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Letter
Paediatric treatment trials for COVID-19 are an ethical imperative
  1. Amanda Gwee1,2,3,
  2. Alison Boast3,
  3. Joshua Osowicki1,2,3,
  4. Andrew C Steer1,2,3,
  5. Simon Coghlan4
  1. 1 Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital Melbourne Department of General Medicine, Parkville, Victoria, Australia
  2. 2 Infection and Immunity theme, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
  3. 3 Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
  4. 4 Centre for AI and Digital Ethics (CAIDE), Melbourne School of Engineering, The University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Dr Amanda Gwee, Department of General Medicine, Royal Children's Hospital Melbourne, Parkville, VIC 3052, Australia; amanda.gwee{at}rch.org.au

https://doi.org/10.1136/archdischild-2020-319701

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    Our proposal to perform a randomised trial of antiviral treatments for children with moderate to severe COVID-19 has frequently been met with the view that it is not ethical. Central concerns have been that children frequently have no symptoms (when in fact symptoms occur in 21% of children), that severe presentations are rare (2%)1 and that treatments should only be evaluated in children once the results of adult trials are available.

    Certainly, medical research involving children raises distinctive ethical issues. Children are more vulnerable than most adults, and many lack capacity to provide informed consent to potentially harmful research.2 As with all human research, the risks of a trial in children must be carefully weighed against the possible benefits to …

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    Footnotes

    • Twitter @alisonboast

    • Contributor Statement: AG and SC drafted initial version and reviewed and revised the manuscript. AB, JO and ACS reviewed and revised the manuscript. All authors approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests AG attended the MSD Asia Pacific forum in 2019.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.