From the Guidelines
Children with Coronavirus Disease 2019 (COVID-19) should be treated based on their specific clinical presentation, with a focus on supportive care and management of symptoms.
Treatment Approach
- For most children, COVID-19 is a mild illness, and treatment is focused on relieving symptoms, such as fever and cough, and supporting the child's overall health 1.
- In cases of Multisystem Inflammatory Syndrome in Children (MIS-C), which is a rare but serious condition associated with COVID-19, treatment may involve immunomodulatory therapy and other supportive measures 1.
- The American College of Rheumatology has provided clinical guidance for the management of MIS-C and hyperinflammation in pediatric COVID-19, which includes recommendations for diagnostic evaluation and treatment 1.
Medications
- There is currently no specific antiviral medication approved for the treatment of COVID-19 in children, although remdesivir has been used in some cases of severe COVID-19 1.
- The use of corticosteroids and other immunomodulatory medications may be considered in cases of MIS-C or hyperinflammation, but should be individualized based on the child's specific clinical presentation and needs 1.
Important Considerations
- Clinical judgment and individualized care are essential in the management of children with COVID-19, as the disease can present differently in each child 1.
- The American College of Rheumatology's clinical guidance for MIS-C and hyperinflammation in pediatric COVID-19 is based on the best available evidence and expert opinion, but may need to be revised as new information becomes available 1.
From the Research
Treatment for Children with COVID-19
The treatment for children with Coronavirus Disease 2019 (COVID-19) depends on the severity of the disease.
- For mild cases, supportive care alone is suggested 2, 3.
- For severe or critical cases, antiviral therapy may be considered, with remdesivir being the preferred agent 2, 3.
- Monoclonal antibody therapy may also be considered for adolescents (≥12 years of age) at high risk of progression to hospitalization or severe disease 4.
- Remdesivir has been approved by the FDA for use in children ≥28 days old, weighing ≥3 kilograms, who are at high risk for progression to severe COVID-19 5.
Antiviral Therapy
- Remdesivir is the most commonly used antiviral drug in children with COVID-19, with few reports of serious adverse effects 6.
- The duration of remdesivir treatment is typically 5 days 3.
- Hydroxychloroquine and lopinavir-ritonavir are not recommended for use in children with COVID-19 3.
Anti-Inflammatory Medications
- Anti-inflammatory medications, including corticosteroids, are commonly used in children with severe COVID-19 6.
- Intravenous immune globulin (IVIG) and other anti-inflammatory/immunomodulatory agents, such as anakinra, aspirin, and anticoagulants, may be used in cases with multisystem inflammatory syndrome in children (MIS-C) 6.