Principles of Rational COVID-19 Therapy in Pediatrics
Abstract
:1. Introduction
2. Clinical Manifestations, Risk Factors and Features of the Course of COVID-19 in Pediatric Patients
- −
- Respiratory cluster, in which children show separate respiratory episodes of coughing, other symptoms from the upper and lower respiratory tract, and fever;
- −
- Systemic muco-cutaneous-intestinal clusters are manifested by headache, myalgia, gastrointestinal symptoms, lymphadenopathy, fatigue, rash, and conjunctivitis;
- −
- A rarer cluster of neurological signs, especially seizures and confusion.
- −
- High body mass index (obesity);
- −
- Severe pre-existing respiratory disease (asthma, COPD);
- −
- Complex genetic or metabolic conditions associated with concomitant diseases (diabetes mellitus and impaired glucose tolerance, heart and vascular diseases);
- −
- -
- Oxygen saturation < 90% in room air;
- -
- Signs of pneumonia;
- -
3. International Approaches to COVID-19 Pharmacotherapy in Children
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Ladhani, S.N.; Amin-Chowdhury, Z.; Davies, H.G.; Aiano, F.; Hayden, I.; Lacy, J.; Sinnathamby, M.; de Lusignan, S.; Demirjian, A.; Whittaker, H.; et al. COVID-19 in children: Analysis of the first pandemic peak in England. Arch. Dis. Child. 2020, 105, 1180–1185. [Google Scholar] [CrossRef] [PubMed]
- Parri, N.; Lenge, M.; Buonsenso, D.; Coronavirus Infection in Pediatric Emergency Departments (CONFIDENCE) Research Group. Children with COVID-19 in Pediatric Emergency Departments in Italy. N. Engl. J. Med. 2020, 383, 187–190. [Google Scholar] [CrossRef] [PubMed]
- Wu, Z.; McGoogan, J.M. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020, 323, 1239–1242. [Google Scholar] [CrossRef] [PubMed]
- Public Health Ontario. COVID-19 Infection in Children: January 15, 2020 to June 30, 2021. Available online: https://www.publichealthontario.ca/-/media/documents/ncov/epi/2020/05/covid-19-epi-infection-children.pdf?la=en (accessed on 18 May 2021).
- Nikolopoulou, G.B.; Maltezou, H.C. COVID-19 in Children: Where do we Stand? Arch. Med. Res. 2022, 53, 1–8. [Google Scholar] [CrossRef]
- American Academy of Pediatrics. Children and COVID-19: State-Level Data Report. Available online: https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/outpatient-covid-19-management-strategies-in-children-and-adolescents/ (accessed on 18 May 2021).
- World Health Organization. Coronavirus Disease (COVID-19): Schools 2020. Available online: https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-schools (accessed on 18 May 2021).
- World Health Organization. COVID-19 Disease in Children and Adolescents: Scientific Background. 2021. Available online: https://apps.who.int/iris/bitstream/handle/10665/345575/WHO-2019-nCoV-Sci-Brief-Children-and-adolescents-2021.1-rus.pdf (accessed on 29 September 2021). (In Russian).
- Centers for Disease Control and Prevention. COVID Data Tracker: Demographic Trends of COVID-19 Cases and Deaths in the US Reported to CDC. Available online: https://covid.cdc.gov/covid-data-tracker/#demographics (accessed on 17 August 2022).
