Recommendations for children with COVID-19
National COVID-19 Clinical Evidence Taskforce
The National COVID-19 Clinical Evidence Taskforce has issued a number of recommendations for the care of children with COVID-19.
The Taskforce was established in March 2020, and has been providing guidance on the management of COVID-19 for Australian health practitioners throughout the pandemic.
Dr David Fraile Navarro, of the Australian Institute of Health Innovation at Macquarie University and Cochrane Australia at Monash University, said the Taskforce had formed a paediatric and adolescent care panel to incorporate expert advice from around Australia.
“COVID-19 is generally milder in children, but a small number may suffer complications and become acutely ill,” he said.
“The emergence of a rare, sub-acute condition known as Paediatric Inflammatory Multisystem Syndrome (PIMS-TS) made it even more pressing to provide specific guidance for caring for children with COVID-19.
“The Taskforce’s latest recommendations include definitions of disease severity, appropriate therapy, respiratory support, and venous thromboembolism prophylaxis for COVID‑19 and for the management of PIMS-TS.”
Dr Fraile Navarro said with children traditionally excluded from clinical trials, the Taskforce had to extrapolate from the information collected on adults – a process that comes with risks and limitations.
“With this in mind, the Taskforce has conditionally recommended that corticosteroids should be used to treat children and adolescents with acute COVID-19 who require oxygen,” he said.
“Tocilizumab – a drug often used to treat rheumatoid arthritis – could be considered in acute cases, but the antiviral remdesivir should not be routinely used in children as it has only been trialled for adults with COVID-19 and has not been tested in children for other indications.
“For children with PIMS-TS, a multidisciplinary team should be assembled to manage their care, and intravenous immunoglobulin, corticosteroids, immunomodulatory agents, aspirin and thromboprophylaxis all considered for treatment.”
Need to know more?
- The recommendations for the management of COVID-19 for all ages are ‘living’ recommendations that are updated regularly as new evidence emerges. They are available at https://covid19evidence.net.au
- Listen to the MJA Podcast here with Associate Professor Asha Bowen, Dr Brendan McMullan, and Dr David Fraile Navarro.
- Read the guidelines summary in MJA here .
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