Don't Use Remdesivir, Limit CT Scan, Steroid: Centre's Covid Treatment Guidelines for Kids
The Centre late on Wednesday night released a list of guidelines to manage Covid-19 among children as anxiety over the third wave continues. The Directorate General of Health Services advised against use of anti-viral drug Remdesivir in children.
The new rules have come even as top doctors in India, involved with the national coronavirus task force, have said that there is no data to suggest any such threat to children. AIIMS director Dr Randeep Guleria said that 60-70 percent of the children, who got infected and were hospitalised during the second wave, had either co-morbidities or low immunity, and healthy children recovered with mild illness without need for being admitted.
Dr VK Paul said that it is uncertain that a wave would affect children specifically. “Till now, children have displayed similar seroprevalence as adults, which means, they are as much affected as adults," he added.
- Steroids are harmful in asymptomatic and mild cases of infection and antimicrobials are not recommended for therapy or prophylaxis.
- Rational use of HRCT imaging has been recommended.
- For mild infection paracetamol 10-15mg/kg/dose can be given every 4 to 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, guidelines suggest 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 cases among children, acc to the guidelines if Acute Respiratory Distress Syndrome develops, necessary management should 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. Child may need organ support in case of organ dysfunction.
- A six-minute walk test is recommended for children above 12 years under the supervision of parents/guardians to assess cardiopulmonary exercise tolerance and is used to unmask hypoxia. Place a pulse oximeter to kids finger and ask the child to walk in the confines of their room for six minutes continuously.