Management of infantile hemangiomas during the COVID pandemic
Ilona J. Frieden, Katherine B. Püttgen, Beth A. Drolet, Maria C. Garzón, Sarah L. Chamlin, Elena Pope, Anthony J. Mancini, Christine T. Lauren, Erin F. Mathes, Dawn H. Siegel, Deepti Gupta, Anita N. Haggstrom, Megha M. Tollefson, Eulàlia Baselga, Kimberly D. Morel, Sonal D. Shah, Kristen E. Holland, Denise M. Adams, Kimberly A. Horii, Brandon Newell, Julie Powell, Catherine McCuaïg, Amy J. Nopper, Denise W. Metry, Sheilagh Maguiness, For The Hemangioma Investigator Group
Abstract
The COVID-19 pandemic has caused significant shifts in patient care including a steep decline in ambulatory visits and a marked increase in the use of telemedicine. Infantile hemangiomas (IH) can require urgent evaluation and risk stratification to determine which infants need treatment and which can be managed with continued observation. For those requiring treatment, prompt initiation decreases morbidity and improves long-term outcomes. The Hemangioma Investigator Group has created consensus recommendations for management of IH via telemedicine. FDA/EMA-approved monitoring guidelines, clinical practice guidelines, and relevant, up-to-date publications regarding initiation and monitoring of beta-blocker therapy were used to inform the recommendations. Clinical decision-making guidelines about when telehealth is an appropriate alternative to in-office visits, including medication initiation, dosage changes, and ongoing evaluation, are included. The importance of communication with caregivers in the context of telemedicine is discussed, and online resources for both hemangioma education and propranolol therapy are provided.