Potentially effective drugs for the treatment of COVID-19 or MIS-C in children: a systematic review

作者全名："Wang, Zijun; Zhao, Siya; Tang, Yuyi; Wang, Zhili; Shi, Qianling; Dang, Xiangyang; Gan, Lidan; Peng, Shuai; Li, Weiguo; Zhou, Qi; Li, Qinyuan; Mafiana, Joy James; Cortes, Rafael Gonzalez; Luo, Zhengxiu; Liu, Enmei; Chen, Yaolong"

作者地址："[Wang, Zijun; Zhou, Qi; Chen, Yaolong] Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, Lanzhou, Peoples R China; [Wang, Zijun; Zhou, Qi; Chen, Yaolong] Lanzhou Univ, Inst Hlth Data Sci, Lanzhou, Peoples R China; [Zhao, Siya; Mafiana, Joy James; Chen, Yaolong] Lanzhou Univ, Sch Publ Hlth, Lanzhou, Peoples R China; [Tang, Yuyi; Wang, Zhili; Dang, Xiangyang; Gan, Lidan; Peng, Shuai; Li, Weiguo; Li, Qinyuan; Cortes, Rafael Gonzalez; Luo, Zhengxiu; Chen, Yaolong] Chongqing Med Univ, Dept Resp Med, Childrens Hosp, Chongqing, Peoples R China; [Tang, Yuyi; Wang, Zhili; Dang, Xiangyang; Gan, Lidan; Peng, Shuai; Li, Weiguo; Li, Qinyuan; Luo, Zhengxiu; Liu, Enmei] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Minist Educ Key Lab Child Dev & Disorders, China Int Sci & Technol Cooperat Base Child Dev &, Chongqing, Peoples R China; [Tang, Yuyi; Wang, Zhili; Dang, Xiangyang; Gan, Lidan; Peng, Shuai; Li, Weiguo; Li, Qinyuan; Luo, Zhengxiu; Liu, Enmei] Chongqing Key Lab Pediat, Chongqing, Peoples R China; [Shi, Qianling] Lanzhou Univ, Sch Clin Med 1, Lanzhou, Peoples R China; [Cortes, Rafael Gonzalez] Hosp Gen Univ Gregorio Maranon, Paediat Intens Care Unit, Calle Doctor Castelo 47, Madrid 28007, Spain; [Chen, Yaolong] WHO Collaborating Ctr Guideline Implementat & Kno, Lanzhou, Peoples R China; [Chen, Yaolong] Lanzhou Univ, GRADE Ctr, Lanzhou, Peoples R China"

通信作者："Chen, YL (通讯作者)，Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, Lanzhou, Peoples R China.; Chen, YL (通讯作者)，Lanzhou Univ, Inst Hlth Data Sci, Lanzhou, Peoples R China.; Chen, YL (通讯作者)，Lanzhou Univ, Sch Publ Hlth, Lanzhou, Peoples R China.; Chen, YL (通讯作者)，Chongqing Med Univ, Dept Resp Med, Childrens Hosp, Chongqing, Peoples R China.; Liu, EM (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Minist Educ Key Lab Child Dev & Disorders, China Int Sci & Technol Cooperat Base Child Dev &, Chongqing, Peoples R China.; Liu, EM (通讯作者)，Chongqing Key Lab Pediat, Chongqing, Peoples R China.; Chen, YL (通讯作者)，WHO Collaborating Ctr Guideline Implementat & Kno, Lanzhou, Peoples R China.; Chen, YL (通讯作者)，Lanzhou Univ, GRADE Ctr, Lanzhou, Peoples R China."

来源：EUROPEAN JOURNAL OF PEDIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000759349000003

JCR分区：Q1

影响因子：3.6

年份：2022

卷号：181

期号：5

开始页：2135

结束页：2146

文献类型：Review

关键词：Children; COVID-19; MIS-C; Glucocorticoids; Intravenous immunoglobulin; Remdesivir

摘要："The purpose of this systematic review is to evaluate the efficacy and safety of using potential drugs: remdesivir and glucocorticoid in treating children and adolescents with COVID-19 and intravenous immunoglobulin (IVIG) in treating MIS-C. We searched seven databases, three preprint platform, ClinicalTrials.gov, and Google from December 1, 2019, to August 5, 2021, to collect evidence of remdesivir, glucocorticoid, and IVIG which were used in children and adolescents with COVID-19 or MIS-C. A total of nine cohort studies and one case series study were included in this systematic review. In terms of remdesivir, the meta-analysis of single-arm cohort studies have shown that after the treatment, 54.7% (95%CI, 10.3 to 99.1%) experienced adverse events, 5.6% (95%CI, 1.2 to 10.1%) died, and 27.0% (95%CI, 0 to 73.0%) needed extracorporeal membrane oxygenation or invasive mechanical ventilation. As for glucocorticoids, the results of the meta-analysis showed that the fixed-effect summary odds ratio for the association with mortality was 2.79 (95%CI, 0.13 to 60.87), and the mechanical ventilation rate was 3.12 (95%CI, 0.80 to 12.08) for glucocorticoids compared with the control group. In terms of IVIG, most of the included cohort studies showed that for MIS-C patients with more severe clinical symptoms, IVIG combined with methylprednisolone could achieve better clinical efficacy than IVIG alone. Conclusions: Overall, the current evidence in the included studies is insignificant and of low quality. It is recommended to conduct high-quality randomized controlled trials of remdesivir, glucocorticoids, and IVIG in children and adolescents with COVID-19 or MIS-C to provide substantial evidence for the development of guidelines."

基金机构："National Clinical Research Center for Child Health and Disorders (Children's Hospital of Chongqing Medical University, Chongqing, China) [NCRCCHD-2020-EP-01]; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province [GSEBMKT-2020YJ01]; Fundamental Research Funds for the Central Universities [lzujbky-2021-ey13]"

基金资助正文："This work was supported by grants from the National Clinical Research Center for Child Health and Disorders (Children's Hospital of Chongqing Medical University, Chongqing, China) (grant number NCRCCHD-2020-EP-01), special funding for prevention and control of emergency of COVID-19 from Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province (grant number No. GSEBMKT-2020YJ01), and The Fundamental Research Funds for the Central Universities (lzujbky-2021-ey13)."