The Directorate General of Health has Services (DGHS) has issued guidelines under the health ministry for the management and treatment of COVID-19 among children
It did not recommend Remdesivir and suggested rational use of HRCT imaging and said steroids are harmful in asymptomatic and mild cases of infection.
Following are the guidelines issued by DGHS:-
# The steroids are recommended only in hospitalised moderately severe and critically ill COVID-19 cases under strict supervision. Corticosteroids are not required in all children with moderate illness; they may be administered in rapidly progressive disease and anticoagulants may also be indicated.
# Remdesivir (an emergency use authorization drug) is not recommended in children as there is lack of sufficient safety and efficacy data with respect to Remdesivir in children below 18 years of age.
# It suggested that treating physicians should be highly selective in ordering HRCT imaging of the chest in COVID-19 patients as HRCT scan of the chest often has little impact on treatment decisions. It almost entirely on clinical severity and physiological impairment.
# COVID-19 is a viral infection, and antimicrobials have no role in the prevention or treatment of uncomplicated COVID-19 infection. For asymptomatic and mild cases, 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.
# In case of moderate infection initiating immediate oxygen therapy.
# If Acute Respiratory Distress Syndrome (ARDS) 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.
# For asymptomatic infection among children, mask, strict hand hygiene, physical distancing and suggested giving nutritious diet.
# for mild infection paracetamol 10-15mg/kg/dose may be given every 4-6 hours for fever and throat soothing agents and warm saline gargles in older children and adolescents have been recommended for cough.
# a six-minute walk test for children above 12 years is recommended 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.