The Union Health Ministry has issued fresh guidelines for the treatment of COVID-19 in children. Directorate General of Health Services (DGHS) issued comprehensive guidelines following concerts that the COVID-19 third wave likely to affect those who are below 18 years old.
What do the guidelines for the management of COVID-19 in children say
Usage of Remdesivir
Remdesivir, an emergency use authorization drug is not recommended for the treatment of children.
“There is lack of sufficient safety and efficacy data with respect to Remdesivir in children below 18 years of age,” the guidelines said.
Usage of Steroids
The DGHS has recommended the usage of steroids only for children hospitalised with moderately severe and severe symptoms. It has said that steroids should be used under the supervision of doctors.
“Steroids are not indicated and are harmful in asymptomatic and mild cases of COVID-19. Steroids should be used at the right time, in the right dose, and for the right duration. Self-medication of steroids must be avoided,” the guidelines said.
The DGHS has suggested the use of Corticosteroids for rapidly progressive moderate and severe cases. Use of Dexamethasone 0.15 mg/kg per dose (maximum of 6 mg) twice a day. It said that an equivalent dose of methylprednisolone can be used if Dexamethasone is not available. It said these doses should be given for 5 to 14 days according to clinical assessment.
The DGHS said steroids prolong viral shedding hence caution should be exercised while using the steroids.
Use of a High-resolution CT scan is suggested to check the extent of lung infection in children who have 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. Therefore, treating physicians should be highly selective in ordering HRCT imaging of the chest in COVID-19 patients,” the guidelines said.
Six-minute walk test
The guidelines recommend the use of a six-minute walk test for children above 12 years old.
“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.
Children below 5 years of age do not require to wear masks. Children aged between 6 to 11 years have to use the masks appropriately under the supervision of parents or guardians. Children above 12 years should wear the masks under the same condition as adults.