- Guidelines issued by DGHS under the Health Ministry
- Ruled out the administration of Remdesivir and recommended a '6-minute walk test'
- HRCT to be used as a rational diagnostic aid
New Delhi: The Centre issued fresh guidelines for the management of COVID-19 in children below 18 years of age, according to which antiviral drug Remdesivir has been ruled out and rational use of HRCT imaging has been suggested.
The Directorate General of Health Services (DGHS) guideline said, “Remdesivir, an emergency use authorisation drug, is not recommended in children. There is a lack of sufficient safety and efficacy data with respect to Remdesivir in children below 18 years of age.”
The DGHS has recommended steroid administration only during hospitalization of moderately severe and critically ill COVID-19 cases under strict supervision.
As per the new guidelines:
All mild infections should be treated with paracetamol 10-15mg/kg/dose every 4 to 6 hours for fever. The infection should be ruled out by imaging through HRCT. Warm saline gargles in older children and adolescents have been recommended for cough.
However, in moderate infections, immediate oxygen therapy is recommended. 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 infections, if a child experiences ARDS Acute Respiratory Distress Syndrome, necessary management is recommended. Antimicrobials are advised if superadded bacterial infection is recognised. Organ Support might be required if the child presents organ dysfunction. Additionally, 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.
The DGHS disregarded hospitalization of asymptomatic children and prompted the practice of appropriate COVID-19 behaviour.