- Balasubramanian, S.; Rao, N.M.; Goenka, A.; Roderick, M.; Ramanan, A.V. Coronavirus Disease 2019 (COVID-19) in Children—What We Know So Far and What We Do Not. Indian Pediatr. 2020, 57, 435–442. [Google Scholar] [CrossRef]
- She, J.; Liu, L.; Liu, W. COVID-19 epidemic: Disease characteristics in children. J. Med. Virol. 2020, 92, 747–754. [Google Scholar] [CrossRef]
- Chen, F.; Liu, Z.S.; Zhang, F.R.; Xiong, R.H.; Chen, Y.; Cheng, X.F.; Wang, W.Y.; Ren, J. First case of severe childhood novel coronavirus pneumonia in China. Zhonghua Er Ke Za Zhi 2020, 58, 179–182. [Google Scholar] [CrossRef]
- Ludvigsson, J.F. Convulsions in children with COVID-19 during the Omicron wave. Acta Paediatr. 2022, 111, 1023–1026. [Google Scholar] [CrossRef]
- Zhu, F.; Ang, J.Y. COVID-19 Infection in Children: Diagnosis and Management. Curr. Infect. Dis. Rep. 2022, 24, 51–62. [Google Scholar] [CrossRef]
- Alsohime, F.; Temsah, M.H.; Al-Nemri, A.M.; Somily, A.M.; Al-Subaie, S. COVID-19 infection prevalence in pediatric population: Etiology, clinical presentation, and outcome. J. Infect. Public Health 2020, 13, 1791–1796. [Google Scholar] [CrossRef]
- Alekseeva, E.I.; Anciferov, M.B.; Aronov, L.S. Clinical Protocol for the Treatment of Children with a New Coronavirus Infection (COVID-19) Who Are Hospitalized in Medical Organizations of the State Healthcare System of Moscow; Version 1; Hripun, A.I., Ed.; GBU “NIIOZMM DZM”: Moscow, Russia, 2021; 52p. [Google Scholar]
- Belykh, N.A.; Solovyova, O.A.; Anikeeva, N.A. Epidemiological and clinical and laboratory features of COVID-19 in pediatric patients. Pediatrician 2021, 12, 63–76. [Google Scholar] [CrossRef]
- Swann, O.V.; Holden, K.A.; Turtle, L.; Pollock, L.; Fairfield, C.J.; Drake, T.M.; Seth, S.; Egan, C.; Hardwick, H.E.; Halpin, S.; et al. Clinical characteristics of children and young people admitted to hospital with COVID-19 in United Kingdom: Prospective multicentre observational cohort study. BMJ 2020, 370, m3249. [Google Scholar] [CrossRef]
- British Paediatric Allergy, Immunity and Infection Group. COVID-19—Guidance for Management of Children Admitted to Hospital and for Treatment of Non-Hospitalised Children at Risk of Severe Disease. Available online: https://www.rcpch.ac.uk/resources/covid-19-management-children-hospital-and-non-hospitalised (accessed on 18 May 2022).
- Marzano, A.V.; Genovese, G.; Fabbrocini, G.; Pigatto, P.; Monfrecola, G.; Piraccini, B.M.; Veraldi, S.; Rubegni, P.; Cusini, M.; Caputo, V.; et al. Varicella-like exanthem as a specific COVID-19-associated skin manifestation: Multicenter case series of 22 patients. J. Am. Acad. Dermatol. 2020, 83, 280–285. [Google Scholar] [CrossRef]
- Genovese, G.; Colonna, C.; Marzano, A.V. Varicella-like exanthem associated with COVID-19 in an 8-year-old girl: A diagnostic clue? Pediatr. Dermatol. 2020, 37, 435–436. [Google Scholar] [CrossRef]
- Moore, J.T.; Ricaldi, J.N.; Rose, C.E.; Fuld, J.; Parise, M.; Kang, G.J.; Driscoll, A.K.; Norris, T.; Wilson, N.; Rainisch, G.; et al. Disparities in Incidence of COVID-19 Among Underrepresented Racial/Ethnic Groups in Counties Identified as Hotspots During June 5–18, 2020–22 States, February-June 2020. MMWR Morb. Mortal. Wkly. Rep. 2020, 69, 1122–1126. [Google Scholar] [CrossRef]
- Harwood, R.; Yan, H.; Talawila Da Camara, N.; Smith, C.; Ward, J.; Tudur-Smith, C.; Linney, M.; Clark, M.; Whittaker, E.; Saatci, D.; et al. Which children and young people are at higher risk of severe disease and death after hospitalisation with SARS-CoV-2 infection in children and young people: A systematic review and individual patient meta-analysis. EClinicalMedicine 2022, 44, 101287. [Google Scholar] [CrossRef]
- Namazova-Baranova, L.S.; Baranov, A.A. COVID-19 and children. Pul’monologiya 2020, 30, 609–628. [Google Scholar] [CrossRef]
