Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
J Pediatric Infect Dis Soc. 2024 Mar 19;13(3):159-185. doi: 10.1093/jpids/piad116.
Since November 2019, the SARS-CoV-2 pandemic has created challenges for preventing and managing COVID-19 in children and adolescents. Most research to develop new therapeutic interventions or to repurpose existing ones has been undertaken in adults, and although most cases of infection in pediatric populations are mild, there have been many cases of critical and fatal infection. Understanding the risk factors for severe illness and the evidence for safety, efficacy, and effectiveness of therapies for COVID-19 in children is necessary to optimize therapy.
A panel of experts in pediatric infectious diseases, pediatric infectious diseases pharmacology, and pediatric intensive care medicine from 21 geographically diverse North American institutions was re-convened. Through a series of teleconferences and web-based surveys and a systematic review with meta-analysis of data for risk factors, a guidance statement comprising a series of recommendations for risk stratification, treatment, and prevention of COVID-19 was developed and refined based on expert consensus.
There are identifiable clinical characteristics that enable risk stratification for patients at risk for severe COVID-19. These risk factors can be used to guide the treatment of hospitalized and non-hospitalized children and adolescents with COVID-19 and to guide preventative therapy where options remain available.
自 2019 年 11 月以来,SARS-CoV-2 大流行给儿童和青少年的 COVID-19 预防和管理带来了挑战。大多数开发新治疗干预措施或重新利用现有治疗措施的研究都是在成年人中进行的,尽管儿科人群中的大多数感染病例都是轻症,但也有许多重症和致命感染病例。了解 COVID-19 在儿童中的严重疾病的危险因素以及治疗方法的安全性、疗效和有效性证据,对于优化治疗至关重要。
来自 21 个地理位置不同的北美机构的儿科传染病学、儿科传染病药理学和小儿重症监护医学专家小组重新召开会议。通过一系列电话会议和基于网络的调查以及对危险因素进行系统评价和荟萃分析,根据专家共识制定并完善了一份包含一系列 COVID-19 风险分层、治疗和预防建议的指南声明。
存在可识别的临床特征,可对有发生严重 COVID-19 风险的患者进行风险分层。这些危险因素可用于指导住院和非住院 COVID-19 患儿的治疗,并指导有治疗选择时的预防性治疗。