• Peter C Rimensberger, KneyberMartin C JMCJDivision of Paediatric Critical Care Medicine, Department of Paediatrics, Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.Critical Care, Department of Anaesthesiolog, Akash Deep, Mehak Bansal, Aparna Hoskote, Etienne Javouhey, Gilles Jourdain, Lynne Latten, Graeme MacLaren, Luc Morin, Marti Pons-Odena, Zaccaria Ricci, Yogen Singh, Luregn J Schlapbach, Barnaby R Scholefield, Ulrich Terheggen, Pierre Tissières, Lyvonne N Tume, Sascha Verbruggen, Joe Brierley, and European Society of Pediatric and Neonatal Intensive Care (ESPNIC) Scientific Sections’ Collaborative Group.
• Division of Neonatology and Paediatric Intensive Care, Department of Paediatrics, University Hospital of Geneva, University of Geneva, Geneva, Switzerland.
• Pediatr Crit Care Me. 2021 Jan 1; 22 (1): 566756-67.

ObjectivesIn children, coronavirus disease 2019 is usually mild but can develop severe hypoxemic failure or a severe multisystem inflammatory syndrome, the latter considered to be a postinfectious syndrome, with cardiac involvement alone or together with a toxic shock like-presentation. Given the novelty of severe acute respiratory syndrome coronavirus 2, the causative agent of the recent coronavirus disease 2019 pandemic, little is known about the pathophysiology and phenotypic expressions of this new infectious disease nor the optimal treatment approach.Study SelectionFrom inception to July 10, 2020, repeated PubMed and open Web searches have been done by the scientific section collaborative group members of the European Society of Pediatric and Neonatal Intensive Care.Data ExtractionThere is little in the way of clinical research in children affected by coronavirus disease 2019, apart from descriptive data and epidemiology.Data SynthesisEven though basic treatment and organ support considerations seem not to differ much from other critical illness, such as pediatric septic shock and multiple organ failure, seen in PICUs, some specific issues must be considered when caring for children with severe coronavirus disease 2019 disease.ConclusionsIn this clinical guidance article, we review the current clinical knowledge of coronavirus disease 2019 disease in critically ill children and discuss some specific treatment concepts based mainly on expert opinion based on limited experience and the lack of any completed controlled trials in children at this time.Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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