- Antipkin, Y.; Podolskiy, V.; Podolskiy, V.l.; Lapshyn, V.; Umanets, T.; Kaminska, T.; Livshits, L.; Harashchenko, T. COVID-19 in Children: Clinical and Epidemiological Data. Pediatr. East. Eur. 2021, 9, 160–165. [Google Scholar] [CrossRef]
- Sahu, K.K.; Mishra, A.K.; Lal, A. COVID-2019: Update on epidemiology, disease spread and management. Monaldi Arch. Chest Dis. 2020, 90. [Google Scholar] [CrossRef]
- Zhang, C.; Zheng, W.; Huang, X.; Bell, E.W.; Zhou, X.; Zhang, Y. Protein Structure and Sequence Reanalysis of 2019-nCoV Genome Refutes Snakes as Its Intermediate Host and the Unique Similarity between Its Spike Protein Insertions and HIV-1. J. Proteome Res. 2020, 19, 1351–1360. [Google Scholar] [CrossRef] [Green Version]
- Meyerowitz, E.A.; Richterman, A.; Gandhi, R.T.; Sax, P.E. Transmission of SARS-CoV-2: A Review of Viral, Host, and Environmental Factors. Ann. Intern. Med. 2021, 174, 69–79. [Google Scholar] [CrossRef] [PubMed]
- Drosten, C.; Günther, S.; Preiser, W.; van der Werf, S.; Brodt, H.R.; Becker, S.; Rabenau, H.; Panning, M.; Kolesnikova, L.; Fouchier, R.A.; et al. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. N. Engl. J. Med. 2003, 348, 1967–1976. [Google Scholar] [CrossRef] [PubMed]
- COVID-19 Treatment Guidelines. Special Considerations in Children. Available online: https://www.covid19treatmentguidelines.nih.gov/management/clinical-management-of-children/special-considerations-in-children/ (accessed on 8 August 2022).
- Methodological Recommendations of the Ministry of Health of the Russian Federation “Peculiarities of Clinical Manifestations and Treatment of a Disease Caused by a New Coronavirus Infection (COVID-19) in Children” Version 2 (03.07.2020). Available online: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/050/914/original/03062020_%D0%B4%D0%B5%D1%82%D0%B8_COVID-19_v2.pdf (accessed on 8 August 2022).
- World Health Organization. Therapeutics and COVID-19: Living Guideline; Version 8; World Health Organization: Geneva, Switzerland, 2022; Available online: https://www.who.int/publications/i/item/WHO-2019-nCoV-therapeutics-2022.4 (accessed on 14 July 2022).
- Riphagen, S.; Gomez, X.; Gonzalez-Martinez, C.; Wilkinson, N.; Theocharis, P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet 2020, 395, 1607–1608. [Google Scholar] [CrossRef] [PubMed]
- Whittaker, E.; Bamford, A.; Kenny, J.; Kaforou, M.; Jones, C.E.; Shah, P.; Ramnarayan, P.; Fraisse, A.; Miller, O.; Davies, P.; et al. Clinical Characteristics of 58 Children with a Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2. JAMA 2020, 324, 259–269. [Google Scholar] [CrossRef]
- Dufort, E.M.; Koumans, E.H.; Chow, E.J.; Rosenthal, E.M.; Muse, A.; Rowlands, J.; Barranco, M.A.; Maxted, A.M.; Rosenberg, E.S.; Easton, D.; et al. New York State and Centers for Disease Control and Prevention Multisystem Inflammatory Syndrome in Children Investigation Team. Multisystem Inflammatory Syndrome in Children in New York State. N. Engl. J. Med. 2020, 383, 347–358. [Google Scholar] [CrossRef]
- Feldstein, L.R.; Rose, E.B.; Horwitz, S.M.; Collins, J.P.; Newhams, M.M.; Son, M.B.F.; Newburger, J.W.; Kleinman, L.C.; Heidemann, S.M.; Martin, A.A.; et al. Overcoming COVID-19 Investigators; CDC COVID-19 Response Team. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N. Engl. J. Med. 2020, 383, 334–346. [Google Scholar] [CrossRef]
- Patel, J.M. Multisystem Inflammatory Syndrome in Children (MIS-C). Curr. Allergy Asthma Rep. 2022, 22, 53–60. [Google Scholar] [CrossRef]
- Kundu, A.; Maji, S.; Kumar, S.; Bhattacharya, S.; Chakraborty, P.; Sarkar, J. Clinical aspects and presumed etiology of multisystem inflammatory syndrome in children (MIS-C): A review. Clin. Epidemiol. Glob. Health 2022, 14, 100966. [Google Scholar] [CrossRef]
- Centers for Disease Control and Prevention. Information for Healthcare Providers about Multisystem Inflammatory Syndrome in Children (MIS-C). Available online: https://www.cdc.gov/mis/mis-c/hcp/index.html (accessed on 26 July 2022).
