Paediatric treatment trials for COVID-19 are an ethical imperative

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 …