Suggested reading: Antiviral remdesivir prevents disease progression in monkeys with COVID-19, in a controlled trial

Source: Healio

In new guidance, a panel of pediatric infectious diseases physicians and pharmacists suggested that supportive care alone is sufficient to treat most children with COVID-19. Among children who develop severe or critical cases — a rare occurrence — the panel suggested the use of remdesivir as the preferred antiviral.

In the guidance, Kathleen Chiotos, MD, MSCE, attending physician in the PICU at the Children’s Hospital of Philadelphia, Mari M. Nakamura, MD, MPH, associate physician in pediatrics at Boston Children’s Hospital, and colleagues said antiviral use should be considered on a case-by-case basis. If antiviral therapy is considered, the medications “should preferably be used as part of a clinical trial” as they become available for pediatric patients, they wrote.

“We hope that this guidance will provide clinicians a framework to approach treatment decisions in a time of uncertainty,” Chiotos and Nakamura told Healio. “One thing that we hope was clear from the guidance is that the literature around therapy is changing rapidly — so clinicians should continue to critically review the literature as therapeutic decisions are being considered.”

The panel considered pediatric cases of COVID-19 as “severe” when a patient needed supplemental oxygen. Although it is rare for children to become severely ill with COVID-19, the authors of the guidance approximately 6% of 2,143 pediatric COVID-19 cases were categorized as severe and critical.

“The most important thing to remember is that most pediatric patients will recover with supportive care, meaning no antiviral therapy,” Chiotos and Nakamura said. “Therefore, use of these medications outside of a clinical trial should really be the exception, not the rule.”

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