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Table 3a. Therapeutic Management of Nonhospitalized Children With COVID-19

Last Updated: August 8, 2022

See Table 3b for the Panel’s framework for assessing the risk of progression to severe COVID-19 based on patient conditions and vaccination status.

Table 3a. Therapeutic Management of Nonhospitalized Children With COVID-19
Risk of Severe COVID-19Panel's Recommendations
Aged 12–17 yearsAged <12 years
Symptomatic, Regardless of Risk Factors
  • Provide supportive care (AIII).
    • Provide supportive care (AIII).
      High Riska,b
      • Use 1 of the following options (listed in order of preference):c
        • Ritonavir-boosted nirmatrelvir (Paxlovid) within 5 days of symptom onset (BIII)
        • Remdesivir within 7 days of symptom onset (CIII)
      • There is insufficient evidence to recommend either for or against the use of bebtelovimab.d
      • Ritonavir-boosted nirmatrelvir is not authorized by the FDA for use in children aged <12 years.
      • There is insufficient evidence to recommend either for or against routine use of remdesivir. Consider treatment based on age and other risk factors.
      Intermediate Riskb,e
      • There is insufficient evidence to recommend either for or against the use of any antiviral therapy. Consider treatment based on age and other risk factors.
      • There is insufficient evidence to recommend either for or against routine use of remdesivir.
      Low Riskb,f
      • Manage with supportive care alone (BIII).
      • Manage with supportive care alone (BIII).
      Rating of Recommendations: A = Strong; B = Moderate; C = Weak
      Rating of Evidence: I = One or more randomized trials without major limitations; IIa = Other randomized trials or subgroup analyses of randomized trials; IIb = Nonrandomized trials or observational cohort studies; III = Expert opinion

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