J Korean Med Sci.  2021 Jul;36(29):e203. 10.3346/jkms.2021.36.e203.

A Case Report for Severe COVID-19 in a 9-Year-Old Child Treated with Remdesivir and Dexamethasone

• Jo YH
• Hwang Y
• Choi SH

• KMID: 2518741
• DOI: http://doi.org/10.3346/jkms.2021.36.e203

Abstract

Coronavirus disease 2019 (COVID-19) is generally milder in children than in adults, and a substantial proportion of children with the disease have asymptomatic infections. Remdesivir is recommended for severe COVID-19. To date, there are little data on the outcomes of remdesivir treatment in children. We report a case of severe COVID-19 in a previously healthy but obese (body mass index, 27.6; 99.8 th percentile of the age) 9-year-old boy treated with remdesivir and dexamethasone. The patient had pneumonia at the time of diagnosis and required supplemental oxygen due to hypoxia one day after diagnosis. The patient developed respiratory distress as his pneumonia progressed rapidly. Therefore, remdesivir with dexamethasone therapy was initiated on hospital day 2. Supplemental oxygen was gradually weaned on hospital day 6 and stopped on hospital day 9. Significant improvement in pneumonic consolidations on chest X-ray was noted on hospital day 8. The patient was discharged on hospital day 21. We did not observe any adverse effects of remdesivir therapy and successfully treated a 9-year-old child with severe COVID-19.

Keyword

COVID-19; Child; Remdesivir

Figure

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  Fig. 1 Timeline before hospitalization at our hospital. The index case was the patient's uncle, who was asymptomatic and tested for COVID-19 because there was a confirmed case at the workplace. The patient's mother was also confirmed with asymptomatic COVID-19 on the day of the patient's hospitalization.COVID-19 = coronavirus disease 2019, HD = hospital day.

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  Fig. 2 Chest X-ray and CT images performed on the day coronavirus disease 2019 was confirmed. (A) The chest X-ray showed diffuse pneumonic consolidations in both lung fields. (B-I) The chest CT showed several small round and patchy consolidations diffusely scattered in the peripheral, subpleural, and peribronchial areas of both lungs.CT = computed tomography.

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  Fig. 3 Timeline of clinical course, treatment and laboratory findings.SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2, PCR = polymerase chain reaction.

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  Fig. 4 Serial chest X-rays of the patient. The patient received remdesivir therapy from HD 2 to 6.HD = hospital day.

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