The acute management of COVID-19 in paediatrics (spring 2021 update)

Question 1

Percentage of pediatric patients who died from COVID-19 infection

Answer 1

less than 0.0025%

Question 2

Percentage of pediatric patients with COVID-19 hospitalized

Answer 2

1.5%

Question 3

Common symptoms of COVID-19 infection

Answer 3

General: Fever, myalgia
ENT: Sore throat, anosmia, and ageusia
Resp: Cough, shortness of breath, dyspnea, rhinorrhea, nasal congestion
GI: Nausea and vomiting, diarrhea, abdominal pain
Neurologic: Headache, seizures, confusion

Question 4

transmission

Answer 4

droplet and contact

Question 5

Sensitivity

Answer 5

true positive

Question 6

specificity

Answer 6

true negative

Question 7

pooled sensitivity of NP swab testing

Answer 7

83.2%

Question 8

pooled specificity of NP swab testing

Answer 8

99.2%

Question 9

Role of dexamethasone

Answer 9

in severe or critical cases

Question 10

Dose of Dex

Answer 10

0.15 mg/kg, IV or PO, to a maximum of 6 mg once daily for up to 10 days

Question 11

Remdesivir (MOA)

Answer 11

a nucleotide analog prodrug that inhibits viral RNA polymerases,

Question 12

Remdesivir indications

Answer 12

1. severe symptoms of COVID-19 in children >12 years old and weighing at least 40 kg, who have pneumonia and require supplemental oxygen.
2. consider for children with moderate disease who are at high risk for developing more severe illness.

Question 13

Dose of Remdesivir

Answer 13

children >40 kg: 200 mg on day 1, then 100 mg on days 2 to 5, with continuation for an additional 5 days if there is no clinical improvement

Question 14

Bamlanivimab

Answer 14

neutralizing IgG1 monoclonal antibody that binds to the spike protein of SARS-CoV2, blocking the spike protein’s attachment to human ACE2 receptors.

Question 15

Bamlanivimab indication

Answer 15

children >12 years old with mild to moderate COVID-19 disease (ID consult required)

Question 16

High risk for server disease

Answer 16

infants and children with a medically complex disease, including genetic, neurologic, cardiac, haematologic, and metabolic disease

Question 17

MDI for epinephrine delivery during the pandemic

Answer 17

2 puffs for infants under 1 year of age, and 4 puffs for older children.

Question 18

IM Epi dose for croup

Answer 18

7.5 to 15 kg: 0.1 mg IM/SC
15 to 30 kg: 0.15 mg IM/SC
>30 kg: 0.3 mg IM/SC