- Godfred-Cato, S.; Bryant, B.; Leung, J.; Oster, M.E.; Conklin, L.; Abrams, J.; Roguski, K.; Wallace, B.; Prezzato, E.; Koumans, E.H.; et al. COVID-19-Associated Multisystem Inflammatory Syndrome in Children—United States, March-July 2020. MMWR Morb. Mortal. Wkly. Rep. 2020, 69, 1074–1080. [Google Scholar] [CrossRef]
- Fainardi, V.; Meoli, A.; Chiopris, G.; Motta, M.; Skenderaj, K.; Grandinetti, R.; Bergomi, A.; Antodaro, F.; Zona, S.; Esposito, S. Long COVID in Children and Adolescents. Life 2022, 12, 285. [Google Scholar] [CrossRef]
- Osmanov, I.M.; Spiridonova, E.; Bobkova, P.; Gamirova, A.; Shikhaleva, A.; Andreeva, M.; Blyuss, O.; El-Taravi, Y.; DunnGalvin, A.; Comberiati, P.; et al. Risk factors for post-COVID-19 condition in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study. Eur. Respir. J. 2022, 59, 2101341. [Google Scholar] [CrossRef]
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 5. (08.04.2020). Available online: https://static-1.rosminzdrav.ru/system/attachments/attaches/000/049/951/original/09042020_%D0%9C%D0%A0_COVID-19_v5.pdf (accessed on 18 May 2021). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 6. (24.04.2020). Available online: https://static-1.rosminzdrav.ru/system/attachments/attaches/000/050/116/original/28042020_%D0%9CR_COVID-19_v6.pdf (accessed on 18 May 2021). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 7. (03.06.2020). Available online: http://edu.rosminzdrav.ru/fileadmin/user_upload/specialists/COVID-19/MR_COVID-19_v7.pdf (accessed on 18 May 2021). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 8. (03.09.2020). Available online: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/051/777/original/030902020_COVID-19_v8.pdf (accessed on 18 May 2021). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 9. (26.10.2020). Available online: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/052/548/original/%D0%9C%D0%A0_COVID-19_%28v.9%29.pdf (accessed on 18 May 2021). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 10. (08.02.2021). Available online: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/054/588/original/%D0%92%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5_%D0%9C%D0%A0_COVID-19_%28v.10%29-08.02.2021_%281%29.pdf (accessed on 18 May 2021). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 11. (07.05.2021). Available online: https://xn--80aesfpebagmfblc0a.xn--p1ai/ai/doc/872/attach/Bmr_COVID-19_compressed.pdf (accessed on 17 May 2022). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 12. (21.09.2021). Available online: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/058/075/original/%D0%92%D0%9C%D0%A0_COVID-19_V12.pdf (accessed on 17 May 2022). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 13. (14.10.2021). Available online: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/058/211/original/BMP-13.pdf (accessed on 17 May 2022). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 14. (27.12.2021). Available online: https://xn--80aesfpebagmfblc0a.xn--p1ai/ai/doc/1213/attach/vmr_COVID-19_V14_27-12-2021.pdf (accessed on 17 May 2022). (In Russian)
- Osmanov, I.M.; Alekseeva, E.I.; Mazankova, L.N.; Zaharova, I.N. Clinical Protocol for the Treatment of Children with a New Coronavirus Infection (COVID-19) Who are Hospitalized in Medical Organizations of the State Healthcare System of MOSCOW; Version 2; Hripun, A.I., Ed.; GBU “NIIOZMM DZM”: Moscow, Russia, 2021; 92p. [Google Scholar]
- Order of the Ministry of Health of the Republic of Belarus Dated June 24, 2022 No. 858 “On Approval of (Temporary) Recommendations on the Specifics of Providing Medical Care to Patients under the Age of 18 with COVID-19 Infection”. Available online: https://minzdrav.gov.by/upload/lcfiles/%D0%BF%D1%80%D0%B8%D0%BA%D0%B0%D0%B7_%D0%9C%D0%97_2022_858.pdf (accessed on 4 January 2023).
