AUTHOR=Gatti Elisabetta , Piotto Marta , Lelii Mara , Pensabene Mariacarola , Madini Barbara , Cerrato Lucia , Hassan Vittoria , Aliberti Stefano , Bosis Samantha , Marchisio Paola , Patria Maria Francesca TITLE=Therapeutic Strategies for COVID-19 Lung Disease in Children JOURNAL=Frontiers in Pediatrics VOLUME=10 YEAR=2022 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.829521 DOI=10.3389/fped.2022.829521 ISSN=2296-2360 ABSTRACT=

The novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection has milder presentation in children than in adults, mostly requiring only supportive therapy. The immunopathogenic course of COVID-19 can be divided in two distinct but overlapping phases: the first triggered by the virus itself and the second one by the host immune response (cytokine storm). Respiratory failure or systemic involvement as Multisystem Inflammatory Syndrome in Children (MIS-C) requiring intensive care are described only in a small portion of infected children. Less severe lung injury in children could be explained by qualitative and quantitative differences in age-related immune response. Evidence on the best therapeutic approach for COVID-19 lung disease in children is lacking. Currently, the approach is mainly conservative and based on supportive therapy. However, in hospitalized children with critical illness and worsening lung function, antiviral therapy with remdesivir and immunomodulant treatment could be considered the “therapeutic pillars.”