Remdesivir decreased duration of COVID-19 symptoms among children with asthma, atopic dermatitis (AD), and allergic rhinitis, according to study results published in Children.
The study was designed to assess the effect of remdesivir among children with asthma, AD, and/or allergic rhinitis with COVID-19. Patients (N=250) who were treated for COVID-19 at the National Institute of Infectious Diseases in Romania between 2020 and 2022 were evaluated for outcomes on the basis of whether they received remdesivir (n=126) or standard care (n=124) and whether they had allergies (n=42) or not (n=208). Remdesivir was administered as a 5 mg/kg intravenous dose for children under 40 kg on day 1 followed by 2.5 mg/kg from day 2 up to day 10. Children weighing 40 kg or greater received 200 mg on day 1 followed by 100 mg on days 2 to 10.
The patients who received remdesivir and standard care were a median age of 2 (IQR, 3-12) and 4 (IQR, 3-17) years; 52.6% and 53.23% were boys; 7.94% and 6.45% had asthma (P =.05); 2.8% and 1.6% had AD (P =.05); and 2.4% and 2% had allergic rhinitis (P =.05), respectively.
Patients with allergies were more likely to develop severe COVID-19 (P <.05).
The remdesivir recipients were more likely to present with symptoms of fever, cough, gastroenteritis, and nausea, vomiting, or diarrhea than nonrecipients (all P ≤.0123).
Although patients who received remdesivir had greater symptom burden, remdesivir was associated with a greater clinical improvement compared with standard care (odds ratio [OR], 1.56; 95% CI, 1.24-2.83).
Stratified by comorbidities, remdesivir recipients were less likely to require oxygen than patients who received standard care among those with obesity (33.33% vs 58%; P =.001), asthma (40.0% vs 62.5%; P =.0032), and chronic pulmonary disease (62.9% vs 79.2%; P =.031).
The median duration of COVID-19 symptoms was 8 days for patients who received remdesivir and had allergies compared with 14 days for those who did not receive remdesivir (P <.001).
Among the patients with allergy, more remdesivir recipients had clinical improvement at days 3 (13.04% vs 10.53%), 5 (30.43% vs 26.32%), and 7 (39.13% vs 26.32%) compared with standard care, respectively. Time to clinical recovery depended on disease severity, in which those with mild disease were more likely to have improvement on days 3 and 5, whereas those with severe disease did not show improvement until day 10.
The presence of comorbidities (eg, obesity, hypertension, asthma, chronic pulmonary disease) associated with longer hospital stays, but receipt of remdesivir decreased hospitalization duration (all P =.05).
Laboratory abnormalities associated with remdesivir were of grades 1 or 2 severity and did not require discontinuation. No deaths were observed in the study.
The study authors concluded, “[T]his single-center retrospective study shows that the use of RDV [remdesivir] for COVID-19 in children led to no serious adverse events in children, no allergies, and reduced days of hospitalizations in patients with comorbidities and improved moderate and severe forms of COVID-19 associated with asthma, allergic rhinitis, and atopic dermatitis.”
Jugulete G, Luminos M, Pavelescu C, Merişescu MM. Remdesivir efficacy and tolerability in children with COVID-19-associated allergic comorbidities such as asthma, allergic thinitis, and atopic dermatitis. Children. Published online April 29, 2023. doi:10.3390/children10050810