Children’s Hospital & Medical Center’s goal is to provide the highest level of care for the community’s children, as well as support the primary care providers who care for them. We want to share with you information on our process for testing pediatric patients for COVID-19 and information on screening for Multisystem Inflammatory Syndrome in Children (MIS-C).
Informational COVID-19 resources to share with families:
Find helpful COVID-19 resources from our Max The Vax and Fruitful COVID-19 Vaccine toolkits at https://maxthevaxne.org/provider-toolkit/ or join more than 180 physicians and providers from across Nebraska who have signed a Statement of Support for FDA-Approved COVID-19 Vaccinations for kids five and older at https://www.neprovidersforthevax.org.
COVID-19 Testing Process
If you are affiliated with a health system with a lab that is processing COVID-19 testing, please have your patient tested through your affiliated system.
If you are not affiliated with a health system with a lab that is processing COVID-19 testing, and you have a patient that needs to be tested, please follow the steps below:
- Have the legal guardian call Children’s Access Center at 402-955-4066 to complete the registration process and let them know the child is coming to the Respiratory Assessment Center (RAC) with a prescription.
- Send a paper prescription with the patient.
- The RAC is located on the east side of Children’s, and can be accessed from 84th Street between West Dodge Road and Indian Hills Drive. Families should turn into the entrance by the large white tent and follow the directional signage. They will then be greeted and screened by Children’s staff. Please note: The patient should be accompanied by an adult who has NOT tested positive for COVID-19.
If you have a symptomatic patient who has not been physically seen by you, please follow these steps:
- Direct the parent to call Children’s COVID-19 Hotline at 402-955-3200.
- A virtual visit will be scheduled. If it’s deemed appropriate, the patient will be sent to the RAC for a physical assessment and test. All documentation and test results will be available for your review via Physician Connect.
Please note: You will be responsible for contacting your patient families with results and reviewing self-isolation guidance based on test results.
COVID 19 Treatments Available at Children’s for Monoclonal Antibody Therapies
The proportion of COVID-19 cases caused by the Omicron BA.2 subvariant is above 50 percent across the U.S., including Nebraska. The COVID-19 monoclonal antibody therapy (Sotrovimab) that was available at Children’s is not active against this subvariant and is no longer authorized for treatment. Other options exist, but not all of them are available at Children’s.
Currently there are two outpatient treatment options at Children’s:
1. Remdesivir is FDA-approved for treatment of non-hospitalized patients over 3.0 kg and 28 days old, who have mild to moderate COVID-19 and are at high risk of progression to severe illness, when given within seven days of symptom onset. Remdesivir is administered as a daily outpatient infusion for three consecutive days.
2. Bebtelovimab is another monoclonal antibody. It has retained activity against BA.2 variant and is authorized under EUA as an alternative treatment for treatment of COVID-19 in patients (> 12 years and >40 kg), who are at high risk of progression to severe COVID-19 (hospitalization and/or death), when given within seven days of symptom onset. This is administered as a single outpatient infusion.
Currently, the National Institutes of Health (NIH) only recommends outpatient treatment in high-risk, non-hospitalized pediatric patients.
To request one of these treatments for a patient, please complete the Remdesivir and Betelovimab request form.
In addition, Children’s offers pre-exposure prophylaxis. Tixagevimab/Cilgavimab (Evusheld), is authorized under EUA for pre-exposure prophylaxis in pediatric patients (ages 12 years and older and weighing 40 kg or more) who are moderate to severe immune-compromised due to a medical condition or who have received immunosuppressive medications or treatments AND who may not mount an adequate immune response to COVID-19 vaccination OR those to whom vaccine cannot be given. This medication is administered via intramuscular injection. This is not to be used for patients who qualify but decline vaccination.
To request this treatment for a patient, please complete the EVUSHELD request form.
Requests are reviewed Monday through Friday, 8 a.m. to 4 p.m.
Screening for Multisystem Inflammatory Syndrome in Children
Although MIS-C is a rare occurrence, quick diagnosis is important in expediting positive outcomes. Children’s hospitalist team has developed a MIS-C screening algorithm.
CHILDREN’S PRIORITY LINE: 855-850-KIDS (5437)
Disclaimer: Pathways and/or protocols are intended as a guide for practitioners and do not indicate an exclusive course of treatment nor serve as a standard of medical care. These pathways and/or protocols should be adapted by medical providers, when indicated, based on their professional judgment and taking into account individual patient and family circumstances.
Please review these guidelines and if you have any non-emergent questions, contact Dr. Aleisha Nabower at [email protected].
For an immediate consult, please call Children’s Physicians Priority Line at 855-850-5437.
Acute COVID-19 Infection vs. MIS-C