- World Health Organization. Therapeutics and COVID-19: Living Guideline, 13 January 2023; Version 13; World Health Organization: Geneva, Switzerland, 2023; (WHO/2019-nCoV/therapeutics/2023.1). [Google Scholar]
- National Health Commission of the People’s Republic of China (NHC). New Coronavirus Pneumonia Prevention and Control Program (7nd ed.) (In Chinese). Available online: http://en.nhc.gov.cn/2020-03/29/c_78469.htm (accessed on 26 July 2022).
- The National Institute for Health and Care Excellence (NICE). COVID-19 Rapid Guideline: Managing COVID-19. Available online: https://app.magicapp.org/#/guideline/L4Qb5n/rec/LwomXLThe%20National%20Institute%20for%20Health%20and%20Care%20Excellence (accessed on 4 January 2023).
- Methodological Recommendations of the Ministry of Health of the Russian Federation “Peculiarities of Clinical Manifestations and Treatment of a Disease Caused by a New Coronavirus Infection (COVID-19) in Children” Version 1. (03.07.2020). Available online: http://nasci.ru/?id=11049&download=1 (accessed on 8 August 2022).
- Weinreich, D.M.; Sivapalasingam, S.; Norton, T.; Ali, S.; Gao, H.; Bhore, R.; Xiao, J.; Hooper, A.T.; Hamilton, J.D.; Musser, B.J.; et al. REGEN-COV Antibody Combination and Outcomes in Outpatients with COVID-19. N. Eng. J. Med. 2021, 385, e81. [Google Scholar] [CrossRef]
- Kim, J.Y.; Jang, Y.R.; Hong, J.H.; Jung, J.G.; Park, J.H.; Streinu-Cercel, A.; Streinu-Cercel, A.; Săndulescu, O.; Lee, S.J.; Kim, S.H.; et al. Safety, Virologic Efficacy, and Pharmacokinetics of CT-P59, a Neutralizing Monoclonal Antibody Against SARS-CoV-2 Spike Receptor-Binding Protein: Two Randomized, Placebo-Controlled, Phase I Studies in Healthy Individuals and Patients With Mild SARS-CoV-2 Infection. Clin. Ther. 2021, 43, 1706–1727. [Google Scholar] [CrossRef]
- Ison, M.G.; Kim, J.Y.; Sandulescu, O.; Preotescu, L.-L.; Martinez, N.E.R.; Dobryanska, M.; Birlutiu, V.; Miftode, E.G.; Gaibu, N.; Caliman-Sturdza, O.A. 546. Therapeutic Effect of Regdanvimab in Patients with Mild to Moderate COVID-19: Day 28 Results from a Multicentre, Randomised, Controlled Pivotal Trial. Open Forum Infect. Dis. 2021, 8, S375. [Google Scholar] [CrossRef]
- Miguez-Rey, E.; Choi, D.; Kim, S.; Yoon, S.; Săndulescu, O. Monoclonal antibody therapies in the management of SARS-CoV-2 infection. Expert. Opin. Investig. Drugs. 2022, 31, 41–58. [Google Scholar] [CrossRef]
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (2019-nCoV). Version 1. (29.01.2020). Available online: https://minzdrav.midural.ru/uploads/%D0%92%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5_%D0%9C%D0%A0_2019-nCov_%2829_01_2020_-_9%291-3.pdf (accessed on 18 May 2021). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (2019-nCoV). Version 2. (03.02.2020). Available online: https://minzdrav.midural.ru/uploads/%D0%92%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5%20%D1%80%D0%B5%D0%BA%D0%BE%D0%BC%D0%B5%D0%BD%D0%B4%D0%B0%D1%86%D0%B8%D0%B8%20%D0%B2%D0%B5%D1%80%D1%81%D0%B8%D1%8F%202.pdf (accessed on 18 May 2021). (In Russian)
- Solov’yeva, A.V.; Korshunova, L.V.; Shurpo, E.M.; Namestnikova, A.S. Prospects of Hyaluronidase Therapy in Novel COVID-19 Infection with Damage to Lungs. IP Pavlov. Russ. Med. Biol. Herald. 2022, 30, 313–322. [Google Scholar] [CrossRef]
- Filimonova, A.A.; Shurpo, E.M.; Kotlyarov, S.N.; Bulgakov, A.A. Acute myocardial injury in COVID-19: Types, mechanisms of development, diagnosis criteria, prognosis. Sci. Young Erud. 2022, 10, 311–326. [Google Scholar] [CrossRef]
- Therapeutic Management of Hospitalized Pediatric Patients with MIS-C. Available online: https://www.covid19treatmentguidelines.nih.gov/tables/therapeutic-management-of-mis-c/ (accessed on 18 January 2023).
