New Delhi: The government has issued comprehensive guidelines for the management of COVID-19 in children, in which Remdesivir is not recommended and the rational use of HRCT imaging is advised.
The guidelines issued by the health ministry’s Directorate General of Health Services (DGHS) also stated that steroids are harmful in asymptomatic and mild cases of infection.
Only in hospitalised moderately severe and critically ill COVID-19 cases under strict supervision did the DGHS recommend steroids.
“Steroids should be used at the appropriate time, in the appropriate dose, and for the appropriate duration. Self-medication with steroids should be avoided “It stated.
Remdesivir (an emergency use authorization drug) is also not recommended in children, according to the guidelines.
“There is a lack of sufficient safety and efficacy data for Remdesivir in children under the age of 18,” the guidelines stated.
The guidelines suggested rational use of High-resolution CT (HRCT) for seeing the extent and nature of lung involvement in patients with COVID-19.
“However, any additional information gained from HRCT scan of the chest often has little impact on treatment decisions, which are based almost entirely on clinical severity and physiological impairment.
“As a result, treating physicians should be highly selective in ordering HRCT imaging of the chest in COVID-19 patients,” according to the guidelines.
They stated that COVID-19 is a viral infection and that antimicrobials play no role in the prevention or treatment of simple COVID-19 infection.
Antimicrobials are not recommended for therapy or prophylaxis in asymptomatic or mild cases, according to the guidelines, and in moderate and severe cases, antimicrobials should not be prescribed unless there is clinical suspicion of a superadded infection.
Admission to a hospital raises the risk of healthcare-associated infections caused by multidrug-resistant organisms.
The guidelines recommended no specific medication for asymptomatic infection in children and instead promoted COVID-appropriate behaviour (mask, strict hand hygiene, physical distancing) and a nutritious diet.
According to the guidelines, for mild infections, 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 for cough.
In the case of a moderate infection, the guidelines recommended starting oxygen therapy right away.
“Corticosteroids are not necessary in all children with moderate illness; they may be administered in rapidly progressive disease, and anticoagulants may also be indicated,” according to the guidelines.
The guidelines stated that if Acute Respiratory Distress Syndrome (ARDS) develops in children with severe COVID-19, necessary management should be initiated.
“In the event that shock develops, the necessary management should be initiated. If there is evidence/strong suspicion of superadded bacterial infection, antimicrobials should be administered. In the event of organ failure, organ support, such as renal replacement therapy, may be required “it’s
The guidelines also suggested a six-minute walk test for children over the age of 12 under the supervision of their parents/guardians.
“It is a simple clinical test used to detect hypoxia and assess cardiopulmonary exercise tolerance. Attach a pulse oximeter to his/her finger and ask the child to walk around their room for six minutes straight “It stated.