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Researchers found the oral antiviral drug nirmatrelvir/ritonavir (Paxlovid) is safe for kids as young as age 6 with mild/moderate COVID-19 who were at increased risk for severe disease, as published in Pediatrics. Of the in 75 children in the international study, 81% had 1 risk factor for severe COVID-19, most commonly obesity (49%) or chronic lung disease (40%). Additionally, 56% were unvaccinated. Children aged 6–17 years who weighed 40 kg or more received 300 mg of nirmatrelvir plus 100 mg of ritonavir twice daily (the same dose used in adults). Children aged 6–17 years who weighed at least 20 kg but less than 40 kg received 150 mg of nirmatrelvir plus 100 mg of ritonavir twice daily. The goal was to determine whether these doses were effective while remaining safe for children. No COVID-19-related hospitalizations or deaths occurred through 28 days of follow-up, and viral RNA levels declined substantially by the end of the 5-day treatment course. Treatment was generally well tolerated, with diarrhea and headache each reported in 4% of participants.
Possible treatment for more patients: The authors say this small study supports weight-based nirmatrelvir/ritonavir dosing as a safe outpatient treatment option for high-risk children as young as 6 years. Currently, nirmatrelvir/ritonavir is only authorized for emergency use in the United States in adolescents aged at least 12 years and at least 40 kg.
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