Govt issues guidelines on Covid in children

The Directorate General of Health Services (DGHS) under the health ministry has issued guidelines for the management and treatment of COVID-19 among children.

The guidelines do not recommend the use of Remdesivir in children and suggest that steroids are harmful in asymptomatic and mild cases of infection.

The following are the important recommendations of the guidelines issued.

1. Rational use of High-resolution CT (HRCT) for seeing the extent and nature of lung involvement in patients with Covid-19. It further adds that the information gained from the HRCT scan of the chest often has little impact on treatment decisions, which are based almost entirely on clinical severity and physiological impairment.
     
2. 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. The Covid-19 is a viral infection and antimicrobials will have no role in the prevention or treatment of uncomplicated Covid-19 infection. 
     
3. Corticosteroids are not required in all children with moderate illness; they may be administered in rapidly progressive disease and anticoagulants may also be indicated
     
4. Recommends no specific medication.
     
5. Recommends giving a nutritious diet and Covid-appropriate behaviour (mask, strict hand hygiene, physical distancing) 
     
6. 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.
     
7. In the case of moderate infection, the guidelines suggest initiating immediate oxygen therapy.
     
8. if  Acute Respiratory Distress Syndrome (ARDS) develops, necessary management to be initiated.
     
9. The guidelines also recommended a six-minute walk test 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.