{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:54:08Z","timestamp":1747191248506,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Critical Care"],"published-print":{"date-parts":[[2023,5,16]]},"abstract":"<jats:p>Diagnosis and management of SARS-CoV-2 infection in immunocompromised patients are extremely challenging. These patients can have atypical clinical courses, and there is a paucity of data regarding clinical features, diagnostic findings, and the safety and efficacy of available therapeutic agents used to treat COVID-19 in these patients. In this case series, we report atypical COVID-19 presentations in 4 immunocompromised pediatric patients who were admitted with acute respiratory failure after an initial diagnosis of COVID-19 a few weeks earlier. All patients included in this cohort showed persistent worsening respiratory symptoms for several weeks before hospital presentation. While they manifested common COVID-19 sequelae, they also had rare COVID-19-related pathognomonic and radiographic features developed along their hospital course. Multiple therapeutic agents were used in their COVID-19 management, including corticosteroids, remdesivir, and monoclonal antibodies. All three patients who have received concurrent therapy with remdesivir, hydrocortisone, and monoclonal antibodies survived, and only one patient died as a direct complication of COVID-19 ARDS with secondary pulmonary mucormycosis. Our outcomes suggest the potential benefit of remdesivir use in combination with hydrocortisone and monoclonal antibodies in the management of severe COVID-19 ARDS in this group, as well as the importance of close surveillance and early administration of broad empirical antimicrobial and antifungal coverage if clinically indicated in this high-risk population.<\/jats:p>","DOI":"10.1155\/2023\/1699770","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T17:07:25Z","timestamp":1684256845000},"page":"1-6","source":"Crossref","is-referenced-by-count":1,"title":["A Case Series of Persistent SARS-CoV-2 Infection in Immunocompromised Pediatric Patients"],"prefix":"10.1155","volume":"2023","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4622-4416","authenticated-orcid":true,"given":"Mohamed Y.","family":"Ahmed","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Critical Care Medicine, Indiana University School of Medicine, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane B.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pulmonology, University of Pittsburgh School of Medicine, UPMC Children\u2019s Hospital of Pittsburgh, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajesh K.","family":"Aneja","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, University of Pittsburgh School of Medicine, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Pittsburgh School of Medicine, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John V.","family":"Williams","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Pittsburgh School of Medicine, UPMC Children\u2019s Hospital of Pittsburgh, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.12603"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2020.07.004"},{"key":"3","unstructured":"World Health Organization (WHO)WHO Report of the WHO-China joint mission on Coronavirus disease 2019 (COVID-19)September 2020, https:\/\/www.who.int\/docs\/default-source\/coronaviruse\/who-china-joint-mission-on-covid-19-final-report.pdf"},{"issue":"6","key":"4","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1016\/j.jinf.2020.08.029","article-title":"Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19","volume":"81","author":"E. Garrigues","year":"2020","journal-title":"J Infect"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa446"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30086-4"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-06975-7"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.20.22976"},{"issue":"5","key":"9","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.02697-2020","article-title":"COVID-19 and pneumothorax: a multicenter retrospective case series","volume":"56","author":"A. W. 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Liu","year":"2020","journal-title":"EBioMedicine"}],"container-title":["Case Reports in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2023\/1699770.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2023\/1699770.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2023\/1699770.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T17:07:31Z","timestamp":1684256851000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/cricc\/2023\/1699770\/"}},"subtitle":[],"editor":[{"given":"Mehmet","family":"Doganay","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,5,16]]},"references-count":19,"alternative-id":["1699770","1699770"],"URL":"https:\/\/doi.org\/10.1155\/2023\/1699770","relation":{},"ISSN":["2090-6439","2090-6420"],"issn-type":[{"type":"electronic","value":"2090-6439"},{"type":"print","value":"2090-6420"}],"subject":[],"published":{"date-parts":[[2023,5,16]]}}}