Abstract：
OBJECTIVE: This study reviewed the current knowledge and guidelines on managing COVID-19 in children and proposed a practical approach to drug treatment.
METHODS: We analysed international guidelines from four prominent scientific bodies on treating COVID-19 in children. These were the UK National Institute for Health and Care Excellence, the American National Institutes of Health, the Infectious Diseases Society of America and the Australian National Clinical Evidence Taskforce COVID-19.
RESULTS: Most paediatric patients with COVID-19 only require symptomatic treatment. There was limited evidence on treatment recommendations for children with severe COVID-19 or at risk of disease progression. However, several drugs are available for children and we have summarised the guidelines, in order to provide a concise, practical format for clinicians. All the guidelines agree that nirmatrelvir plus ritonavir or remdesivir can be used as prophylaxis for severe COVID-19 in high-risk patients. Remdesivir can also be used for severe COVID-19 cases. Glucocorticosteroids are recommended, particularly in patients requiring oxygen therapy. Tocilizumab or baricitinib should be reserved for patients with progressive disease and/or signs of systemic inflammation.
CONCLUSIONS: The guidelines provide useful advice and a degree of consensus on specific drug treatment for children with severe COVID-19 or at risk of progression.
METHODS: We analysed international guidelines from four prominent scientific bodies on treating COVID-19 in children. These were the UK National Institute for Health and Care Excellence, the American National Institutes of Health, the Infectious Diseases Society of America and the Australian National Clinical Evidence Taskforce COVID-19.
RESULTS: Most paediatric patients with COVID-19 only require symptomatic treatment. There was limited evidence on treatment recommendations for children with severe COVID-19 or at risk of disease progression. However, several drugs are available for children and we have summarised the guidelines, in order to provide a concise, practical format for clinicians. All the guidelines agree that nirmatrelvir plus ritonavir or remdesivir can be used as prophylaxis for severe COVID-19 in high-risk patients. Remdesivir can also be used for severe COVID-19 cases. Glucocorticosteroids are recommended, particularly in patients requiring oxygen therapy. Tocilizumab or baricitinib should be reserved for patients with progressive disease and/or signs of systemic inflammation.
CONCLUSIONS: The guidelines provide useful advice and a degree of consensus on specific drug treatment for children with severe COVID-19 or at risk of progression.
摘要：
目的：本研究回顾了当前关于儿童COVID-19管理的知识和指南，并提出了一种切实可行的药物治疗方法。
方法：我们分析了四个著名科学机构关于治疗儿童COVID-19的国际指南。这些是英国国家健康与护理卓越研究所，美国国立卫生研究院，美国传染病学会和澳大利亚国家临床证据工作组COVID-19。
结果：大多数患有COVID-19的儿科患者仅需要对症治疗。对于患有严重COVID-19或有疾病进展风险的儿童，治疗建议的证据有限。然而,有几种药物可供儿童使用，我们总结了指导方针，为了提供一个简洁的，临床医生的实用格式。所有指南都同意尼马特雷韦加利托那韦或雷德西韦可用于预防高危患者的严重COVID-19。Remdesivir也可用于重症COVID-19病例。建议使用糖皮质激素，特别是需要氧气治疗的患者。Tocilizumab或baricitinib应保留用于患有进行性疾病和/或全身性炎症体征的患者。
结论：指南为患有严重COVID-19或有进展风险的儿童的特定药物治疗提供了有用的建议和一定程度的共识。
方法：我们分析了四个著名科学机构关于治疗儿童COVID-19的国际指南。这些是英国国家健康与护理卓越研究所，美国国立卫生研究院，美国传染病学会和澳大利亚国家临床证据工作组COVID-19。
结果：大多数患有COVID-19的儿科患者仅需要对症治疗。对于患有严重COVID-19或有疾病进展风险的儿童，治疗建议的证据有限。然而,有几种药物可供儿童使用，我们总结了指导方针，为了提供一个简洁的，临床医生的实用格式。所有指南都同意尼马特雷韦加利托那韦或雷德西韦可用于预防高危患者的严重COVID-19。Remdesivir也可用于重症COVID-19病例。建议使用糖皮质激素，特别是需要氧气治疗的患者。Tocilizumab或baricitinib应保留用于患有进行性疾病和/或全身性炎症体征的患者。
结论：指南为患有严重COVID-19或有进展风险的儿童的特定药物治疗提供了有用的建议和一定程度的共识。
