Clinical Pathway for Evaluation and Treatment of
Children with Active COVID-19 Infection
- History and Physical Exam
- Symptoms, Exposure
- Consider MIS-C
- Initiate Isolation Precautions
-
Multisystem Inflammatory Syndrome in Children (MIS-C)
- Guidance for Initial Evaluation of:
- Possible MIS-C
- Guidance for MIS-C/Shock
- Guidance for Initial Evaluation of:
- Neurologic Manifestations
- COVID Toes
- Fever, sore throat, cough
- Myalgias
- No respiratory distress
- No O2 requirement
- Adequate hydration
Child ≥ 12 yrs and ≥ 40 kg
AND high risk condition
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
Treatment Room for
COVID-positive children
Admit to PICU Special Treatment Room
- Additional Inpatient Care Resources
Evidence
- NIH Treatment Guidelines
- Dexamethasone in Hospitalized Patients with COVID-19
- Remdesivir for the Treatment of COVID-19 – Final Report
- Interleukin-6 Receptor Antagonists in Critically Ill Patients with COVID-19
- Tocilizumab in Patients Admitted to the Hospital with COVID-19 (RECOVERY): a Randomized, Controlled, Open-label Platform Trial
- Baricitinib Plus Remdesivir for Hospitalized Adults with COVID-19
- Efficacy and Safety of Baricitinib for the Treatment of Hospitalized Adults with COVID-19 (COV-BARRIER): a Randomized, Double-blind, Parallel Group, Placebo-controlled Phase 3 Trial