Clinical Pathway for Evaluation and Treatment of
Children with Active COVID-19 Infection

  • History & Physical Exam
    • Symptoms, Exposure
    • Consider MIS-C
    • Initiate Isolation Precautions
  • Fever, sore throat, cough
  • Myalgias
  • No respiratory distress
  • No O2 requirement
  • Adequate hydration
Child < 12 yrs or < 40 kg
AND child ≥ 12 yrs old
without high risk condition
Child ≥ 12 yrs and ≥ 40 kg
AND high risk condition
  • New O2 requirement
    • Not rapidly escalating
    • Not requiring CPAP, BiPap, or intubation
  • Escalation in baseline respiratory support, PICU not required
  • Hypoxia or respiratory distress requiring
    • Invasive or non-invasive ventilation
  • SIRS/sepsis/multisystem organ failure
  • Escalation in baseline
    • Invasive or non-invasive ventilation requiring PICU admission
  • Rapidly deteriorating clinical condition that does not yet meet these criteria
Supportive Care, Discharge
Consider Outpatient Treatment
Admit to Special
Treatment Room for
COVID-positive children
Admit to PICU Special Treatment Room
Posted: June 2020
Revised: March 2023
Authors: K. Chiotos, MD; D. Davis, MD; C. Kerman, MD; J. Gerber, MD; J. Lavelle, MD