Remdesivir therapy for severe pediatric COVID‐19 in Singapore: A single‐center retrospective observational cohort study

{ 'indexed': { 'date-parts': [[2023, 12, 15]], 'date-time': '2023-12-15T00:40:48Z', 'timestamp': 1702600848612}, 'reference-count': 27, 'publisher': 'Wiley', 'issue': '12', 'license': [ { 'start': { 'date-parts': [[2023, 12, 14]], 'date-time': '2023-12-14T00:00:00Z', 'timestamp': 1702512000000}, 'content-version': 'vor', 'delay-in-days': 13, 'URL': 'http://creativecommons.org/licenses/by-nc-nd/4.0/'}], 'content-domain': {'domain': ['onlinelibrary.wiley.com'], 'crossmark-restriction': True}, 'published-print': {'date-parts': [[2023, 12]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec><jats:title>Background and ' 'Aims</jats:title><jats:p>There is a paucity of information on remdesivir (RDV)\xa0use in ' 'severe pediatric coronavirus disease 2019 (COVID‐19).\xa0We aimed to explore the ' 'effectiveness of RDV as the cumulative proportion of pediatric COVID‐19\xa0patients ' 'deescalated from Day 5 of high dependency or intensive care unit ' '(HD/ICU).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>All children ' "≤18 years admitted to Singapore's largest pediatric hospital from January\xa01, 2020 to March " '18, 2022 were reviewed retrospectively. Patients were included if they were positive for ' 'severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)\xa0on reverse transcriptase ' 'polymerase chain reaction, required oxygen, and HD/ICU care. The characteristics and outcomes ' 'of those who received RDV or not (no‐RDV)\xa0were ' 'compared.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We reviewed 15 ' 'children with a median age of 2.5 years (interquartile range [IQR]: 0.8–11.0), of which 7 ' '(46.7%) received RDV. There was no difference in cumulative proportion of children ' 'deescalated from Day 5 of HD/ICU\xa0care in the RDV versus the no‐RDV\xa0group (5/7, 70% vs. ' '7/8, 87.5%, <jats:italic>p</jats:italic>\u2009=\u20090.57). The RDV versus no‐RDV group had ' 'higher disease severity, that is,\xa0WHO Ordinal Scale scores (median 6, IQR: 5–7 vs. 5, IQR: ' '4–5, <jats:italic>p</jats:italic>\u2009=\u20090.03), higher procalcitonin levels (ug/L) ' '(median 4.31, IQR: 0.8–24.2 vs. 0.12, IQR: 0.09–0.26, <jats:italic>p</jats:italic>\u2009' '=\u20090.02), and longer HD/ICU\xa0care days (median 5, IQR: 4–9, vs. 1, IQR: 1–4, ' '<jats:italic>p</jats:italic>\u2009=\u20090.01). There was no significant difference in ' 'hospitalization days. There were no adverse events directly attributable to RDV. None died ' 'from COVID‐19\xa0' 'infection.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Our ' 'observational analysis was unable to detect any clear benefit of RDV in terms of reducing ' 'duration in HD/ICU.\xa0RDV was well‐tolerated in children with severe ' 'COVID‐19.</jats:p></jats:sec>', 'DOI': '10.1002/hsr2.1698', 'type': 'journal-article', 'created': { 'date-parts': [[2023, 12, 14]], 'date-time': '2023-12-14T11:34:31Z', 'timestamp': 1702553671000}, 'update-policy': 'http://dx.doi.org/10.1002/crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Remdesivir therapy for severe pediatric COVID‐19 in Singapore: A single‐center retrospective ' 'observational cohort study', 'prefix': '10.1002', 'volume': '6', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-7775-6987', 'authenticated-orcid': False, 'given': 'Valerie Xue Fen', 'family': 'Seah', 'sequence': 'first', 'affiliation': [ { 'name': "Department of Pharmacy KK Women's and Children's Hospital " 'Singapore Singapore'}]}, { 'given': 'Rina Yue Ling', 'family': 'Ong', 'sequence': 'additional', 'affiliation': [ { 'name': "Department of Pharmacy KK Women's and Children's Hospital " 'Singapore Singapore'}]}, { 'given': 'Kai Qian', 