No remdesivir to the rational use of CT scan, latest government guidelines for COVID-19 management in children

Amid the rising concern over the potential third wave of the COVID-19 pandemic, which is said to affect the health of children, the government on Wednesday has released some new guidelines for managing COVID-19 among children. Here is everything about the latest guidelines.

As per the guidelines issued by the Directorate General of Health Services, doctors have been warned against the use of Remdesivir injections in children. This is due to a lack of sufficient safety and efficacy data with respect to Remdesivir in children below 18 of age.

Doctors have been advised to use HRCT imaging rationally among kids. This is because the additional information gained from the HRCT scan of the chest often has little impact on the treatment decisions, which are based almost entirely on clinical severity and physiological impairment.

It is also suggested that the use of steroids in asymptomatic and mild cases of infections are harmful, which can lead to severe problems.

Steroids to be used only in hospitalised moderately severe and critically ill COVID-19 cases, under strict supervision. Self-medication of steroids to be avoided and it's important to use steroids at the right time and right dose.

The guidelines said antimicrobials are not recommended for therapy for prophylaxis, while for moderate and severe cases antimicrobials should not be prescribed unless there is clinical suspicion of a superadded infection.

For asymptomatic cases, there is no specific medication. COVID appropriate behaviours (mask, strict hand hygiene, physical distancing) is promoted, along with a nutritious diet.

For mild infection, paracetamol 10-15 mg/kg/dose may be given every 4-6 hours for fever and throat soothing agents, warm saline gargles in older children and adolescents have been recommended for cough. For moderate infection, oxygen therapy should be initiated immediately.

If Acute Respiratory Distress Syndrome develops, necessary management is to be initiated. Antimicrobial should be administered if there is evidence of superadded bacterial infection. Organ support may be needed in case of organ dysfunction.

The guidelines also recommend taking a 6-minute walk test for children above 12 years of age. It's a simple test to assess cardiopulmonary exercise tolerance and used to mask hypoxia. Attach the pulse oximeter to the kid's finger and ask him to walk for 6 minutes continuously. Read here: Here is what is6-minutes walking test.