Use of drugs in pediatric patients with COVID-19 hospitalized in a reference hospital in Lima, Peru

Abstract

Introduction: Different types of drugs were used as possible treatments during the COVID-19 pandemic in Peru. However, in pediatrics, trends in medication use during waves of COVID-19 have not been explored.

Objective: To describe the use of medications in pediatric patients with COVID-19 hospitalized at the Instituto Nacional de Salud del Niño San Borja (INSN-SB) between March 2020 and March 2022. 

Materials and Methods: Descriptive observational study that included all hospitalized patients (<18 years old) diagnosed with COVID-19, at the INSN-SB during March 2020 and March 2022. Data were obtained from electronic and epidemiological records. We evaluated the use of six medications: corticosteroids, ceftriaxone, azithromycin, immunoglobulin, hydroxychloroquine, and ivermectin. We compared the results between subpopulations defined according to the waves of the COVID-19 pandemic. 

Results: We included 421 pediatric patients (male: 57.7%, median age: 7 years). Regarding the severity of the COVID-19 condition during the three waves, in the first wave there was a higher frequency of admission to the Intensive Care Unit and in the third wave there was a higher frequency of asymptomatic patients. In the use of medications, 40.4% had a prescription for corticosteroids, 35.6% ceftriaxone, 12.1% azithromycin, 3.6% immunoglobulin, 2.4% hydroxychloroquine, and 0.5% ivermectin. The use of corticosteroids, ceftriaxone and azithromycin was more frequent during the second wave; likewise, there was a lower prescription of these drugs in asymptomatic patients. The use of hydroxychloroquine was almost exclusive to the first wave, and the use of immunoglobulin was only seen in patients with pediatric multisystem inflammatory syndrome. 

Conclusions: The prescription of medications varied according to the degree of severity of COVID-19 in the three waves.