- Santos, M.O.; Gonçalves, L.C.; Silva, P.A.N.; Moreira, A.L.E.; Ito, C.R.M.; Peixoto, F.A.O.; Wastowski, I.J.; Carneiro, L.C.; Avelino, M.A.G. Multisystem inflammatory syndrome (MIS-C): A systematic review and meta-analysis of clinical characteristics, treatment, and outcomes. J. Pediatr. 2022, 98, 338–349. [Google Scholar] [CrossRef]
- Ministry of Health of the Republic of Kazakhstan. Clinical Protocol for the Diagnosis and Treatment of COVID-19 Coronavirus Infections in Children. Available online: https://online.zakon.kz/Document/?doc_id=36043894 (accessed on 8 August 2022).
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (2019-nCoV). Version 3. (03.03.2020). Available online: https://minzdrav.midural.ru/uploads/%D0%92%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5_%D0%9C%D0%A0_COVID-19_03_03_2020_%28%D0%B2%D0%B5%D1%80%D1%81%D0%B8%D1%8F_3%29_6-6.pdf (accessed on 18 May 2021). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 15. (22.02.2022). Available online: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/059/392/original/%D0%92%D0%9C%D0%A0_COVID-19_V15.pdf (accessed on 18 September 2022). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 16. (18.08.2022). Available online: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/060/193/original/%D0%92%D0%9C%D0%A0_COVID-19_V16.pdf (accessed on 18 September 2022). (In Russian)
- Russian Ministry of Health. Temporary Guidelines. Prevention, Diagnosis and Treatment of Novel Coronavirus Infection (COVID-19). Version 17. (14.12.2023). Available online: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/061/252/original/%D0%92%D0%9C%D0%A0_COVID-19_V17.pdf (accessed on 18 January 2023). (In Russian)
- Narkevich, I.A.; Nemyatykh, O.D.; Basakina, I.I.; Siukaeva, D.D. Pharmaceutical development of drugs for pediatric practice: Fundamental bases and specific features. Drug Dev. Regist. 2016, 16, 194–201. Available online: https://www.elibrary.ru/download/elibrary_28803947_12621285.pdf (accessed on 8 August 2022). (In Russian).
- Therapeutic Management of Nonhospitalized Children with COVID-19. Available online: https://www.covid19treatmentguidelines.nih.gov/management/clinical-management-of-children/nonhospitalized-children-therapeutic-management/ (accessed on 18 January 2023).
- Therapeutic Management of Hospitalized Children with COVID-19. Available online: https://www.covid19treatmentguidelines.nih.gov/management/clinical-management-of-children/hospitalized-children-therapeutic-management/ (accessed on 18 January 2023).
