Yes, there are treatments for children with COVID-19

The American Academy of Pediatrics (AAP) said there were more than 243,000 child COVID-19 cases from Sept. 2-9 -- the second-highest number of child cases in a week since the pandemic began 18 months ago. The week with the most child COVID-19 cases was the week prior -- nearly 252,000 cases from Aug. 26 to Sept. 2, according to the AAP. The rise in cases coincides with the spread of the contagious delta variant.

As more children test positive for COVID-19, parents are concerned about the health of their kids. While children ages 12 through 17 can get the Pfizer COVID-19 vaccine, children younger than 12 can’t yet get vaccinated. A VERIFY viewer was wondering if there are treatments for children who get sick with the virus.

THE QUESTION

Are there treatments for children with COVID-19?

THE SOURCES

• National Institutes of Health
• Dr. Jim Campbell, professor of pediatrics at the University of Maryland School of Medicine
• Dr. Bill Kapogiannis, pediatric infectious disease specialist at the Eunice Kennedy Shriver National Institute of Child Health and Human Development. 
• U.S. Food and Drug Administration
• American Academy of Pediatrics

THE ANSWER

Yes, there are treatments for children with COVID-19. But the majority of children who test positive for COVID-19 don’t have symptoms that require hospital-administered treatments.

WHAT WE FOUND

Most children infected with COVID-19 don’t have severe enough symptoms that require hospitalization. According to the American Academy of Pediatrics (AAP), there have been nearly 5.3 million child COVID-19 cases during the pandemic. Among states that report hospitalizations, the AAP said between 0.1% and 1.9% of all child COVID-19 cases have resulted in hospitalization.

Treatment guidelines from the National Institutes of Health (NIH) also say most children with COVID-19 will recover without any specific therapy. If they need treatment, most children need what is called supportive treatment, according to Dr. Jim Campbell, a professor of pediatrics at the University of Maryland School of Medicine. Supportive treatment can be done at home or in a hospital. 

At-home supportive treatment for children includes doing things that are typically done to treat a bad flu or cold, according to Dr. Bill Kapogiannis, a pediatric infectious disease specialist at the Eunice Kennedy Shriver National Institute of Child Health and Human Development. That includes making sure a child is hydrated and their fever is under control. 

While not common, some children with COVID-19 get sick enough that they need supportive treatment at a hospital to take care of issues like blood pressure or oxygen irregularities, Kapogiannis said. 

In some severe and select COVID-19 cases, there are hospital-administered therapies for children. However, data on the safety and effectiveness of those therapies is extremely limited, according to the NIH. The agency says its guidance for COVID-19 treatments in children is mostly extrapolated from recommended adult treatments. 

“Given that [children] just don't get as sick as frequently, there's not as much data to be able to support their use,” Campbell said of the treatments. “But they're still there and available for us to use, and we know what the dose is and how to use them.”

A couple of those treatments are remdesivir and dexamethasone.

Remdesivir limits the spread of the virus in the body, according to the U.S. National Library of Medicine. It is approved by the U.S. Food and Drug Administration (FDA) to treat hospitalized COVID-19 patients 12 and older who weigh at least 40 kilograms -- about 88 pounds. The FDA also authorized the emergency use of remdesivir for hospitalized COVID-19 patients who weigh between 3.5 kilograms -- nearly 8 pounds -- and 40 kilograms, as well as children younger than 12 who weigh at least 3.5 kilograms. 

Remdesivir is primarily recommended for children hospitalized with COVID-19 who have an increasing need for supplemental oxygen, the NIH says.

The NIH recommends dexamethasone, an anti-inflammatory medicine, for children hospitalized with COVID-19 “who require high-flow oxygen, noninvasive ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation.”

Monoclonal antibodies are another treatment doctors may provide for some children with COVID-19. Campbell said monoclonal antibodies are “preformed antibodies against the spike protein.” The FDA has authorized the emergency use of monoclonal antibodies for high-risk individuals 12 and older who weigh at least 40 kilograms. 

Monoclonal antibody treatments differ from remdesivir and dexamethasone in that they’re not for people who are hospitalized with COVID-19 or require oxygen therapy due to COVID-19. Instead, monoclonal antibodies are meant for people who have COVID-19 and don’t have severe symptoms but are at high risk of progressing to severe COVID-19.

“There's two uses. One is the treatment of mild cases to try to prevent them from going to severe,” Campbell said of monoclonal antibodies. “And post-exposure prophylaxis, which means you're exposed to someone, you're still in the incubation period, you don't have symptoms yet, and try to prevent you from having symptoms. They're only used for children who are at high risk of severe disease.”

According to the AAP, children 12 and older with any of the following conditions are considered high risk under the FDA's emergency use authorization:

• Body mass index (BMI) ≥85th percentile for their age and gender based on the Centers for Disease Control and Prevention growth charts
• Immunosuppressive disease or receipt of immunosuppressive therapies
• Neurodevelopmental disorders (eg, cerebral palsy)
• A medical-related technological dependence that is not related to COVID-19 (eg, tracheostomy, positive pressure ventilation, gastrostomy)
• Sickle cell disease
• Congenital or acquired heart disease
• Asthma or a reactive airway or other chronic respiratory disease that requires daily medication for control
• Diabetes
• Chronic kidney disease
• Pregnancy

So, there are treatment options for children with severe COVID-19 or at high risk of developing severe COVID-19. But most children don’t have COVID-19 symptoms that require specific treatment intervention. For parents concerned about their child’s COVID-19 symptoms, Kapogiannis said it’s important to contact a doctor who can provide treatment information.

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