TY - JOUR
T1 - Clinical care of children and adolescents with COVID-19
T2 - Recommendations from the National COVID-19 Clinical Evidence Taskforce
AU - Fraile Navarro, David
AU - Tendal, Britta
AU - Tingay, David
AU - Vasilunas, Nan
AU - Anderson, Lorraine
AU - Burns, Penelope
AU - Best, James
AU - Cheyne, Saskia
AU - Craig, Simon S.
AU - Fancourt, Nicholas S.S.
AU - Erickson, Simon J.
AU - Goff, Zoy
AU - Kapuya, Vimbai
AU - Keyte, Catherine
AU - Malyon, Lorelle
AU - McDonald, Steve
AU - White, Heath
AU - Wurzel, Danielle
AU - Bowen, Asha C.
AU - McMullan, Brendan
AU - for the National COVID-19 Clinical Evidence Taskforce
N1 - Funding Information:
The National COVID‐19 Clinical Evidence Taskforce acknowledges the member organisations, partners, governments and funders that support the initiative (online Supporting Information ). These guidelines have received funding from the Australian Government Department of Health, the Victorian Government Department of Health and Human Services, the Ian Potter Foundation, the Walter Cottman Endowment Fund managed by Equity Trustees, the Lord Mayor’s Charitable Foundation, and the Victorian Government Operational Infrastructure Support Program. David Tingay was supported by a National Health and Medical Research Council Clinical Research Fellowship (Grant ID 1053889).
Publisher Copyright:
© 2021 AMPCo Pty Ltd
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2022/3/21
Y1 - 2022/3/21
N2 - Introduction: The epidemiology and clinical manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are different in children and adolescents compared with adults. Although coronavirus disease 2019 (COVID-19) appears to be less common in children, with milder disease overall, severe complications may occur, including paediatric inflammatory multisystem syndrome (PIMS-TS). Recognising the distinct needs of this population, the National COVID-19 Clinical Evidence Taskforce formed a Paediatric and Adolescent Care Panel to provide living guidelines for Australian clinicians to manage children and adolescents with COVID-19 and COVID-19 complications. Living guidelines mean that these evidence-based recommendations are updated in near real time to give reliable, contemporaneous advice to Australian clinicians providing paediatric care. Main recommendations: To date, the Taskforce has made 20 specific recommendations for children and adolescents, including definitions of disease severity, recommendations for therapy, respiratory support, and venous thromboembolism prophylaxis for COVID-19 and for the management of PIMS-TS. Changes in management as a result of the guidelines: The Taskforce currently recommends corticosteroids as first line treatment for acute COVID-19 in children and adolescents who require oxygen. Tocilizumab could be considered, and remdesivir should not be administered routinely in this population. Non-invasive ventilation or high flow nasal cannulae should be considered in children and adolescents with hypoxaemia or respiratory distress unresponsive to low flow oxygen if appropriate infection control measures can be used. Children and adolescents with PIMS-TS should be managed by a multidisciplinary team. Intravenous immunoglobulin and corticosteroids, with concomitant aspirin and thromboprophylaxis, should be considered for the treatment of PIMS-TS. The latest updates and full recommendations are available at www.covid19evidence.net.au.
AB - Introduction: The epidemiology and clinical manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are different in children and adolescents compared with adults. Although coronavirus disease 2019 (COVID-19) appears to be less common in children, with milder disease overall, severe complications may occur, including paediatric inflammatory multisystem syndrome (PIMS-TS). Recognising the distinct needs of this population, the National COVID-19 Clinical Evidence Taskforce formed a Paediatric and Adolescent Care Panel to provide living guidelines for Australian clinicians to manage children and adolescents with COVID-19 and COVID-19 complications. Living guidelines mean that these evidence-based recommendations are updated in near real time to give reliable, contemporaneous advice to Australian clinicians providing paediatric care. Main recommendations: To date, the Taskforce has made 20 specific recommendations for children and adolescents, including definitions of disease severity, recommendations for therapy, respiratory support, and venous thromboembolism prophylaxis for COVID-19 and for the management of PIMS-TS. Changes in management as a result of the guidelines: The Taskforce currently recommends corticosteroids as first line treatment for acute COVID-19 in children and adolescents who require oxygen. Tocilizumab could be considered, and remdesivir should not be administered routinely in this population. Non-invasive ventilation or high flow nasal cannulae should be considered in children and adolescents with hypoxaemia or respiratory distress unresponsive to low flow oxygen if appropriate infection control measures can be used. Children and adolescents with PIMS-TS should be managed by a multidisciplinary team. Intravenous immunoglobulin and corticosteroids, with concomitant aspirin and thromboprophylaxis, should be considered for the treatment of PIMS-TS. The latest updates and full recommendations are available at www.covid19evidence.net.au.
KW - Child health
KW - COVID-19
KW - Guidelines as topic
KW - Infectious diseases
KW - Pediatrics
KW - Respiratory tract infections
UR - http://www.scopus.com/inward/record.url?scp=85117927218&partnerID=8YFLogxK
U2 - 10.5694/mja2.51305
DO - 10.5694/mja2.51305
M3 - Article
C2 - 34689329
AN - SCOPUS:85117927218
SN - 0025-729X
VL - 216
SP - 255
EP - 263
JO - Medical Journal of Australia
JF - Medical Journal of Australia
IS - 5
ER -