COVID-19 therapeutics for children: Where are we now, and how did we get here?

Mari M. Nakamura, MD, MPH, Medical Director, antimicrobial stewardship; associate physician and assistant professor in Pediatrics, Boston Children’s Hospital/Harvard Medical School, Boston, Massachusetts, took a look at the current COVID-19 therapeutics for children and the woeful lack of pediatric drug trials. After displaying statistics on cases and deaths by age as a result of the ongoing COVID-19 pandemic, and noting the explosion of publications covering the virus in the pediatric population, Nakamura noted, “There is still almost no clinical trials open to children.” An example: from February 1, 2020 to April 11, 2020, 275 COVID-19 interventional trials were registered on ClinicalTrials.gov, but only 30 of these accepted patients less than 18 years. “With limited initial evidence to inform pediatric treatment, almost no clinical trials open to children and limited access to therapies for children, there is a need for a rapid response,” she said. Her presentation also includes the state and treatments of COVID-19 conditions for children, ranging in cases from mild to critical, with a look at the most commonly-used interventions (oral antivirals such as molnupiravir and paxlovid; lV antivirals like remdesivir; and monoclonal antibodies that include sotrovimab and bebtelovimab.

Her takeaways for pediatric HCPs when it comes to assessing and treating COVID-19:
--Consider pediatric COVID-19 epidemiology and risk factors in treatment decisions
--Become familiar with local and national pediatric COVID-19 treatment guidance
--Keep an eye out for pediatric COVID-19 trials and discuss participation with patients and families.

Reference
Nakamura MM. COVID-19 in children: medication and vaccine dosing, safety, and regulatory considerations. 2022 AAP National Conference & Exhibition. October 8, 2022. Anaheim, California.