Pharmacotherapy in sars cov 2 infection in children – a review

ABSTRACT

The pharmacotherapy in SARS CoV has been a challenge with respect to pediatric SARS CoV 2 infection. The guidelines evolve each day, however there are limited number of studies and trials in children regarding the drugs available, their dosage and their safety profiles. This review article details the drugs that have been tried against SARS CoV 2 infection from a pediatric perspective. The drugs have been classified into 3 main groups (i) Drugs with antiviral activity like remedesvir, ivermectin and ribavirin that directly act on the virus affecting viral entry, assembly and replication.(ii) Drugs that are immunomodulators like anakinra and interferons which act upon the immune system to modulate the immune response to the virus (iii) Drugs that mitigate the complications like immunoglobulins, glucocorticoids and anticoagulants like aspirin which act at the cytokine release and in treatment of complications like Pediatric Multisystem Inflammatory Syndrome. Pediatric weight loused dosage and safety profiles have been established in other conditions and are being explored in SARS CoV2 infection in these drugs and many drugs are still to establish pediatric doses. (iv) Drugs that have been tried earlier were hydroxychloroquine, lopinavir/ritonavir and azithromycin but have not shown any therapeutic benefit over the course of the pandemic. With the SARS CoV 2 global pandemic causing varied clinical pictures and outcomes in children, that differ from adults, knowledge of the drugs that can be used in children, their safety profile and their dosage is imperative and will guide the way in the future management of pediatric SARS CoV 2 infection.