A Case Series of Persistent SARS-CoV-2 Infection in Immunocompromised Pediatric Patients

Table 1

Summary of cases.

Cases	Age	Cause of immunosuppression	Duration of persistent symptoms (from initial diagnosis with COVID-19 until admission with acute respiratory failure)	Associated complications	Management	Clinical outcome
Case 1	16-year-old	H/o ALL; s/p peripheral stem cell transplantation	3-4 weeks	Diffuse alveolar hemorrhage; Atypical hemolytic-uremic syndrome; Pulmonary infarction secondary to invasive mucormycosis	Hydrocortisone; Eculizumab; Vancomycin; Cefepime; Amphotericin (after pulmonary infarction)	Death
Case 2	12-year-old	H/o ALL; s/p bone marrow transplant	4 weeks	Diffuse alveolar hemorrhage; Pulmonary embolism	Remdesivir; Hydrocortisone; Tocilizumab; Vancomycin; Cefepime; Amphotericin	Discharge home on room air
Case 3	14-year-old	P-ANCA vasculitis with end-stage renal disease	5 weeks	Diffuse alveolar hemorrhage; Pneumothorax; Pneumomediastinum; Hyperferritinemia	Remdesivir; Hydrocortisone; Anakinra; IVIG; Plasmapheresis; Vancomycin; Cefepime; Amphotericin	Discharge home on room air
Case 4	19-year-old	Granulomatosis with polyangiitis	5 weeks	Diffuse alveolar hemorrhage	Remdesivir; Hydrocortisone; Unasyn	Discharge home on room air