Home-care guidelines for patients with COVID-19

General advice for the care of children with COVID-19

In Australia, to date, there have been very few hospital admissions required for children due to COVID-19 illness severity. Children are significantly less likely to suffer severe COVID-19 than adults and many children with COVID-19 will be asymptomatic. Common symptoms are similar to those of adults, including rhinorrhoea, cough, sore throat, fever and gastrointestinal symptoms. They might also suffer headaches, myalgia, or loss of taste or smell. They are much less likely to suffer breathlessness, and this symptom should escalate clinical assessment.

The National COVID-19 Clinical Evidence Taskforce provides recommendations for children and adolescents in regard to disease-modifying treatments, chemoprophylaxis and respiratory support for the management of COVID-19.

In most cases, only children meeting criteria for the low-risk monitoring protocol (refer to Box 5) should be managed in the community. It might be appropriate for GPs to care for children with moderate risk factors depending on local requirements, resources and escalation pathways.

Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2’ (PIMS-TS A inflammatory condition has been described in children and adolescents settings with significant COVID-19 community transmission, known as ‘Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2’ (PIMS-TS) or ‘Multisystem Inflammatory Syndrome in Children [MIS-C]’ as it is referred to in the United States of America. PIMS-TS usually presents 2–6 weeks after the acute infection, which may be asymptomatic.  PIMS-TS  should be considered in an unwell child or adolescent with persistent fever (lasting more than 72 hours), signs of shock, rash and abdominal pain, and there may be several features overlapping with Kawasaki disease and toxic shock syndrome. 21

If PIMS-TS is suspected, early transfer to a paediatric hospital with ICU facilities should be considered due to potential for rapid deterioration.