COVID-19 Clinical Guidelines–General Pediatrics

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American College of Rheumatology guidance for the management of children with pediatric rheumatic disease during the COVID-19 pandemic: version 1

Date: 2020 Nov
Developer: American College of Rheumatology (ACR)

Guideline Focus
Management of rheumatic disease during COVID-19 pandemic

Patient Population
Pediatric patients with rheumatic disease during COVID-19 pandemic

Major Interventions

  • Risk mitigation and considerations for ophthalmology monitoring and vaccination
  • Monitoring for mental health issues
  • Guidance on use of SARS-CoV-2 antibody testing
  • Continuation of treatment for patients without COVID-19 exposure or infection
  • Modifications to care for patients without COVID-19 exposure or disease, and for patients with COVID-19 exposure, asymptomatic infection, or symptomatic disease

American College of Rheumatology clinical guidance for multisystem inflammatory syndrome in children associated with SARS-CoV-2 and hyperinflammation in pediatric COVID-19: version 1

Date: 2020 Nov
Developer: American College of Rheumatology (ACR)

Guideline Focus
Management of multisystem inflammatory syndrome (MIS-C) and hyperinflammation associated with COVID-19

Patient Population
Pediatric patients with MIS-C or hyperinflammation associated with COVID-19

Major Interventions

  • Tiered diagnostic evaluation, including diagnostic algorithm
  • Comparison of features of MIS-C and Kawasaki disease
  • Cardiac evaluation, monitoring, and follow-up
  • Immunomodulatory treatment options
  • Antiplatelet and anticoagulation therapy
  • Considerations for management of hyperinflammation, including immunomodulatory therapy

COVID-19 - clinical management of children admitted to hospital with suspected COVID-19

Date: 2020 May 29
Developer: Royal College of Paediatrics and Child Health (RCPCH)

Guideline Focus
Management of children hospitalized with COVID-19

Patient Population
Pediatric patients hospitalized with COVID-19

Major Interventions

  • Considerations for providing good patient care for children
  • Considerations for children with pre-existing conditions
  • Indications for laboratory and imaging studies
  • Guidance on treatment options, including bronchodilators, systemic steroids, antibiotics, antivirals, and diuretics
  • Continuation of chronic ACE inhibitors and NSAIDS
  • Preference for paracetamol over NSAIDS as first-line antipyretic therapy
  • Escalation of respiratory support and management of respiratory failure
  • Role of clinical trials and infectious disease experts in treatment

COVID-19 rapid guideline: children and young people who are immunocompromised

Date: 2020 May 1
Developer: National Institute for Health and Care Excellence (NICE)

Guideline Focus
Management of immunocompromised pediatric patients during the COVID-19 pandemic

Patient Population
Pediatric patients who are immunocompromised

Major Interventions

  • Communicating with patients and infection prevention
  • Modifications to routine care, including appointments, laboratory testing, and medication initiation, continuation, and provision
  • Considerations for immunocompromised patients diagnosed with COVID-19, including management of chronic medications
  • Infection control and personal protective equipment (PPE) considerations for health care workers

Guidance: paediatric multisystem inflammatory syndrome temporally associated with COVID-19

Date: 2020 May 1
Developer: Royal College of Paediatrics and Child Health (RCPCH)

Guideline Focus
Diagnosis and management of multisystem inflammatory syndrome for COVID-19

Patient Population
Pediatric patients with COVID-19

Major Interventions

  • Description of symptoms, exclusion of alternate causes, and diagnostic studies
  • Use of personal protective equipment (PPE), supportive management, laboratory, and cardiac monitoring
  • Role of intravenous immunoglobulin (IVIG) and aspirin treatment
  • Management principles and level of care considerations
  • Treatment options, including antiviral and immunomodulatory therapy, and the role of specialists

Nursing guidance for the care of the child with suspected or proven COVID-19 infection. Version 1.0

Date: 2020 Mar 29
Developer: European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

Guideline Focus
Nursing care for children with COVID-19

Patient Population
Children with COVID-19

Major Interventions

  • Guidance on use of personal protective equipment (PPE), especially during aerosol-generating events
  • Modifications to airway and suctioning techniques
  • General nursing care, including ventilator care and feeding
  • Maintaining child- and family-centered care

Pediatric endoscopy in the era of coronavirus disease 2019: a North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition position paper

Date: 2020 Jun
Developer: North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN)

Guideline Focus
Pediatric endoscopy during the COVID-19 pandemic

Patient Population
Pediatric patients requiring endoscopy during the COVID-19 pandemic

Major Interventions

  • Use of personal protective equipment (PPE) and procedure setting
  • Risk assessment for triaging procedure necessity
  • Intraprocedure precautions, and postprocedure cleaning and infection prevention measures
  • Personnel and trainee considerations

Post-natal follow-up for women and neonates during the COVID-19 pandemic: French National Authority for Health recommendations

Date: 2020 Sep
Developer: French National Authority for Health (HAS)

Guideline Focus
Post-natal follow-up for women and neonates during the COVID-19 pandemic

Patient Population
Post-partum women and neonates during the COVID-19 pandemic

Major Interventions

  • Vertical transmission, breastfeeding considerations, and precautions with maternal COVID-19
  • Timing of discharge and first outpatient newborn visit
  • Modifications to follow-up visits, including remote consultation and maintenance of psychological support
  • Monitoring and follow-up for jaundice

Practice recommendations for the management of children with suspected or proven COVID-19 infections from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC) and the section Respiratory Failure from the European Society for Paediatric and Neonatal Intensive Care (ESPNIC): a consensus statement

Date: 2020
Developer: European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

Guideline Focus
Management and treatment of respiratory illness in patients with COVID-19

Patient Population
Children with COVID-19 requiring respiratory support

Major Interventions

  • Modes of respiratory support for patients at-risk for acute respiratory distress syndrome (ARDS)
  • Management of invasively ventilated patients
  • Escalating therapies for refractory hypoxemia
  • Guidance on use of personal protective equipment (PPE) and infection control measures

Rapid advice guidelines for management of children with COVID-19

Date: 2020 May 8
Developer: National Clinical Research Center for Child Health and Disorders (NCRCCHD)

Guideline Focus
Management of COVID-19

Patient Population
Children with COVID-19

Major Interventions

  • Symptom identification and quarantine following exposure
  • Guidance on use of computed tomography (CT) for diagnosis
  • Guidance on pharmacological treatment options (e.g., antivirals, antibiotics, corticosteroids, intravenous immunoglobulin IVIG)
  • Supportive care for children with severe COVID-19
  • Information for parents and continuation of breastfeeding

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