literature to point out the main clinical attitudes to support these pediatric patients during their period in respiratory support. Radiologic findings, fluid therapy, hemodynamic support, use of inotropic/vasopressors, nutritional therapy, antiviral therapy, corticosteroids, antithrombotic therapy, and immunoglobulins are analyzed to guide all professionals during hospitalization. We emphasize the importance of a multi-professional approach for adequate recovery.
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Affiliation(s)
- Juliana Ferreira Ferranti
- . Universidade de São Paulo Instituto da Criança, Unidade de Terapia Intensiva Pediátrica, São Paulo, SP, Brasil.,. Hospital Municipal Vila Santa Catarina - Sociedade Beneficente Israelita Brasileira Albert Einstein, Unidade de Terapia Intensiva Pediátrica.Brasil
| | - Isadora Souza Rodriguez
- . Universidade de São Paulo Instituto da Criança, Unidade de Terapia Intensiva Pediátrica, São Paulo, SP, Brasil
| | - Emiliana Motta
- . Universidade de São Paulo Instituto da Criança, Unidade de Terapia Intensiva Pediátrica, São Paulo, SP, Brasil
| | - Cíntia Johnston
- . Fisioterapeuta/RRT, Pós-Doutorado, Instituto da Criança do Hospital das Clínicas da FMUSP, Pediatria, São Paulo, SP, Brasil
| | - Werther Brunow de B Carvalho
- . Universidade de São Paulo Instituto da Criança, Unidade de Terapia Intensiva Pediátrica, São Paulo, SP, Brasil
| | - Artur Figueiredo Delgado
- . Universidade de São Paulo Instituto da Criança, Unidade de Terapia Intensiva Pediátrica, São Paulo, SP, Brasil
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38
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Gbinigie K, Frie K. Should chloroquine and hydroxychloroquine be used to treat COVID-19? A rapid review. BJGP Open 2020; 4:bjgpopen20X101069. [PMID: 32265182 PMCID: PMC7330219 DOI: 10.3399/bjgpopen20x101069] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/01/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND On the 11 March 2020, the World Health Organization (WHO) declared that COVID-19 was a pandemic. To date, there are no medical treatments for COVID-19 with proven effectiveness. Novel treatments and/or vaccines will take time to be developed and distributed to patients. In light of this, there has been growing interest in the use of existing medications, such as chloroquine (CQ) and hydroxychloroquine (HCQ), as potential treatments of this disease. AIM To establish the current evidence for the effectiveness of CQ and HCQ in treating COVID-19. DESIGN & SETTING A rapid review of the literature was conducted. METHOD Electronic searches in PubMed and Google Scholar were conducted on 21 March 2020. A further search was conducted in Google for relevant literature on 28 March 2020. RESULTS There is limited evidence of in vitro activity of CQ/HCQ against SARS-CoV-2. A number of in vivo clinical trials are underway. The empirical data available from two of these trials reveal conflicting results. Both trials are characterised by small numbers of participants (n = 30 and n = 36) and suffer methodological limitations. No medium or long-term follow-up data is available. CONCLUSION At present, there is insufficient evidence to determine whether CQ/HCQ are safe and effective treatments for COVID-19. High quality, adequately powered randomised clinical trials in primary and secondary care settings are urgently required to guide policymakers and clinicians. These studies should report medium- and long-term follow-up results, and safety data.
