Enhanced Droplet/Contact Precautions

Please refer to the PCRA to determine which type of isolation precautions are required for the patient.

Droplet / Contact Precautions

Please refer to PCRA to determine which type of isolation precautions are required for the patient.

Diagnostic Considerations

  • Risk factors for progression to severe disease include, but are not limited to: 
    • obesity
    • neurological comorbidities
    • chronic respiratory disorders
  • Populations that may be at higher risk for severe infection include infants <1 year of age and children with comorbid conditions including:
    • lung disease
    • immune compromise
    • obesity
    • congenital heart disease
    • sickle cell disease
    • genetic abnormalities
    • neurological disease
    • diabetes mellitus

Severity Definitions

  • Symptoms of acute upper respiratory tract infection and/or mild lower respiratory tract infection; may also include fatigue, myalgia, and gastrointestinal symptoms.
  • Mild or no work of breathing
  • No O2 requirement
  • Clinical and/or radiological signs of pneumonia present
  • Increased respiratory rate
  • Signs of increased work of breathing.
  • O2saturation >92% on room air or low flow oxygen
  • Moderate or severe work of breathing or significant hypoxia. 
  • Non-invasive ventilation
  • Paediatric Acute Respiratory Distress Syndrome (pARDS), 
  • Invasive mechanical ventilation
  • May also be characterized by:
    • Shock/requirement of vasopressors to maintain blood pressure
    • Multi-Organ failure
    • Evidence of myocardial injury or heart failure
    • Acute kidney injury
    • Coagulation dysfunction

More Information

Revised Nov 2022. Approved by Drugs and Therapeutics. 

Original document, Revised 2021, based on a guideline developed by members of the Division of Infectious Diseases, SickKids, Toronto, with input from a COVID-19 working group including representation from the following groups:
(in alphabetical order)

  • Critical Care
    • Dr Anne-Marie Guerguerian
    • Dr Gail Annich
    • Dr Steven Schwartz
    • Dr Andrew Helmers
  • Emergency Medicine
    • Dr Kathy Boutis
    • Dr Suzanne Schuh
  • Haematology/Oncology
    • Dr Jim Whitlock
    • Dr Ahmed Naqvi
  • Immunology and Allergy
    • Dr Eyal Grunebaum
    • Dr Vy Kim
    • Dr Julia Upton
  • Infectious Diseases
    • Dr Upton Allen
    • Dr Stanley Read
    • Dr Ari Bitnun
    • Dr Anu Wadhwa
    • Dr Michelle Science
    • Dr Shaun Morris
    • Dr Valerie Waters
  • Fellows:
    • Dr Helen Groves
    • Dr Pierre-Philippe Piche-Renaud
    • Dr Taito Kitano
  • Pharmacy
    • Dr Kathryn Timberlake
  • Paediatrics
    • Dr Jeremy Friedman
    • Dr Michael Weinstein
    • Dr Zia Bismilla
    • Dr Carolyn Beck
  • Respiratory Medicine
    • Dr Felix Ratjen
  • Rheumatology
    • Dr Rayfel Schneider
    • Dr Ronald Laxer
  • Additional input on thrombosis management from Dr Leonardo Brandao