‘Comprehensive Guidelines For Management Of COVID-19 In Children’

With the rampant fear-mongering state over the belief that Children might soon get affected with the virus on a larger basis, the Centre on Wednesday released a list of guidelines to manage Covid-19 among children in a detailed document titled ‘Comprehensive Guidelines for Management of COVID-19 in Children’. Despite the reiteration from health experts that there is no confirmation on any such threat to children, the new rules popped in to ease the fear among the public.

The Directorate General of Health Services has strongly advised to not opt for any anti-viral drugs or Remdesivir in children. “Remdesivir is NOT recommended in children…There is lack of sufficient safety and efficacy data with respect to Remdesivir in children below 18 years of age,” the document reads.

The government has recommended the use of the ‘6-Minute Walk Test’ on children above 12 to assess “cardio-pulmonary exercise tolerance”. “Make children above 12 years go for a six-minute walk test by attaching a pulse oximeter to his/her finger. The child has to walk for six minutes continuously. Check if there is a drop in saturation less than 94% or an absolute drop of more than 3–5%. Also feeling giddy and short of breath should be observed. Children with the positive 6-minute walk test may progress to become hypoxic and early admission to the hospital is recommended. (Note: The test is not recommended for patients with uncontrolled asthma).

AIIMS director Dr Randeep Guleria stated that among children who were hospitalized during the second wave, nearly 70 per cent of them had either co-morbidities or low immunity. He assured that children with no health problems recovered in a jiff, even without the need for the hospital admission.

THE NEW GOVT GUIDELINES FOR CHILDREN:

  1. If a child is suffering from a mild infection, do not give steroids. They can be dangerous in asymptomatic and mild cases. Also, antimicrobials are not recommended for therapy or prophylaxis. Rational use of HRCT imaging has been recommended. A child with mild infection can be given paracetamol 10-15mg/kg/dose every 4 to 6 hours. For cough, warm saline gargles in older children and adolescents have been recommended.
  2. If a child is suffering from a moderate infection, immediate oxygen therapy is advised in the guidelines. However, corticosteroids are not required in all children with moderate illness.
  3. If a child is suffering from severe infection, it is obvious that they might develop acute Respiratory Distress Syndrome, necessary management should be initiated. Antimicrobials to be administered if there is evidence/strong suspicion of superadded bacterial infection. A child may need organ support in case of organ dysfunction.
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