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Affiliation(s)
- Kome Gbinigie
- GP and Doctoral Researcher, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kerstin Frie
- Post-Doctoral Researcher, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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39
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COVID -19 pandemic and paediatric population with special reference to congenital heart disease. Indian Heart J 2020; 72:141-144. [PMID: 32768011 PMCID: PMC7411102 DOI: 10.1016/j.ihj.2020.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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40
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Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020; 109:1088-1095. [PMID: 32202343 PMCID: PMC7228328 DOI: 10.1111/apa.15270] [Citation(s) in RCA: 1415] [Impact Index Per Article: 353.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 02/06/2023]
Abstract
Aim The coronavirus disease 2019 (COVID‐19) pandemic has affected hundreds of thousands of people. Data on symptoms and prognosis in children are rare. Methods A systematic literature review was carried out to identify papers on COVID‐19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), using the MEDLINE and Embase databases between January 1 and March 18, 2020. Results The search identified 45 relevant scientific papers and letters. The review showed that children have so far accounted for 1%‐5% of diagnosed COVID‐19 cases, they often have milder disease than adults and deaths have been extremely rare. Diagnostic findings have been similar to adults, with fever and respiratory symptoms being prevalent, but fewer children seem to have developed severe pneumonia. Elevated inflammatory markers were less common in children, and lymphocytopenia seemed rare. Newborn infants have developed symptomatic COVID‐19, but evidence of vertical intrauterine transmission was scarce. Suggested treatment included providing oxygen, inhalations, nutritional support and maintaining fluids and electrolyte balances. Conclusions The coronavirus disease 2019 has occurred in children, but they seemed to have a milder disease course and better prognosis than adults. Deaths were extremely rare.
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Affiliation(s)
- Jonas F. Ludvigsson
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Paediatrics Orebro University Hospital Orebro Sweden
- Division of Epidemiology and Public Health School of Medicine University of Nottingham UK
- Department of Medicine Columbia University College of Physicians and Surgeons New York NY USA
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41
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Gasmi A, Noor S, Tippairote T, Dadar M, Menzel A, Bjørklund G. Individual risk management strategy and potential therapeutic options for the COVID-19 pandemic. Clin Immunol 2020; 215:108409. [PMID: 32276137 PMCID: PMC7139252 DOI: 10.1016/j.clim.2020.108409] [Citation(s) in RCA: 168] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/04/2020] [Accepted: 04/04/2020] [Indexed: 02/07/2023]
Abstract
It is an ugly fact that a significant amount of the world's population will contract SARS-CoV-II infection with the current spreading. While a specific treatment is not yet coming soon, individual risk assessment and management strategies are crucial. The individual preventive and protective measures drive the personal risk of getting the disease. Among the virus-contracted hosts, their different metabolic status, as determined by their diet, nutrition, age, sex, medical conditions, lifestyle, and environmental factors, govern the personal fate toward different clinical severity of COVID-19, from asymptomatic, mild, moderate, to death. The careful individual assessment for the possible dietary, nutritional, medical, lifestyle, and environmental risks, together with the proper relevant risk management strategies, is the sensible way to deal with the pandemic of SARS-CoV-II.
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Affiliation(s)
- Amin Gasmi
- Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
| | - Sadaf Noor
- Institute of Molecular Biology and Biotechnology, Bahauddin Zakariya University Multan, Pakistan
| | - Torsak Tippairote
- Nutritional and Environmental Medicine Department, BBH Hospital, Bangkok, Thailand; Faculty of Medicine, Ramathibodi Hospital and Institute of Nutrition, Mahidol University, Bangkok, Thailand
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | | | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Mo i Rana, Norway.
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42
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Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. ACTA PAEDIATRICA (OSLO, NORWAY : 1992) 2020. [PMID: 32202343 DOI: 10.1111/apa.15270)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The coronavirus disease 2019 (COVID-19) pandemic has affected hundreds of thousands of people. Data on symptoms and prognosis in children are rare. METHODS A systematic literature review was carried out to identify papers on COVID-19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), using the MEDLINE and Embase databases between January 1 and March 18, 2020. RESULTS The search identified 45 relevant scientific papers and letters. The review showed that children have so far accounted for 1%-5% of diagnosed COVID-19 cases, they often have milder disease than adults and deaths have been extremely rare. Diagnostic findings have been similar to adults, with fever and respiratory symptoms being prevalent, but fewer children seem to have developed severe pneumonia. Elevated inflammatory markers were less common in children, and lymphocytopenia seemed rare. Newborn infants have developed symptomatic COVID-19, but evidence of vertical intrauterine transmission was scarce. Suggested treatment included providing oxygen, inhalations, nutritional support and maintaining fluids and electrolyte balances. CONCLUSIONS The coronavirus disease 2019 has occurred in children, but they seemed to have a milder disease course and better prognosis than adults. Deaths were extremely rare.
