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Treatment of infants and children with SARS-CoV-2 monoclonal antibodies: a European case series

Item Type:Article
Title:Treatment of infants and children with SARS-CoV-2 monoclonal antibodies: a European case series
Creators Name:Rau, C. and Auer-Hackenberg, L. and Deubzer, H.E. and Schwabel, E. and Jaros, M. and Diederichs, A. and Lehrnbecher, T. and Holm, M. and von Linstow, M.L. and Martin, L. and Dinges, S.S. and Rothensteiner, M. and Siepermann, M. and Strenger, V. and von Both, U. and Teig, N. and Brinkmann, F. and Leeb, F. and Zeitlinger, M. and Kobbe, R. and Götzinger, F.
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.
Keywords:SARS-CoV-2, COVID-19, Children, Treatment, Monoclonal Antibodies
Source:Pediatric Infectious Disease Journal
Publisher:Lippincott Williams & Wilkins
Page Range:125-129
Date:February 2023
Official Publication:https://doi.org/10.1097/inf.0000000000003773
PubMed:View item in PubMed

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