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Clinical and Therapeutic Approach to Hospitalized COVID-19 Patients: A Pediatric Cohort in Portugal

dc.contributor.authorSaraiva, BM
dc.contributor.authorGarcia, AM
dc.contributor.authorSilva, TM
dc.contributor.authorGouveia, C
dc.contributor.authorBrito, MJ
dc.date.accessioned2022-11-15T14:52:05Z
dc.date.available2022-11-15T14:52:05Z
dc.date.issued2021
dc.description.abstractIntroduction: Coronavirus disease 2019, or COVID-19, in children is usually a mild disease, but severe illness has been reported. Currently, the therapy benefits of antiviral experimental drugs are still uncertain. The main aim of this study is to describe the experience of a level III hospital regarding therapeutic management of hospitalized children with COVID-19 and to characterize clinical features and evolution. Material and methods: This is a descriptive study of patients with COVID-19 in a level III pediatric hospital in Portugal between March and June 2020. Experimental drugs were administered according to the best scientific evidence at the time as 'off-label use'. Results: Among 200 children with SARS-CoV-2 infection, 37 were admitted due to COVID-19. Median age was one year (23 days - 18 years), 43% had comorbidities and 20/37 (54%) received antiviral therapy. Hydroxychloroquine was administered in 13 patients, in monotherapy or combined with lopinavir/ritonavir or azithromycin. Lopinavir/ritonavir was administered in eight patients and three children were treated with remdesivir. The patients who were treated had pneumonia (14), multisystem inflammatory syndrome in children (2), sepsis (2), myocarditis (1), acute respiratory distress syndrome (1), and mild illness with comorbidities (3). Other therapies included methylprednisolone and immunoglobulin (3), enoxaparin (2), antibiotics (16), oxygen (7), corticosteroids, and other inhaled therapy (16). Discussion: Several treatment approaches have been proposed for severe COVID-19, even though none of them had been proven effective or approved for small children. Currently, remdesivir is approved for children aged above 12 years-old. Although 54% of our patients were treated with antivirals, it is important to understand that the favorable clinical evolution could be related with the natural course of the disease. Conclusion: A significant proportion of our population presented severe and critical disease, was hospitalized and received treatment according to the most recent data, although most patients had mild disease. COVID-19 treatment in children is a clinical challenge and clinical trials are urgently needed.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationActa Med Port 2021 Apr;34(4):283-290pt_PT
dc.identifier.doi10.20344/amp.15360pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4275
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherCentro Editor Livreiro da Ordem dos Médicospt_PT
dc.subjectAntiviral Agents/therapeutic usept_PT
dc.subjectCOVID-19pt_PT
dc.subjectSARS-CoV-2pt_PT
dc.subjectChildpt_PT
dc.subjectPortugalpt_PT
dc.subjectHDE INF PEDpt_PT
dc.titleClinical and Therapeutic Approach to Hospitalized COVID-19 Patients: A Pediatric Cohort in Portugalpt_PT
dc.title.alternativeAbordagem Clínica e Terapêutica de Doentes Internados por COVID-19: Uma Coorte Pediátrica em Portugalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage290pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage283pt_PT
oaire.citation.titleActa Médica Portuguesapt_PT
oaire.citation.volume34pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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