- Gupta, M.; Gupta, N.; Esang, M. Long COVID in Children and Adolescents. Prim. Care Companion CNS Disord. 2022, 24, 21r03218. [Google Scholar] [CrossRef]
- Goldman, R.D. Long COVID in children. Can. Fam. Physician 2022, 68, 263–265. [Google Scholar] [CrossRef] [PubMed]
No | WHO Approaches | Approaches in Russian Practice |
---|---|---|
1. | Unified classification of forms and severity of the disease for all ages. | Different classifications for children and adults. |
2. | 3–4 forms of gravity. | 5 forms of gravity. |
3. | The classification does not provide. specific criteria by which the patient should be assigned to a particular form of severity. | The classification details the symptoms and results of examinations that allow the patient to be attributed to one form or another of severity. |
4. | Oxygen saturation of the blood in severe form should be less than 90%. | Oxygen saturation of the blood in severe form should be less than 93%. |
5. | The critical form includes “sepsis, septic shock”. | “Sepsis” and “septic shock” are prescribed as complications. |
ATC-Code | INN/Grouping Name | WHO | CDC | NIH | RCHCH/ NICE | Ministry of Health of Russia | Ministry of Health of the Republic of Belarus | Ministry of Health of the Republic of Kazakhstan |
---|---|---|---|---|---|---|---|---|
Antiviral drugs | ||||||||
J05AX13 | Umifenovir | NA | NA | NA | NA | R | NR | NA |
J05AE30 | Nirmatrelvir + ritonavir | NA | R | R | R | NA | R | NA |
J05AB16 | Remdesivir | NA | R | R | R | R | R | NA |
J05AB18 | Molnupiravir | NA | C | C | NA | NA | NA | NA |
Interferons | ||||||||
L03AB | Recombinant interferon-alpha | NR | NA | NR | NA | R | NA | NA |
Immunoglobulins | ||||||||
J06BA02 | Human normal immunoglobulin | NA | NA | R | NA | R | NA | NA |
Monoclonal antibodies | ||||||||
Specific monoclonal antibodies against COVID-19 | ||||||||
J06BD05 | Sotrovimab | NR | NA | NA | R | R | NA | NA |
Bamlanivimab+ etesevimab | NA | NA | NA | NA | R | NA | NA | |
J06BD07 | Kazirivimab+ imdevimab | NR | NA | NA | NA | R | NA | NA |
Non-specific monoclonal antibodies | ||||||||
L04AC07 L04AC14 | Tocilizumab Sarilumab | NA | NA | R | R | R | R | R |
L04AC08 | Kanakinumab | NA | NA | NA | NA | R | NA | NA |
L04AC03 | Anakinra | NA | NA | R | NA | R | NA | R |
L04AB02 | Infliximab | NA | NA | R | NA | NA | NA | R |
L04AA37 L04AA29 | Baricitinib Tofacitinib | NA | NA | R | R | R | R | NA |
L01EL02 L01EL01 | Akalabrutinib Ibrutinib | NA | NA | C | NA | NA | NA | NA |
Glucocorticoids | ||||||||
H02AB02 | Dexamethasone | NA | NA | C | R | R | R | R |
H02AB04 | Methylprednisolone | NA | NA | R | NA | R | R | NA |
D07AA03 | Prednisolone | NA | NA | NA | NA | R | R | R |
D07AA02 | Hydrocortisone | NA | NA | NA | NA | NA | R | NA |
Anticoagulants | ||||||||
B01AB04 | Dalteparin | NA | NA | R | R | R | R | NA |
C05BA53 | Heparin | NA | NA | NA | NA | R | NA | R |
B01AB05 | Enoxaparin | NA | NA | R | NA | NA | R | NA |
B01AB06 | Nadroparin | NA | NA | NA | NA | NA | R | NA |
Antiplatelet agents | ||||||||
N02BA01 | Acetylsalicylic acid | NA | NA | R | NA | NA | NA | NA |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Nemyatykh, O.D.; Maistrenko, M.A.; Demchenko, D.D.; Narkevich, I.A.; Okovityi, S.V.; Timchenko, V.N. Principles of Rational COVID-19 Therapy in Pediatrics. J. Clin. Med. 2023, 12, 4731. https://doi.org/10.3390/jcm12144731
Nemyatykh OD, Maistrenko MA, Demchenko DD, Narkevich IA, Okovityi SV, Timchenko VN. Principles of Rational COVID-19 Therapy in Pediatrics. Journal of Clinical Medicine. 2023; 12(14):4731. https://doi.org/10.3390/jcm12144731
Chicago/Turabian StyleNemyatykh, Oksana D., Marina A. Maistrenko, Dina D. Demchenko, Igor A. Narkevich, Sergey V. Okovityi, and Vladimir N. Timchenko. 2023. "Principles of Rational COVID-19 Therapy in Pediatrics" Journal of Clinical Medicine 12, no. 14: 4731. https://doi.org/10.3390/jcm12144731