Favipiravir use in children with COVID-19 and acute kidney injury: is it safe?
Acute Kidney Injury
/ drug therapy
Adenosine Monophosphate
/ administration & dosage
Adolescent
Alanine
/ administration & dosage
Amides
/ administration & dosage
COVID-19
/ complications
Child
Creatinine
/ blood
Dose-Response Relationship, Drug
Drug Therapy, Combination
Female
Glomerular Filtration Rate
Humans
Male
Pyrazines
/ administration & dosage
Renal Elimination
SARS-CoV-2
/ isolation & purification
Systemic Inflammatory Response Syndrome
/ complications
Treatment Outcome
COVID-19 Drug Treatment
COVID-19
Favipiravir
Pediatrics
Remdesivir
SARS-CoV-2
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
04
03
2021
accepted:
29
04
2021
revised:
11
04
2021
pubmed:
23
5
2021
medline:
21
10
2021
entrez:
22
5
2021
Statut:
ppublish
Résumé
The rising number of infections due to Severe Acute Respiratory Syndrome Coronavirus-2 (popularly known as COVID-19) has brought to the fore new antiviral drugs as possible treatments, including favipiravir. However, there is currently no data regarding the safety of this drug in patients with kidney impairment. The aim of this paper, therefore, is to share our experience of the use of favipiravir in pediatric patients affected by COVID-19 with any degree of kidney impairment. The study enrolled pediatric patients aged under 18 years and confirmed as suffering from COVID-19 and multisystem inflammatory syndrome in children (MIS-C) with any degree of kidney injury, who were treated with favipiravir at the time of admission. Out of a total of 11 patients, 7 were diagnosed with MIS-C and 4 with severe COVID-19. The median age of the cases was 15.45 (9-17.8) years and the male/female ratio was 7/4. At the time of admission, the median serum creatinine level was 1.1 mg/dl. Nine patients were treated with favipiravir for 5 days, and 2 patients for 5 days followed by remdesivir for 5-10 days despite kidney injury at the time of admission. Seven patients underwent plasma exchange for MIS-C while 2 severely affected cases underwent continuous kidney replacement therapy (CKRT) as well. One severe COVID-19 patient received plasma exchange as well as CKRT. Serum creatinine values returned to normal in mean 3.07 days. Favipiravir seems a suitable therapeutic option in patients affected by COVID-19 with kidney injury without a need for dose adjustment.
Sections du résumé
BACKGROUND
The rising number of infections due to Severe Acute Respiratory Syndrome Coronavirus-2 (popularly known as COVID-19) has brought to the fore new antiviral drugs as possible treatments, including favipiravir. However, there is currently no data regarding the safety of this drug in patients with kidney impairment. The aim of this paper, therefore, is to share our experience of the use of favipiravir in pediatric patients affected by COVID-19 with any degree of kidney impairment.
METHODS
The study enrolled pediatric patients aged under 18 years and confirmed as suffering from COVID-19 and multisystem inflammatory syndrome in children (MIS-C) with any degree of kidney injury, who were treated with favipiravir at the time of admission.
RESULTS
Out of a total of 11 patients, 7 were diagnosed with MIS-C and 4 with severe COVID-19. The median age of the cases was 15.45 (9-17.8) years and the male/female ratio was 7/4. At the time of admission, the median serum creatinine level was 1.1 mg/dl. Nine patients were treated with favipiravir for 5 days, and 2 patients for 5 days followed by remdesivir for 5-10 days despite kidney injury at the time of admission. Seven patients underwent plasma exchange for MIS-C while 2 severely affected cases underwent continuous kidney replacement therapy (CKRT) as well. One severe COVID-19 patient received plasma exchange as well as CKRT. Serum creatinine values returned to normal in mean 3.07 days.
CONCLUSIONS
Favipiravir seems a suitable therapeutic option in patients affected by COVID-19 with kidney injury without a need for dose adjustment.
Identifiants
pubmed: 34021797
doi: 10.1007/s00467-021-05111-x
pii: 10.1007/s00467-021-05111-x
pmc: PMC8140325
doi:
Substances chimiques
Amides
0
Pyrazines
0
remdesivir
3QKI37EEHE
Adenosine Monophosphate
415SHH325A
Creatinine
AYI8EX34EU
favipiravir
EW5GL2X7E0
Alanine
OF5P57N2ZX
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3771-3776Informations de copyright
© 2021. IPNA.
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