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Affiliation(s)
- Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Paediatrics, Orebro University Hospital, Orebro, Sweden.,Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, UK.,Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
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43
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Saleem H, Rahman J, Aslam N, Murtazaliev S, Khan S. Coronavirus Disease 2019 (COVID-19) in Children: Vulnerable or Spared? A Systematic Review. Cureus 2020; 12:e8207. [PMID: 32577325 PMCID: PMC7305578 DOI: 10.7759/cureus.8207] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/20/2020] [Indexed: 01/08/2023] Open
Abstract
The ongoing pandemic of coronavirus disease 2019 (COVID-19) has affected people from all cultures, religions, gender, and age groups around the world. In the last few months, several studies have been conducted on various aspects of COVID-19. Our goal was to see if the pediatric population is vulnerable to this infection. In this review, we conducted extensive research mainly by using the PubMed database. We used Medical Subject Headings (MeSH) and associated keywords to engage in an extensive search focussing on COVID-19 in the pediatric population. We discovered that most of the studies were from China, and some of them were in the Chinese language. However, English translations of many of the studies were available. For accessing the relevant statistical data, we relied on the World Health Organization (WHO) resources and the official website of the Ontario Government (ontario.ca). Most of the studies showed that the virus has affected the pediatric population. However, we found some differences among these studies regarding the severity of symptoms in children affected by COVID-19. While a few studies stated that the virus has presented with milder symptoms in the pediatric population, some studies have presented data of children who have suffered life-threatening complications due to COVID-19. Although the data is limited, we have been able to conclude from the studies we reviewed that COVID-19 does indeed affect children the same way as any other age group. Moreover, children can act as carriers of the virus and can endanger the lives of other individuals. Besides, neonates and infants can easily acquire the infection from family members without having any exposure to the outside world. Hence, utmost care should be taken while handling this population. More trials and studies should be conducted to analyze the impact of early diagnosis of infection in children and its management.
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Affiliation(s)
- Hajra Saleem
- Family Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Jawaria Rahman
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Nida Aslam
- Dermatology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Salikh Murtazaliev
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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44
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45
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Gbinigie K, Frie K. Should chloroquine and hydroxychloroquine be used to treat COVID-19? A rapid review. BJGP Open 2020. [PMID: 32265182 DOI: 10.14322/publons.r7750240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND On the 11 March 2020, the World Health Organization (WHO) declared that COVID-19 was a pandemic. To date, there are no medical treatments for COVID-19 with proven effectiveness. Novel treatments and/or vaccines will take time to be developed and distributed to patients. In light of this, there has been growing interest in the use of existing medications, such as chloroquine (CQ) and hydroxychloroquine (HCQ), as potential treatments of this disease. AIM To establish the current evidence for the effectiveness of CQ and HCQ in treating COVID-19. DESIGN & SETTING A rapid review of the literature was conducted. METHOD Electronic searches in PubMed and Google Scholar were conducted on 21 March 2020. A further search was conducted in Google for relevant literature on 28 March 2020. RESULTS There is limited evidence of in vitro activity of CQ/HCQ against SARS-CoV-2. A number of in vivo clinical trials are underway. The empirical data available from two of these trials reveal conflicting results. Both trials are characterised by small numbers of participants (n = 30 and n = 36) and suffer methodological limitations. No medium or long-term follow-up data is available. CONCLUSION At present, there is insufficient evidence to determine whether CQ/HCQ are safe and effective treatments for COVID-19. High quality, adequately powered randomised clinical trials in primary and secondary care settings are urgently required to guide policymakers and clinicians. These studies should report medium- and long-term follow-up results, and safety data.
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Affiliation(s)
- Kome Gbinigie
- GP and Doctoral Researcher, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kerstin Frie
- Post-Doctoral Researcher, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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