Authors Jeffrey I. Campbell, Karen E. Ocwieja, and Mari M. Nakamura are calling for pediatric COVID-19 clinical trials. According to them, “We need pediatric clinical trials to establish the efficacy, safety, and pharmacokinetics of the most promising experimental and repurposed coronavirus disease 2019 (COVID-19) therapies proposed to date.” Researchers of early reports show that pediatric SARS-CoV-2 infection tends to be mild but that some children develop severe disease.
The Proposal of Antiviral Agents
In absence of a vaccine, antiviral agents have been proposed as a strategy to prevent SARS-CoV-2 infection. Because most children experience mild infection, pediatric prophylaxis theoretically would serve to reduce viral reservoirs and mitigate spread from children to individuals at higher risk for severe COVID-19.
Trials studying prophylaxis in children face a number of hurdles, such as challenges with measurement of secondary public health benefits of treating asymptomatic children. However, if antiviral agents do show promise in preventing SARS-CoV-2 infection, use in children should be predicated on robust pediatric trials.
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