Do not modify, reduce, or discontinue usual therapies without a specific clinical indication in children and adolescents with chronic disease and COVID-19.

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Topic Area


Children with chronic illnesses are a high-risk population from an infectious standpoint and, therefore, may be susceptible to developing more severe SARS-CoV-2 illness. Of relevance is the recommendation to educate children and their families about preventive behaviors: social distancing, use of appropriate masks including size, and hand cleaning as well as proper nutrition, adequate exercise, and regular sleep. In the most acute epidemic phases, it is better to reduce clinical controls to those strictly necessary using telemedicine resources, but ensuring direct and timely contact if suspicious symptoms appear (especially in case of respiratory or gastrointestinal involvement). There is no indication to modify, reduce, or suspend usual therapies without a specific clinical indication.


1. Abrams EM, Szefler SJ. Manging asthma during coronavirus disease-2019: An example for other chronic conditions in children and adolescents. J Pediatr 2020;222:221-226.
2. Marlais M, Wlodkowski T, Vivarelli M, Pape L, Tönshoff B, Schaefer F, Tullus K. The severity of COVID-19 in children on immunosuppressive medication. Lancet Child Adolesc Health. 2020;4:e17-e18.
3. Predieri B, Leo F, Candia F, et al. Glycemic Control improvement in Italian Children and Adoles-cents with Type 1 Diabetes followed through Telemedicine during Lockdown due to the COVID-19 Pandemic. Frontiers Endocrinol 2020;11:965.



Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.