'family': 'Kam', 'sequence': 'additional', 'affiliation': [ { 'name': "Infectious Disease Service, Department of Paediatrics KK Women's " "and Children's Hospital Singapore Singapore"}, { 'name': 'Yong Loo Lin School of Medicine National University of ' 'Singapore Singapore Singapore'}, { 'name': 'Duke‐National University of Singapore Medical School Singapore ' 'Singapore'}, { 'name': 'Lee Kong Chian School of Medicine Nanyang Technological ' 'University Singapore Singapore'}]}, { 'given': 'Koh Cheng', 'family': 'Thoon', 'sequence': 'additional', 'affiliation': [ { 'name': "Infectious Disease Service, Department of Paediatrics KK Women's " "and Children's Hospital Singapore Singapore"}, { 'name': 'Yong Loo Lin School of Medicine National University of ' 'Singapore Singapore Singapore'}, { 'name': 'Duke‐National University of Singapore Medical School Singapore ' 'Singapore'}, { 'name': 'Lee Kong Chian School of Medicine Nanyang Technological ' 'University Singapore Singapore'}]}, { 'given': 'Natalie Woon Hui', 'family': 'Tan', 'sequence': 'additional', 'affiliation': [ { 'name': "Infectious Disease Service, Department of Paediatrics KK Women's " "and Children's Hospital Singapore Singapore"}, { 'name': 'Yong Loo Lin School of Medicine National University of ' 'Singapore Singapore Singapore'}, { 'name': 'Duke‐National University of Singapore Medical School Singapore ' 'Singapore'}, { 'name': 'Lee Kong Chian School of Medicine Nanyang Technological ' 'University Singapore Singapore'}]}, { 'given': 'Jiahui', 'family': 'Li', 'sequence': 'additional', 'affiliation': [ { 'name': "Infectious Disease Service, Department of Paediatrics KK Women's " "and Children's Hospital Singapore Singapore"}, { 'name': 'Yong Loo Lin School of Medicine National University of ' 'Singapore Singapore Singapore'}, { 'name': 'Duke‐National University of Singapore Medical School Singapore ' 'Singapore'}, { 'name': 'Lee Kong Chian School of Medicine Nanyang Technological ' 'University Singapore Singapore'}]}, { 'given': 'Karen Donceras', 'family': 'Nadua', 'sequence': 'additional', 'affiliation': [ { 'name': "Infectious Disease Service, Department of Paediatrics KK Women's " "and Children's Hospital Singapore Singapore"}, { 'name': 'Yong Loo Lin School of Medicine National University of ' 'Singapore Singapore Singapore'}, { 'name': 'Duke‐National University of Singapore Medical School Singapore ' 'Singapore'}, { 'name': 'Lee Kong Chian School of Medicine Nanyang Technological ' 'University Singapore Singapore'}]}, { 'ORCID': 'http://orcid.org/0000-0003-3919-3324', 'authenticated-orcid': False, 'given': 'Chia Yin', 'family': 'Chong', 'sequence': 'additional', 'affiliation': [ { 'name': "Infectious Disease Service, Department of Paediatrics KK Women's " "and Children's Hospital Singapore Singapore"}, { 'name': 'Yong Loo Lin School of Medicine National University of ' 'Singapore Singapore Singapore'}, { 'name': 'Duke‐National University of Singapore Medical School Singapore ' 'Singapore'}, { 'name': 'Lee Kong Chian School of Medicine Nanyang Technological ' 'University Singapore Singapore'}]}, { 'ORCID': 'http://orcid.org/0000-0001-9605-7690', 'authenticated-orcid': False, 'given': 'Chee Fu', 'family': 'Yung', 'sequence': 'additional', 'affiliation': [ { 'name': "Infectious Disease Service, Department of Paediatrics KK Women's " "and Children's Hospital Singapore Singapore"}, { 'name': 'Duke‐National University of Singapore Medical School Singapore ' 'Singapore'}, { 'name': 'Lee Kong Chian School of Medicine Nanyang Technological ' 'University Singapore Singapore'}]}], 'member': '311', 'published-online': {'date-parts': [[2023, 12, 14]]}, 'reference': [ { 'key': 'e_1_2_11_2_1', 'unstructured': 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