With numerous clinical trials of novel and repurposed therapies for COVID-19 now underway or under rapid development, a recent JAMA Pediatrics viewpoint article highlighted importance of including children in such trials. Among 275 COVID-19 interventional clinical trials registered on ClinicalTrials.gov from Feb. 1 to April 11, 2020, only 30 were open to patients younger than the age of 18, according to the article.

Calling the exclusion of children a “tremendous lost opportunity,” the authors note that extrapolating from adult to pediatric patients may not account for important differences in pathophysiology and drug metabolism, potentially exposing children to ineffective or even unsafe treatments. “Even in the race to develop new therapies for COVID-19, generating high-quality evidence to guide the treatment of children is necessary, feasible, and could be done efficiently, such as through expansion of existing studies and through parallel pediatric adaptive trials,” the authors wrote.

The call comes amid reports of a severe inflammatory condition seen in children and temporally associated with COVID-19, described as multisystem inflammatory syndrome in children (MIS-C) in a May 14 health advisory issued by the Centers for Disease Control and Prevention urging clinicians to report suspected cases.