A panel of Australian experts have laid out 20 recommendations to provide optimal care of children and adolescents affected by COVID-19.
Researchers from the National COVID-19 Clinical Evidence Taskforce have developed a new set of guidelines for the clinical care of children and adolescents with COVID-19. The new guidelines, published this week in the Medical Journal of Australia, include 20 recommendations that will be updated in real-time, with the goal of providing practitioners with the most up-to-date advice possible.
According to lead researcher Dr David Fraile-Navarro from Cochrane Australia at Monash University and the Centre for Health Informatics at Macquarie University, the new recommendations will provide reliable and up-to-date advice to Australian clinicians caring for children and adolescents.
Overall, the authors note that while these new recommendations are aimed towards children under 16 years of age, individual considerations should be made for each patient. “The decision to apply paediatric or adult recommendations should be guided by consideration of the physical and developmental maturity of individual patients,” the authors wrote in their report.
Another important point noted by authors is the lack of data available from children-based studies, which led to researchers needing to rely on data from adults to formulate the new recommendations. “The Taskforce needed to rely on trial data from adults to formulate recommendations for children, with the well-known limitations and risks of extrapolation of this brings,” the authors wrote. “The need to consider certain paediatric subpopulations separately, such as neonates and adolescents, amplified this problem,” they added.
Some of the proposed changes in care management include, according to their official press release, include:
- 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 cannula 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 paediatric multisystem inflammatory syndrome (PIMS-TS) should be managed by a multidisciplinary team; and,
- intravenous immunoglobulin and corticosteroids, with concomitant aspirin and thromboprophylaxis, should be considered for the treatment of PIMS-TS.
GPs are advised to regularly review the taskforce official website for updates on these guidelines.
“The evidence landscape is changing rapidly, and the guidelines will continue to adapt to this change. We encourage those who care for infants, children and adolescents affected by COVID-19 to keep up-to-date at https://covid19evidence.net.au,” the authors wrote.