NEW DELHI: The government on Wednesday released detailed guidelines for the management of Covid-19 among children. In the guidelines, the Directorate General of Health Services (DGHS) under the Union health ministry has advised against the use of remdesivir in kids.
Here are the key points from the guidelines
* It said steroids are harmful in asymptomatic and mild cases of infection and recommended against self-medication.
“Steroids should be used at the right time, in the right dose and for the right duration. Self-medication of steroids must be avoided,” it said.
* Rational use of HRCT imaging has been recommended. Treating physicians should be highly selective in ordering HRCT imaging of the chest.
* Remdesivir (an emergency use authorization drug) is not recommended in children since there is lack of safety and efficacy data.
* For asymptomatic and mild cases, the guidelines said antimicrobials are not recommended for therapy or prophylaxis while for moderate and severe cases, antimicrobials should not be prescribed unless there is clinical suspicion of a superadded infection.
* For mild infection, paracetamol 10-15mg/kg/dose may be given every 4-6 hours for fever and throat soothing agents. Warm saline gargles in older children and adolescents have been recommended for cough.
* In case of moderate infection, the guidelines suggested initiating immediate oxygen therapy.
* Corticosteroids are not required in all children with moderate illness; they may be administered in rapidly progressive disease and anticoagulants may also be indicated.
* For severe Covid-19 among children, the guidelines said if Acute Respiratory Distress Syndrome (ARDS) develops, necessary management to be initiated.
“In case shock develops, necessary management should be initiated. Antimicrobials to be administered if there is evidence/strong suspicion of superadded bacterial infection. May need organ support in case of organ dysfunction, e.g. renal replacement therapy,” it said.
* A six-minute walk test is recommended for children above 12 years under the supervision of parents/guardians.
“It is a simple clinical test to assess cardiopulmonary exercise tolerance and is used to unmask hypoxia. Attach a pulse oximeter to his/her finger and ask the child to walk in the confines of their room for six minutes continuously,” it said.
Some reports have suggested that the third wave of Covid could be dangerous for children. However, the government has said there is no evidence to back the claims. Several states, including Maharashtra and Delhi, have been ramping up infrastructure to prepare for the likely impact of the Covid surge among children.
