COVID-19 Pathway Background and Objective(s) The COVID-19 pandemic continues to infect millions of people. Although the majority of children who are infected with COVID-19 have milder illnesses, particularly when fully vaccinated, some children can become seriously ill and require hospitalization. New SARS-CoV-2 variants continue to emerge, and effective treatment and preventive strategies are rapidly changing. A panel of experts at Connecticut Children’s continues to monitor recommendations from the Connecticut Department of Public Health and the Centers for Disease Control and Prevention (CDC), as well as new emerging literature to provide providers the most up-to-date guidance for management of COVID-19 and its related disorders. The specific objectives of the COVID-19 clinical pathways are to: Educate community primary care and hospital-based providers on how to safely evaluate and manage patients with a possible COVID-19 infection, MIS-C, COVID-19 Long Haul, and Hypersensitivities to COVID-19 mRNA vaccination Provide the most up-to-date recommendations on effective COVID-19 therapies Provide guidance on safely returning to play after a COVID-19 infection Algorithm Post-COVID Conditions and COVID-19 Long Haul Management for Primary Care Providers – Updated September 23, 2021 Post SARS-CoV-2 Vaccine Myopericarditis Algorithm – Updated March 17, 2023 Connecticut Children’s ED and Inpatient COVID-19 Algorithm – Updated February 14, 2023 Connecticut Children’s Community Primary Care COVID-19 Algorithm – Updated June 20, 2022 Connecticut Children’s Newborn Care and Disposition COVID-19 Algorithm – Updated February 14, 2023 Connecticut Children’s COVID-19 Venous Thromboembolism (VTE) Prevention Algorithm – Updated February 12, 2021 Connecticut Children’s Multi-System Inflammatory Syndrome in Children (MIS-C) Algorithm – Updated March 17, 2023 Connecticut Children’s COVID-19 Cardiology Return to Play Algorithm – Updated October 14, 2022 Inpatient Therapies for COVID-19 – Updated May 9, 2022 Hypersensitivity Post COVID-19 mRNA Vaccination: Management Considerations – Updated June 2, 2021 COVID-19 Monoclonal Antibody Infusions and Outpatient Therapies Connecticut Children’s is offering services for the administration of COVID-19 medications. Available therapies may rapidly change depending on circulating variants and drug availability. Please check back often for the latest status. Treatment Remdesivir IV: Now fully FDA approved for those 28 days and older and weighing at least 3 kg. This requires IV treatment, once daily for 3 days, and may be limited to bed availability Paxlovid PO: 12 years and older and weighing at least 40 kg: Patients MUST meet specific EUA criteria in order to qualify. Paxlovid has multiple contraindications and drug interactions. Fact Sheet for Paxlovid. If the patient is 0-17 years old, symptomatic (but not hospitalized due to illness), and at risk for progressing to severe disease, the patient may be a candidate for a clinical trial investigating oral paxlovid. Contact Principal Investigator Dr. Hassan El Chebib at HElchebib@connecticutchildrens.org or 860-545-9490. Note: bebtelovimb is no longer effective towards circulating COVID-19 strains, and will no longer be available as of 12/1/2022. Pre-Exposure Prophylaxis Evusheld IM is no longer effective against current circulating strains and will no longer be available as of 1/31/2023. If you believe your patient meets criteria for receiving this infusion and you have reviewed the applicable Fact Sheet for Patients and Caregivers (linked above) with them, please call our OneCall Hotline at 833-226-2362 to obtain approval to infuse at Connecticut Children’s. Specifics can be found here: COVID-19 Outpatient Therapies for Providers Requesting Administration at Connecticut Children’s Key References Visit Connecticut Children’s COVID-19 Resources Page to access information for patient families Connecticut Department of Public Health website CDC website Pathway Contacts Ilana Waynik, MD Grace H. Hong, APRN John Schreiber, MD Heather Tory, MD Anand Sekaran, MD Sarah Matney, RN Scott Van Epps, RT Annmarie Golioto, MD Brett Citarella, MD David Sink, MD Kenneth Banasiak, MD Heather Schlott, MD Jennifer Girotto, PharmD Alex Golden, MD Ian Michelow, MD Rob Parker, MD Disclaimer The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case. View all Clinical Pathways >
