The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic is a health care emergency across the world. Although mitigation measures, such as social distancing and face masks, have attempted to slow the spread of the infection, cases continue to rise. Children who are otherwise healthy tend to develop a milder acute Coronavirus disease 2019 (COVID-19) infection and have lower mortality rates compared with adults. There are 6 published pediatric series that included 252 children with acute COVID-19 infection and describe various treatments and outcomes. Guidelines recommend treating pediatric patients similarly to adult patients. Currently, no prophylactic drug therapy has been shown to reduce the spread of infection. Treatment options for acute COVID-19 are limited to remdesivir and glucocorticoids for patients who require oxygen and/or mechanical ventilation. The efficacy of hydroxychloroquine, chloroquine, and azithromycin has not been proven and their safety has been a concern. Other therapies that are being explored include interleukin (IL)-1 and IL-6 inhibitors. In children, an atypical Kawasaki-like disease emerged after recent exposure to SARS-CoV-2 and has been named Multisystem Inflammatory Syndrome in Children (MIS-C). Nine case series, including 418 pediatric patients, described pharmacotherapies used and patient outcomes. These pharmacotherapies included intravenous immune globulin and glucocorticoids and in some patients, IL-1 and IL-6 inhibitors. Given the paucity of data in children, this article presents currently recommended pharmacotherapies for the treatment of acute COVID-19 infection in adult patients and whenever available, in pediatric patients. Pharmacotherapies used in the treatment of MIS-C in children are also reviewed.

中文翻译：

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儿童急性 COVID-19 感染和多系统炎症综合征的药物治疗：知识现状

严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 大流行是世界范围内的卫生保健紧急情况。尽管社交距离和口罩等缓解措施试图减缓感染的传播，但病例仍在继续上升。其他方面健康的儿童往往会患上较轻的 2019 年急性冠状病毒病 (COVID-19) 感染，并且与成人相比死亡率较低。有 6 个已发表的儿科系列包括 252 名急性 COVID-19 感染儿童，并描述了各种治疗方法和结果。指南建议以与成人患者相同的方式治疗儿科患者。目前，没有任何预防性药物治疗被证明可以减少感染的传播。对于需要氧气和/或机械通气的患者，急性 COVID-19 的治疗选择仅限于瑞德西韦和糖皮质激素。羟氯喹、氯喹和阿奇霉素的疗效尚未得到证实，它们的安全性一直是一个问题。正在探索的其他疗法包括白细胞介素 (IL)-1 和 IL-6 抑制剂。在儿童中，最近接触 SARS-CoV-2 后出现了一种非典型的川崎样疾病，被命名为儿童多系统炎症综合征 (MIS-C)。九个病例系列，包括 418 名儿科患者，描述了使用的药物疗法和患者结果。这些药物疗法包括静脉注射免疫球蛋白和糖皮质激素，以及在一些患者中使用 IL-1 和 IL-6 抑制剂。由于缺乏儿童数据，本文介绍了目前推荐的用于治疗成人患者和儿科患者急性 COVID-19 感染的药物疗法。还回顾了用于治疗儿童 MIS-C 的药物疗法。