Guidance for prevention and management of COVID-19 in children and adolescents: A consensus statement from the Pediatric Infectious Diseases Society Pediatric COVID-19 Therapies Taskforce

Author:

Willis Zachary I1ORCID,Oliveira Carlos R2ORCID,Abzug Mark J3,Anosike Brenda I4,Ardura Monica I5ORCID,Bio Laura L6ORCID,Boguniewicz Juri3ORCID,Chiotos Kathleen7,Downes Kevin8ORCID,Grapentine Steven P9,Hersh Adam L10,Heston Sarah M11ORCID,Hijano Diego R12ORCID,Huskins W Charles13,James Scott H14,Jones Sarah15,Lockowitz Christine R16,Lloyd Elizabeth C17,MacBrayne Christine18,Maron Gabriela M12,Hayes McDonough Molly19ORCID,Miller Christine M2ORCID,Morton Theodore H20,Olivero Rosemary M21,Orscheln Rachel C22,Schwenk Hayden T23ORCID,Singh Prachi24,Soma Vijaya L25,Sue Paul K26,Vora Surabhi B27,Nakamura Mari M28ORCID,Wolf Joshua12ORCID

Affiliation:

1. Department of Pediatrics, University of North Carolina School of Medicine , Chapel Hill, NC , USA

2. Department of Pediatrics, Yale University School of Medicine , New Haven, CT , USA

3. Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado , Aurora, CO , USA

4. Department of Pediatrics, The Children’s Hospital at Montefiore and Albert Einstein College of Medicine , Bronx, NY , USA

5. Department of Pediatrics, ID Host Defense Program, Nationwide Children’s Hospital & The Ohio State University , Columbus, OH , USA

6. Department of Pharmacy, Lucile Packard Children’s Hospital , Stanford, CA , USA

7. Departments of Anesthesiology, Critical Care Medicine, and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Divisions of Critical Care Medicine and Infectious Diseases, Children’s Hospital of Philadelphia , Philadelphia, PA , USA

8. Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Division of Infectious Diseases, Children’s Hospital of Philadelphia , Philadelphia, PA , USA

9. Department of Pharmacy, University of California San Francisco Benioff Children’s Hospital , San Francisco, CA , USA

10. Department of Pediatrics, Division of Infectious Diseases, University of Utah , Salt Lake City, UT , USA

11. Department of Pediatrics, Duke University School of Medicine , Durham, NC , USA

12. Department of Infectious Diseases, St. Jude Children’s Research Hospital and Department of Pediatrics, University of Tennessee Health Science Center , Memphis, TN , USA

13. Department of Pediatric and Adolescent Medicine, Mayo Clinic , Rochester, MN , USA

14. Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Alabama at Birmingham , Birmingham, AL , USA

15. Department of Pharmacy, Boston Children’s Hospital , Boston, MA , USA

16. Department of Pharmacy, St. Louis Children’s Hospital , St. Louis, Missouri , USA

17. Department of Pediatrics, University of Michigan , Ann Arbor, MI , USA

18. Department of Pharmacy, Children’s Hospital Colorado , Aurora, CO , USA

19. Center for Healthcare Quality & Analytics, The Children’s Hospital of Philadelphia , Philadelphia, PA , USA

20. Department of Pharmacy, St Jude’s Children’s Research Hospital , Memphis, Tennessee , USA

21. Department of Pediatrics and Human Development, Michigan State College of Human Medicine and Helen DeVos Children’s Hospital of Corewell Health , Grand Rapids, MI , USA

22. Department of Pediatrics, Washington University , St. Louis, MO , USA

23. Department of Pediatrics, Stanford School of Medicine , Stanford, CA , USA

24. Department of Pediatrics, University of California San Francisco , San Francisco, CA , USA

25. Department of Pediatrics, NYU Grossman School of Medicine , New York, NY , USA

26. Department of Pediatrics, Columbia University , New York, NY , USA

27. Department of Pediatrics, University of Washington School of Medicine, and Division of Infectious Diseases, Seattle Children’s Hospital , Seattle, WA , USA

28. Antimicrobial Stewardship Program and Division of Infectious Diseases, Boston Children’s Hospital , Boston, MA , USA

Abstract

Abstract Background Since November 2019, the SARS-CoV-2 pandemic has created challenges for preventing and managing COVID-19 in children and adolescents. Most research to develop new therapeutic interventions or to repurpose existing ones has been undertaken in adults, and although most cases of infection in pediatric populations are mild, there have been many cases of critical and fatal infection. Understanding the risk factors for severe illness and the evidence for safety, efficacy, and effectiveness of therapies for COVID-19 in children is necessary to optimize therapy. Methods A panel of experts in pediatric infectious diseases, pediatric infectious diseases pharmacology, and pediatric intensive care medicine from 21 geographically diverse North American institutions was re-convened. Through a series of teleconferences and web-based surveys and a systematic review with meta-analysis of data for risk factors, a guidance statement comprising a series of recommendations for risk stratification, treatment, and prevention of COVID-19 was developed and refined based on expert consensus. Results There are identifiable clinical characteristics that enable risk stratification for patients at risk for severe COVID-19. These risk factors can be used to guide the treatment of hospitalized and non-hospitalized children and adolescents with COVID-19 and to guide preventative therapy where options remain available.

Publisher

Oxford University Press (OUP)

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