tetano
Editor, Senior Moderator
Pediatr Infect Dis J
. 2023 Feb 1;42(2):125-129.
doi: 10.1097/INF.0000000000003773. Epub 2022 Nov 21.
Treatment of Infants and Children With SARS-CoV-2 Monoclonal Antibodies: A European Case Series
Cornelius Rau[SUP] 1 [/SUP], Lorenz Auer-Hackenberg[SUP] 2 [/SUP], Hedwig E Deubzer[SUP] 3 [/SUP], Elisabeth Schwabel[SUP] 4 [/SUP], Maria Jaros[SUP] 4 [/SUP], Antonia Diederichs[SUP] 5 [/SUP], Thomas Lehrnbecher[SUP] 5 [/SUP], Mette Holm[SUP] 6 [/SUP], Marie-Louise von Linstow[SUP] 7 [/SUP], Luise Martin[SUP] 8 9 [/SUP], Sarah Svenja Dinges[SUP] 8 [/SUP], Maria Rothensteiner[SUP] 10 [/SUP], Meinolf Siepermann[SUP] 11 [/SUP], Volker Strenger[SUP] 12 13 [/SUP], Ulrich von Both[SUP] 14 [/SUP], Norbert Teig[SUP] 15 [/SUP], Folke Brinkmann[SUP] 16 [/SUP], Franziska Leeb[SUP] 17 [/SUP], Markus Zeitlinger[SUP] 18 [/SUP], Robin Kobbe[SUP] 19 20 [/SUP], Florian Götzinger[SUP] 10 [/SUP]
Affiliations
Abstract
Background: Although severe COVID-19 in children is rare, those with certain pre-existing health conditions are more prone to severe disease. Monoclonal antibodies (mAbs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are potent antiviral agents that reduce adverse clinical outcomes in adults, but are commonly not approved for use in pediatric patients.
Methods: We retrospectively evaluated mAb treatment in children <12 years of age or <40kg with SARS-CoV-2 infection between January 1, 2021, and March 7, 2022, in 12 tertiary care centers in 3 European countries.
Results: We received data from 53 patients from Austria, Denmark and Germany. Median age was 5.4 years [0-13.8, interquartile range (IQR) = 6.2], and median body weight was 20 kg (3-50.1, IQR = 13). The most frequent SARS-CoV-2 variant in this study, if known, was Omicron, followed by Delta and Alpha. Pre-existing conditions included immunodeficiency, malignancy, hematologic disease, cardiac disease, chronic lung disease, chronic liver disease, kidney disease and diabetes. Forty-two patients received sotrovimab (79%), 9 casirivimab/imdevimab (17%) and 2 bamlanivimab (4%). All but 1 patient survived. Median duration of hospital stay was 3 days (0-56, IQR = 6). Seven patients required treatment in an intensive care unit, and 5 required high-flow nasal cannula treatment. Potential side effects included neutropenia (6/53, 11%), lymphopenia (3/53, 6%), nausea or vomiting (2/53, 4%), rise of alanine transaminase (1/53, 2%) and hypotonia (1/53, 2%).
Conclusions: MAb treatment was well tolerated by children in this cohort.
. 2023 Feb 1;42(2):125-129.
doi: 10.1097/INF.0000000000003773. Epub 2022 Nov 21.
Treatment of Infants and Children With SARS-CoV-2 Monoclonal Antibodies: A European Case Series
Cornelius Rau[SUP] 1 [/SUP], Lorenz Auer-Hackenberg[SUP] 2 [/SUP], Hedwig E Deubzer[SUP] 3 [/SUP], Elisabeth Schwabel[SUP] 4 [/SUP], Maria Jaros[SUP] 4 [/SUP], Antonia Diederichs[SUP] 5 [/SUP], Thomas Lehrnbecher[SUP] 5 [/SUP], Mette Holm[SUP] 6 [/SUP], Marie-Louise von Linstow[SUP] 7 [/SUP], Luise Martin[SUP] 8 9 [/SUP], Sarah Svenja Dinges[SUP] 8 [/SUP], Maria Rothensteiner[SUP] 10 [/SUP], Meinolf Siepermann[SUP] 11 [/SUP], Volker Strenger[SUP] 12 13 [/SUP], Ulrich von Both[SUP] 14 [/SUP], Norbert Teig[SUP] 15 [/SUP], Folke Brinkmann[SUP] 16 [/SUP], Franziska Leeb[SUP] 17 [/SUP], Markus Zeitlinger[SUP] 18 [/SUP], Robin Kobbe[SUP] 19 20 [/SUP], Florian Götzinger[SUP] 10 [/SUP]
Affiliations
- PMID: 36638398
- DOI: 10.1097/INF.0000000000003773
Abstract
Background: Although severe COVID-19 in children is rare, those with certain pre-existing health conditions are more prone to severe disease. Monoclonal antibodies (mAbs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are potent antiviral agents that reduce adverse clinical outcomes in adults, but are commonly not approved for use in pediatric patients.
Methods: We retrospectively evaluated mAb treatment in children <12 years of age or <40kg with SARS-CoV-2 infection between January 1, 2021, and March 7, 2022, in 12 tertiary care centers in 3 European countries.
Results: We received data from 53 patients from Austria, Denmark and Germany. Median age was 5.4 years [0-13.8, interquartile range (IQR) = 6.2], and median body weight was 20 kg (3-50.1, IQR = 13). The most frequent SARS-CoV-2 variant in this study, if known, was Omicron, followed by Delta and Alpha. Pre-existing conditions included immunodeficiency, malignancy, hematologic disease, cardiac disease, chronic lung disease, chronic liver disease, kidney disease and diabetes. Forty-two patients received sotrovimab (79%), 9 casirivimab/imdevimab (17%) and 2 bamlanivimab (4%). All but 1 patient survived. Median duration of hospital stay was 3 days (0-56, IQR = 6). Seven patients required treatment in an intensive care unit, and 5 required high-flow nasal cannula treatment. Potential side effects included neutropenia (6/53, 11%), lymphopenia (3/53, 6%), nausea or vomiting (2/53, 4%), rise of alanine transaminase (1/53, 2%) and hypotonia (1/53, 2%).
Conclusions: MAb treatment was well tolerated by children in this cohort.