Evaluation of the safety profile and therapeutic efficacy of remdesivir in children with SARS- CoV-2 infection – a single-centre, retrospective, cohort study

Abstract

Purpose Despite 3.5 years of the SARS-CoV-2 pandemic we still lack effective drugs against COVID-19. The first and most used one, remdesivir, still has not been clearly proven to be effective in the treatment of adults. Its effectiveness in children is even less known. Therefore, this retrospective study aimed to evaluate the safety and efficacy of remdesivir in paediatric patients with COVID-19 hospitalized in one medical centre. Methods Medical records of 328 children with COVID-19 were analyzed. The analysis was performed on the subgroups of children treated and not treated with remdesivir. Clinical data regarding general health condition, the course of COVID-19 and the administered treatment were analyzed. Results Remdesivir was administered to 64 children, 16 to treat severe or critical illness, and 48 due to the presence of risk factors to prevent progression to severe COVID-19. Among children with severe COVID-19 remdesivir did not reduce the death rate. However, in patients with milder courses and risk factors, the drug significantly reduced the risk of progression to severe disease. Among the adverse events, only mild elevations of aminotransferases were observed in 4 patients, but none of them required treatment discontinuation. Conclusions Remdesivir is a safe form of treatment in children with COVID-19. However, the effectiveness of such therapy is still uncertain. It seems that in children with asymptomatic to moderate COVID-19 and risk factors for severe disease, remdesivir could be an effective method of prophylaxis. However, its effectiveness in combating severe disease is questionable and requires further studies.