For Providers: COVID-19 and MIS-C Testing at Children’s Hospital & Medical Center

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:

  1. 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.
  2. Send a paper prescription with the patient.
  3. 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:

  1. Direct the parent to call Children’s COVID-19 Hotline at 402-955-3200.
  2. 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.

Monoclonal Antibody Therapies for COVID-19

The Nebraska Department of Health and Human Services is now reporting that Omicron is the predominant variant of SARS-CoV-2 circulating in Nebraska; the same is thought to be true for the surrounding states. The COVID-19 monoclonal antibody therapies that had been available at Children’s (Bamlanivimab-Etesevimab and Casirivimab-Imdevimab) are not active against the Omicron variant. Currently, the NIH only recommends outpatient treatment in high-risk, non-hospitalized pediatric patients. The current effective therapies against Omicron variant available for use in children (>12 years of age and >40 kg) include Paxlovid (PO) and Sotrovimab (IV). Supply of these products statewide is very limited and allocated by the state.

Children’s is expected to receive allocation of Sotrovimab from the state and will start administering doses. Sotrovimab is authorized under Emergency Use Authorization (EUA) for treatment of COVID -19 in patients (over the age of 12 weighing over 40 kg) who are at high risk of progression to severe COVID-19 including hospitalization and or death. It is the only approved monoclonal antibody therapy to show efficacy toward the Omicron variant of SARS-CoV-2 and is for treatment in non-hospitalized patients and will be administered in the infusion center.  Monoclonals are best if given early in the disease but must be given within 10 days of symptom onset. Providers who are requesting this therapy should follow the steps listed on the request form below. Supply of this medication is limited and patients at the highest risk for developing severe disease will be prioritized.

There are currently no effective outpatient treatments approved for children <12 years of age.  As always, the most effective measure to keep our children safe is to fully vaccinate them against SARS-CoV-2 and compliance with the protected health measures. Pre-Exposure Prophylaxis with Evusheld remains available for patients with moderate to severe immunosuppression.

Antibody Therapy Information for Providers

Antibody Therapy Request Form

Monoclonal Antibody FAQ

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.

Download PDF of MIS-C screening algorithm.

Please review these guidelines and if you have any non-emergent questions, contact Dr. Aleisha Nabower at anabower@childrensomaha.org.

For an immediate consult, please call Children’s Physicians Priority Line at 855-850-5437.

Acute COVID-19 Infection vs. MIS-C


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