Table 1.
Main clinical characteristics of pediatric patient’s compassionately treated with RDV
| Previously healthy patients | Patients with underlying diseases | |||||||
|---|---|---|---|---|---|---|---|---|
| Patient | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Age | 11 years | 1.5 months | 5 months | 4.5 months | 1 years | 15 years | 9 years | 11 years |
| Sex | M | M | M | M | F | F | M | F |
| Underlying medical condition | NO | NO | NO | NO |
Premature (GA 29 weeks) ILD |
CTLA-4 haploinsufficiency HSCT BOOP Lobectomy |
T-ALL (complete remission) |
AntiMDA5-associated dermatomyositis ILD |
| Duration of hospital stay (days) | 10 | 16 | 28 | 22 | 22 | 11 | 20 | 32 (until death) |
| Days in PICU | 5 | 14 | 23 | 22 | 13 | 0 | 0 | 23 (until death) |
| Days from first positive PCR result to start of RDV | 3 | 6 | 7 | 6 | 7 | 4 | 8 | 7 |
| Main clinical symptoms |
Multilobar pneumonia Respiratory insufficiency |
Multilobar pneumonia Respiratory insufficiency Anemia |
Lobar pneumonia Respiratory Insufficiency Coagulopathy Pericardiac/pleural effusion Hypopnea-apnea Low level of consciousness |
Multilobar pneumonia Respiratory insufficiency Sepsis-like disease (culture -) |
Multilobar pneumonia Respiratory insufficiency Sepsis-like (culture -) |
Respiratory insufficiency |
Febrile syndrome Respiratory insufficiency HLH |
Multilobar pneumonia Respiratory insufficiency Myocarditis Pneumothorax Pneumomediastinum Pneumoretroperitoneum HLH |
| Basic therapy for underlying medical condition prior to COVID-19 | NO | NO | NO | NO |
Oxygen HCQ AZM |
Oxygen Corticoids TPM-SMX Voriconazole Spironolactone Intermittent home oxygen support |
6-Mercaptopurine Methotrexate |
Cyclophosphamide Tacrolimus Tofacitinib TPM-SMX Corticoids |
| Treatment for COVID-19 |
HQC AZM L/R TCZ RDV |
HQC AZM RDV |
HQC AZM Corticosteroids L/R TCZ RDV |
HQC Corticosteroids L/R RDV |
HQC AZM Corticosteroids IVIG α-IFN L/R RDV |
HQC RDV |
HQC AZM Corticosteroids TCZ RDV |
HQC AZM Corticosteroids TCZ Plasmapheresis RDV |
| Reason for RDV prescription |
ICU admission Worsening respiratory status |
ICU admission Worsening respiratory status |
ICU admission Worsening respiratory status |
ICU admission Worsening respiratory status |
ICU admission Worsening respiratory status |
Underlying condition Hypoxemia |
Underlying condition Hypoxemia Severe lymphopenia ⇑ Inflammatory parameters |
ICU admission Worsening respiratory status |
| Respiratory support | NIV | IMV | IMV | IMV | IMV | Oxygen | Oxygen | IMV |
| Inotropic support |
Dopamine Noradrenaline |
Noradrenaline |
Milrinone Adrenaline |
Noradrenaline | ||||
| SARS-CoV-2 PCR monitorization after starting RDV | Not performed | Negative 2 days after RDV | Not performed |
Positive 4 and 8 days after RDV Negative 15 days after RDV |
Negative 8 days after RDV |
Positive 6, 21 and 65 days after RDV Negative 72 days after RDV |
Negative 11 days after RDV | Negative 5 days after RDV |
| Clinical complications |
Sepsis due to MSSA |
Ventilation-associated pneumonia (P. aeruginosa) |
Sepsis (E. faecimum) Thrombotic microangiopathy Coagulopathy Multiorgan dysfunction syndrome Death |
|||||
α-IFN, alpha interferon; AZM, azythromycin; BOOP, bronchiolitis obliterans organizing pneumonia; F, female; GA, gestational age; HLH, hemophagocytic histiolymphocytosis; HSCT, hematopoietic stem cell transplantation; HQC, hydroxychloroquine; ILD, interstitial lung disease; IMV, invasive mechanical ventilation; IVIG, intravenous immune globulin; L/R, lopinavir/ritonavir; M, male; MSSA, Meti-sensitive S. aureus
NIV, non-invasive ventilation; PICU, pediatric intensive care unit; RDV, remdesivir; T-ALL, T cell acute lymphoblastic leukemia; TCZ, tocilizumab; TPM-SMX, Trimethoprim/sulfometoxazole