A Case Series of Persistent SARS-CoV-2 Infection in Immunocompromised Pediatric Patients
Diagnosis and management of SARS-CoV-2 infection in immunocompromised patients are extremely challenging. These patients can have atypical clinical courses, and there is a paucity of data regarding clinical features, diagnostic findings, and the safety and efficacy of available therapeutic agents us...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2023/1699770 |
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| author | Mohamed Y. Ahmed Jane B. Taylor Rajesh K. Aneja Qian Wang John V. Williams |
| author_facet | Mohamed Y. Ahmed Jane B. Taylor Rajesh K. Aneja Qian Wang John V. Williams |
| author_sort | Mohamed Y. Ahmed |
| collection | DOAJ |
| description | Diagnosis and management of SARS-CoV-2 infection in immunocompromised patients are extremely challenging. These patients can have atypical clinical courses, and there is a paucity of data regarding clinical features, diagnostic findings, and the safety and efficacy of available therapeutic agents used to treat COVID-19 in these patients. In this case series, we report atypical COVID-19 presentations in 4 immunocompromised pediatric patients who were admitted with acute respiratory failure after an initial diagnosis of COVID-19 a few weeks earlier. All patients included in this cohort showed persistent worsening respiratory symptoms for several weeks before hospital presentation. While they manifested common COVID-19 sequelae, they also had rare COVID-19-related pathognomonic and radiographic features developed along their hospital course. Multiple therapeutic agents were used in their COVID-19 management, including corticosteroids, remdesivir, and monoclonal antibodies. All three patients who have received concurrent therapy with remdesivir, hydrocortisone, and monoclonal antibodies survived, and only one patient died as a direct complication of COVID-19 ARDS with secondary pulmonary mucormycosis. Our outcomes suggest the potential benefit of remdesivir use in combination with hydrocortisone and monoclonal antibodies in the management of severe COVID-19 ARDS in this group, as well as the importance of close surveillance and early administration of broad empirical antimicrobial and antifungal coverage if clinically indicated in this high-risk population. |
| format | Article |
| id | doaj-art-3bf2b7f98c1d4c42bd414afcf1a4c851 |
| institution | OA Journals |
| issn | 2090-6439 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-3bf2b7f98c1d4c42bd414afcf1a4c8512025-08-20T02:08:18ZengWileyCase Reports in Critical Care2090-64392023-01-01202310.1155/2023/1699770A Case Series of Persistent SARS-CoV-2 Infection in Immunocompromised Pediatric PatientsMohamed Y. Ahmed0Jane B. Taylor1Rajesh K. Aneja2Qian Wang3John V. Williams4Department of PediatricsDepartment of PediatricsDepartment of Critical Care MedicineDepartment of PathologyDivision of Infectious DiseasesDiagnosis and management of SARS-CoV-2 infection in immunocompromised patients are extremely challenging. These patients can have atypical clinical courses, and there is a paucity of data regarding clinical features, diagnostic findings, and the safety and efficacy of available therapeutic agents used to treat COVID-19 in these patients. In this case series, we report atypical COVID-19 presentations in 4 immunocompromised pediatric patients who were admitted with acute respiratory failure after an initial diagnosis of COVID-19 a few weeks earlier. All patients included in this cohort showed persistent worsening respiratory symptoms for several weeks before hospital presentation. While they manifested common COVID-19 sequelae, they also had rare COVID-19-related pathognomonic and radiographic features developed along their hospital course. Multiple therapeutic agents were used in their COVID-19 management, including corticosteroids, remdesivir, and monoclonal antibodies. All three patients who have received concurrent therapy with remdesivir, hydrocortisone, and monoclonal antibodies survived, and only one patient died as a direct complication of COVID-19 ARDS with secondary pulmonary mucormycosis. Our outcomes suggest the potential benefit of remdesivir use in combination with hydrocortisone and monoclonal antibodies in the management of severe COVID-19 ARDS in this group, as well as the importance of close surveillance and early administration of broad empirical antimicrobial and antifungal coverage if clinically indicated in this high-risk population.http://dx.doi.org/10.1155/2023/1699770 |
| spellingShingle | Mohamed Y. Ahmed Jane B. Taylor Rajesh K. Aneja Qian Wang John V. Williams A Case Series of Persistent SARS-CoV-2 Infection in Immunocompromised Pediatric Patients Case Reports in Critical Care |
| title | A Case Series of Persistent SARS-CoV-2 Infection in Immunocompromised Pediatric Patients |
| title_full | A Case Series of Persistent SARS-CoV-2 Infection in Immunocompromised Pediatric Patients |
| title_fullStr | A Case Series of Persistent SARS-CoV-2 Infection in Immunocompromised Pediatric Patients |
| title_full_unstemmed | A Case Series of Persistent SARS-CoV-2 Infection in Immunocompromised Pediatric Patients |
| title_short | A Case Series of Persistent SARS-CoV-2 Infection in Immunocompromised Pediatric Patients |
| title_sort | case series of persistent sars cov 2 infection in immunocompromised pediatric patients |
| url | http://dx.doi.org/10.1155/2023/1699770 |
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