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The Trilogy of SARS-CoV-2 in Pediatrics (Part 1): Acute COVID-19 in Special Populations.

ABSTRACT: With the emergence of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) virus, the pandemic has resulted in a severe respiratory disease known as COVID-19. Data and literature are limited in the evaluation, treatment, and considerations for pediatric patients including special populations (e.g., neonates, children, immunocompromised patients, and those with sickle cell disease). There exists a need for a comprehensive review of pediatric proven and disproven treatments as therapies continue to emerge. This article evaluates the pharmacologic treatment and prevention therapies used in pediatric patients to date, including emergency use authorizations, as well as rationales for pharmacotherapies not routinely used to treat acute COVID-19 infection. It is important to note this review article is current as of January 25, 2021, given the rapid evolvement of the pandemic.

SUBMITTER: Parsons S

PROVIDER: S-EPMC8021247 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The progress in the development of various vaccine platforms against SARS-CoV-2 have been rather remarkable owing to advancement in molecular and biologic sciences. Most of the current vaccines and those in development focus on targeting the viral spike proteins by generating antibodies of varying spectrum. These vaccines represent a variety of platforms including whole virus vaccines, viral vector vaccines, nucleic acid vaccines representing RNA, DNA, and their hybrid forms.The therapeutic efficacy of these vaccines varies owing to their pharmacodynamic individualities. COVID-19 variants are capable of inducing different pathologic responses and some of which may be resistant to antibodies generated by current vaccines. The current clinical use of these vaccines has been through emergency use authorization until recently. Moreover, the efficacy and safety of these vaccines have been tested in substantial numbers of individuals but studies in special populations that better reflect the global population are pending results. These specialized populations include young children, immunocompromised patients, pregnant individuals, and other specialized groups. Combination approaches, molecularly modified vaccination approaches, and vaccines conferring longer periods of immunity are being currently being investigated, as well as pharmacovigilance studies.The continual transformation of SARS-CoV-2 and its variants are of concern along with the breakthrough infections. These considerations pose new challenges for the development of vaccination platforms. For this purpose, booster doses, combination vaccine approaches, and other modalities are being discussed. This review provides an updated account of currently available vaccines and those in advanced development with reference to their composition and mechanisms of action.A discussion on the use of vaccines in special populations including immunocompromised patients, pregnant women and other specialized populations are also included.

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The Trilogy of SARS-CoV-2 in Pediatrics (Part 1): Acute COVID-19 in Special Populations.

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