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Meta-Analysis
. 2024 Mar 19;13(3):159-185.
doi: 10.1093/jpids/piad116.

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 I Willis  1 , Carlos R Oliveira  2 , Mark J Abzug  3 , Brenda I Anosike  4 , Monica I Ardura  5 , Laura L Bio  6 , Juri Boguniewicz  3 , Kathleen Chiotos  7 , Kevin Downes  8 , Steven P Grapentine  9 , Adam L Hersh  10 , Sarah M Heston  11 , Diego R Hijano  12 , W Charles Huskins  13 , Scott H James  14 , Sarah Jones  15 , Christine R Lockowitz  16 , Elizabeth C Lloyd  17 , Christine MacBrayne  18 , Gabriela M Maron  12 , Molly Hayes McDonough  19 , Christine M Miller  2 , Theodore H Morton  20 , Rosemary M Olivero  21 , Rachel C Orscheln  22 , Hayden T Schwenk  23 , Prachi Singh  24 , Vijaya L Soma  25 , Paul K Sue  26 , Surabhi B Vora  27 , Mari M Nakamura  28 , Joshua Wolf  12
Affiliations
Meta-Analysis

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 I Willis et al. J Pediatric Infect Dis Soc. .

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.

Keywords: COVID-19; evidence-based; guidance; management; pediatric.

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Figures

Figure 1.
Figure 1.
Risk stratification framework. Definite risk factors include immunocompromise, obesity, diabetes (type 1/2), prematurity, chronic cardiac, neurologic, or pulmonary disease (excluding asthma). Probable risk factors include sickle cell disease, mild/moderate immunocompromise, neuro-disabilities, chronic kidney, gastrointestinal or liver disease. Prior immunity is defined as up-to-date immunization or recent infection within the previous 4 months.
Figure 2.
Figure 2.
Association between comorbidities and severe COVID-19 in children. OR (95% CI) = odds ratio and 95% confidence interval, estimated using data extracted from published studies. Red = Definite risk factors; Orange = Probable risk factors; Green = Unlikely risk factors; Gray = Risk modifiers. The yellow bars represent the total number of studies evaluated, with darker shades indicating the subset of studies included in the meta-analysis. ^Certainty downgraded because of small sample sizes in studies or non-significant effects after adjusting for comorbidities. *Reference age, 1–11 years.
Figure 3.
Figure 3.
Management of COVID-19 in children and adolescents not requiring hospitalization for COVID-19.
See this image and copyright information in PMC

References

    1. World Health Organization. COVID-19 Epidemiological Update - 29 September 2023. Available at: https://www.who.int/publications/m/item/covid-19-epidemiological-update-.... Accessed October 15, 2023.
    1. Zimmermann P, Curtis N. Why does the severity of COVID-19 differ with age?: understanding the mechanisms underlying the age gradient in outcome following SARS-CoV-2 infection. Pediatr Infect Dis J 2022; 41:e36–45. - PMC - PubMed
    1. Toussi SS, Hammond JL, Gerstenberger BS, Anderson AS. Therapeutics for COVID-19. Nat Microbiol 2023; 8:771–86. - PubMed
    1. Wolf J, Abzug MJ, Anosike BI, et al. . Updated guidance on use and prioritization of monoclonal antibody therapy for treatment of COVID-19 in adolescents. J Pediatric Infect Dis Soc 2022; 11:177–85. - PMC - PubMed
    1. Chiotos K, Hayes M, Kimberlin DW, et al. . Multicenter interim guidance on use of antivirals for children With Coronavirus Disease 2019/Severe Acute Respiratory Syndrome Coronavirus 2. J Pediatric Infect Dis Soc 2021; 10:34–48. - PMC - PubMed

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