tetano
Editor, Senior Moderator
Ann Transl Med
. 2022 Jun;10(11):619.
doi: 10.21037/atm-22-2791.
The feasibility, safety, and efficacy of Paxlovid treatment in SARS-CoV-2-infected children aged 6-14 years: a cohort study
Gangfeng Yan[SUP] #[/SUP][SUP] 1 [/SUP], Jianguo Zhou[SUP] #[/SUP][SUP] 2 [/SUP], Haitao Zhu[SUP] 3 [/SUP], Yiwei Chen[SUP] 4 [/SUP], Yanming Lu[SUP] 5 [/SUP], Ting Zhang[SUP] 6 [/SUP], Hui Yu[SUP] 7 [/SUP], Libo Wang[SUP] 8 [/SUP], Hong Xu[SUP] 9 [/SUP], Zheng Wang[SUP] 10 [/SUP], Wenhao Zhou[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Paxlovid is recognized as an effective medication in preventing the progression of coronavirus disease of 2019 (COVID-19) to severe form in adults; however, its efficacy has remained unknown in pediatric cases. This study aimed to analyze the feasibility, safety, and efficacy of Paxlovid treatment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children aged 6-14 years.
Methods: We conducted a cohort study based on prospectively collected clinical data. We recruited 5 pediatric cases with underlying diseases treated with Paxlovid from 7 April 2022 to 26 May 2022 and 30 age-matched patients with underlying diseases who were not treated with Paxlovid as controls. The safety and efficacy of Paxlovid were primarily assessed by inter-group comparisons.
Results: Of the 5 Paxlovid-treated cases, including 1 male and 4 females, 3 and 2 cases were mildly and moderately ill, respectively. The underlying diseases included congenital heart defects, cerebral palsy, Down syndrome, and leukemia. Only 1 patient had received 1 dose of an inactivated SARS-CoV-2 vaccine. Paxlovid was initiated within 5 days after the onset of symptoms in all cases. Comedications were used in 2 cases. In the safety analyses, after Paxlovid initiation, 1 patient had transient diarrhea, and 1 patient had transiently elevated liver enzymes [alanine transaminase (ALT), 125 U/L; aspartate transaminase (AST), 83 U/L; normal range, <40 U/L]. In the efficacy analyses, all 5 Paxlovid-treated cases recovered, with the respective viral shedding times of 11, 4, 10, 9, and 9 days. Compared with age-matched controls, the viral shedding times were not significantly different between groups.
Conclusions: Based on the current small sample size study, Paxlovid is a feasible option for treating SARS-CoV-2-infected children aged 6-14 years with underlying diseases. However, the safety and efficacy of Paxlovid warrant further large-scale studies.
Keywords: Coronavirus disease of 2019 (COVID-19); Paxlvoid; children; viral shedding.
. 2022 Jun;10(11):619.
doi: 10.21037/atm-22-2791.
The feasibility, safety, and efficacy of Paxlovid treatment in SARS-CoV-2-infected children aged 6-14 years: a cohort study
Gangfeng Yan[SUP] #[/SUP][SUP] 1 [/SUP], Jianguo Zhou[SUP] #[/SUP][SUP] 2 [/SUP], Haitao Zhu[SUP] 3 [/SUP], Yiwei Chen[SUP] 4 [/SUP], Yanming Lu[SUP] 5 [/SUP], Ting Zhang[SUP] 6 [/SUP], Hui Yu[SUP] 7 [/SUP], Libo Wang[SUP] 8 [/SUP], Hong Xu[SUP] 9 [/SUP], Zheng Wang[SUP] 10 [/SUP], Wenhao Zhou[SUP] 2 [/SUP]
Affiliations
- PMID: 35813342
- PMCID: PMC9263777
- DOI: 10.21037/atm-22-2791
Abstract
Background: Paxlovid is recognized as an effective medication in preventing the progression of coronavirus disease of 2019 (COVID-19) to severe form in adults; however, its efficacy has remained unknown in pediatric cases. This study aimed to analyze the feasibility, safety, and efficacy of Paxlovid treatment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children aged 6-14 years.
Methods: We conducted a cohort study based on prospectively collected clinical data. We recruited 5 pediatric cases with underlying diseases treated with Paxlovid from 7 April 2022 to 26 May 2022 and 30 age-matched patients with underlying diseases who were not treated with Paxlovid as controls. The safety and efficacy of Paxlovid were primarily assessed by inter-group comparisons.
Results: Of the 5 Paxlovid-treated cases, including 1 male and 4 females, 3 and 2 cases were mildly and moderately ill, respectively. The underlying diseases included congenital heart defects, cerebral palsy, Down syndrome, and leukemia. Only 1 patient had received 1 dose of an inactivated SARS-CoV-2 vaccine. Paxlovid was initiated within 5 days after the onset of symptoms in all cases. Comedications were used in 2 cases. In the safety analyses, after Paxlovid initiation, 1 patient had transient diarrhea, and 1 patient had transiently elevated liver enzymes [alanine transaminase (ALT), 125 U/L; aspartate transaminase (AST), 83 U/L; normal range, <40 U/L]. In the efficacy analyses, all 5 Paxlovid-treated cases recovered, with the respective viral shedding times of 11, 4, 10, 9, and 9 days. Compared with age-matched controls, the viral shedding times were not significantly different between groups.
Conclusions: Based on the current small sample size study, Paxlovid is a feasible option for treating SARS-CoV-2-infected children aged 6-14 years with underlying diseases. However, the safety and efficacy of Paxlovid warrant further large-scale studies.
Keywords: Coronavirus disease of 2019 (COVID-19); Paxlvoid; children; viral shedding.