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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد

COVID-19-specific treatments for children and nonpregnant* adolescents

COVID-19-specific treatments for children and nonpregnant* adolescents
Agent Time window for initiation after symptom onset Authorized age and weight Route and duration of administration Clinical considerations
Outpatient management
Nirmatrelvir-ritonavir ≤5 days
  • ≥12 years
  • Weight ≥40 kg
  • Oral
  • 5 days (twice daily)
  • Significant drug-drug interactions with many common medications; consult a reliable prescribing referenceΔ to determine if nirmatrelvir-ritonavir use is appropriate or if risk can be safely mitigated with alteration of the patient's medication regimen
  • Reduce dose for eGFR <30 to 59 mL/min; avoid use in severe hepatic impairment
  • Tablets cannot be chewed, broken, or crushed
  • Data in children are limited
Remdesivir ≤7 days
  • No age limit
  • Weight ≥1.5 kg
  • IV
  • 3 days
  • For use in outpatient management of patients for whom other authorized or approved therapies are not accessible or clinically inappropriate
Inpatient management
Remdesivir ≤7 days
  • No age limit
  • Weight ≥1.5 kg
  • IV
  • ≥5 days or until hospital discharge, whichever comes first
  • Used to treat illness requiring supplemental oxygen via nasal cannula
Dexamethasone◊ NA
  • No age or weight restrictions
  • Oral, IV, or nasogastric
  • Every 24 hours for up to 10 days or until hospital discharge, whichever comes first
  • Used in combination with remdesivir to treat illness requiring supplemental oxygen via HFNC or NIV
  • Used alone if remdesivir criteria are not met
Tocilizumab NA
  • ≥2 years
  • IV
  • Every 8 hours as needed
  • Used in combination with a glucocorticoid to treat illness requiring mechanical ventilation or ECMO
This table summarizes COVID-19-specific treatments for children and nonpregnant adolescents. The decision to prescribe COVID-19-specific therapy is based on the patient's risk for progression to severe disease and includes an assessment of risk factors (eg, underlying comorbidities) and immunization status. Refer to UpToDate content on management of COVID-19 in children for details, including doses and additional considerations. Additional information with links to fact sheets or prescribing information is available in a side-by-side overview from the United States Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response.

COVID-19: coronavirus disease 2019; ECMO: extracorporeal membrane oxygenation; eGFR: estimated glomerular filtration rate; HFNC: high-flow nasal cannula; IV: intravenous; NA: not applicable; NIV: noninvasive ventilation.

* Refer to UpToDate content on the care of pregnant patients with COVID-19 for management of this population.

¶ We encourage initiation of treatment as soon as possible after symptom onset and within the authorized/approved time windows provided in the table. The first day of symptoms is considered day 0, the next day is considered day 1, etc.

Δ As an example, the PAXLOVID Patient Eligibility Screening Checklist Tool for Prescribers from the US Food and Drug Administration.

◊ Refer to UpToDate content on management of COVID-19 in children for other glucocorticoid options.

Reference:
  1. Willis ZI, Oliveira CR, Abzug MJ, et al. Guidance for prevention and management of COVID-19 in children and adolescents: A consensus statement from the Pediatric Infectious Diseases Society Pediatric COVID-19 Therapies Taskforce. J Pediatric Infect Dis Soc 2024; 13:159.
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