Managing acute COVID-19 in immunocompromised pediatric patients.

INTRODUCTION: SARS-CoV-2 infection is a potentially life-threatening infection in immunocompromised pediatric patients and its management has rapidly evolved during the pandemic. For the control of SARS-CoV-2 infection, over time, the scenario changed for the better with the introduction of specific treatments such as antiviral drugs, vaccines and monoclonal antibodies together with drugs blocking the inflammatory cytokine cascade and improvements of supportive care.

AREAS COVERED: the paper discusses the therapeutic strategies to apply for patients affected by COVID-19 in the pediatric population, with a focus on the immunocompromised patients.

EXPERT OPINION: treatment in pediatric patients retrace the therapies investigated and approved in the adults and must be calibrated on the basis of the severity of the infection (anti-Spike monoclonal antibody, antivirals, antiinflammatory drugs and immunomodulators). Transmission prevention policies and vaccination reduce the risk of infection while early intervention in the immunocompromised patients at high-risk of progression to severe-critical COVID-19 May reduce the period of viral shedding and the need for hospitalization, intensive care admission and death. In hemato-oncological patients, the delaying treatment for SARS-CoV-2 infection or COVID-19 disease represents a frequent complication and its impact on the patient outcome remains a matter of research for the next few years.