Active COVID-19, Clinical Pathway — All Settings
Therapies by Severity of Illness: Hospitalized Children
This guidance reflects the limited available evidence and the expert opinion of a multidisciplinary team from CHOP Infectious Diseases, Critical Care, Antimicrobial Stewardship, Oncology, the Dysregulated Immune Response Team (DIRT), Immunology, Emergency Medicine, Primary Care, Laboratory Medicine and Pharmacy. The guidance here is subject to change as new evidence becomes available. Clinicians should continue to tailor clinical decision making to the unique aspects of individual children while weighing the risks/benefit ratio of administering experimental therapies or therapies with limited pediatric data.
All children should receive supportive care, regardless of illness severity. | ||||
Illness Severity Category | Antiviral Medications | Immunomodulator Medications | Anticoagulation | |
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Steroids are not recommended unless indicated for another condition | Anticoagulation per usual recommendations for hospitalized children, VTE pathway |
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|
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Steroids are not recommended unless indicated for another condition | Anticoagulation per recommendations for children with COVID-19 | |
|
Suggest remdesivir |
|
Anticoagulation per recommendations for children with COVID-19 | |
|
Consider remdesivir |
|
Anticoagulation per recommendations for children with COVID-19 | |
|
Remdesivir not recommended |
|
Anticoagulation per recommendations for children with COVID-19 | |
|
Remdesivir is not routinely recommended, given that oxygen requirements are likely multifactorial in these disease processes and given the self-limited nature of these disease processes. |
|
Anticoagulation per recommendations for children with COVID-19 |