Choi Soo-Han, Choi Jae Hong, Yun Ki Wook
Department of Pediatrics, Pusan National University School of Medicine, Busan, Korea.
Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea.
Clin Exp Pediatr. 2022 Aug;65(8):377-386. doi: 10.3345/cep.2022.00458. Epub 2022 Jun 27.
Coronavirus disease 2019 (COVID-19) is a mild to moderate respiratory illness in most children and adolescents, but a small proportion develop severe or critical illness. Although pediatric clinical trials for the treatment of COVID-19 are sparse, there are some available drugs for children and adolescents with severe COVID-19. This review summarizes clinical data focusing on antiviral agents and immunomodulators for COVID-19 treatment. Additionally, the current recommendations for therapeutics for children and adolescents with COVID-19 are discussed. Remdesivir is suggested for pediatric patients with COVID-19 in the following cases: children and adolescents with severe COVID-19 who need supplemental oxygen without mechanical ventilation; adolescents aged ≥12 years and weight of at least 40 kg with COVID-19 who do not require supplemental oxygen and are within 7 days of symptom onset and are at high risk of progression to severe illness. Nirmatrelvir/ritonavir is considered for adolescents aged ≥12 years and weighing at least 40 kg who do not require supplemental oxygen and are within 5 days of symptom onset and are at high risk of progression to severe disease. Corticosteroids are not recommended in children and adolescents with mild to moderate COVID-19. Corticosteroids are recommended in children and adolescents with severe to critical COVID-19.
2019冠状病毒病（COVID-19）在大多数儿童和青少年中为轻至中度呼吸道疾病，但一小部分会发展为重症或危重症。尽管针对COVID-19治疗的儿科临床试验较少，但对于患有重症COVID-19的儿童和青少年有一些可用药物。本综述总结了聚焦于COVID-19治疗的抗病毒药物和免疫调节剂的临床数据。此外，还讨论了目前针对COVID-19儿童和青少年的治疗建议。在以下情况下，建议对患有COVID-19的儿科患者使用瑞德西韦：患有重症COVID-19且需要补充氧气但无需机械通气的儿童和青少年；年龄≥12岁且体重至少40 kg、患有COVID-19且无需补充氧气、症状出现7天内且有进展为重症疾病高风险的青少年。对于年龄≥12岁且体重至少40 kg、无需补充氧气、症状出现5天内且有进展为重症疾病高风险的青少年，可考虑使用奈玛特韦/利托那韦。不建议对轻至中度COVID-19的儿童和青少年使用皮质类固醇。建议对重症至危重症COVID-19的儿童和青少年使用皮质类固醇。
