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
Zachary Willis, Carlos R. Oliveira, Mark J. Abzug, Brenda I. Anosike, Monica I. Ardura, Laura Bio, Juri Boguniewicz, Kathleen Chiotos, Kevin J. Downes, Steven P Grapentine, Adam L. Hersh, Sarah M. Heston, Diego R. Hijano, W. Charles Huskins, Scott H. James, Sarah Bruyn Jones, Christine R Lockowitz, Elizabeth C Lloyd, Christine E. MacBrayne, Gabriela Marón, Molly Hayes, Christine M Miller, Ted Morton, Rosemary Olivero, Rachel C. Orscheln, Hayden T. Schwenk, Prachi Singh, Vijaya L Soma, Paul K. Sue, Surabhi B Vora, Mari Nakamura, Joshua Wolf
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.