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No Remdesivir; 6-min walk test, HRCT imaging recommended: Guidelines for COVID-19 management in children

The DGHS guidelines on COVID-19 management in children advise against using Remdesivir; a six-minute walk test is also recommended to test 'cardiopulmonary exercise tolerance.

No Remdesivir; 6-min walk test, HRCT imaging recommended: Guidelines for COVID-19 management in children

The Union Health Ministry has issued a new set of guidelines for managing COVID-19 among children wherein the use of Remdesivir is out of question and rational use of High resolution-CT (HRCT) imaging is recommended, adding there was not sufficient safety and efficacy data to back Remdesivir use in children below 18 years of age.

"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, issued by Directorate General of Health Services (DGHS) under the Health Ministry mentioned.

They further restrict usage of steroids only for moderately severe and critically ill hospitalised COVID-19 patients, adding use of steroids should be avoided in asymptomatic and mild cases. The DGHS guidelines also advise against self-medication of steroids.

A six-minute walk test is also recommended to test 'cardiopulmonary exercise tolerance'. "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 the confines of their room for six minutes continuously."

Immediate oxygen therapy should be initiated in cases of moderate infection and corticosteroids are not needed in all children with moderate illness. Antimicrobials should not be prescribed even in moderate and severe cases unless there is a clinical suspicion of a superadded infection.

10-15 mg/dose of paracetamol may be given every 4-6 hours for fever and throat soothing agents in mild infection. Warm saline gargles have been recommended for cough in older children and adolescents.

No specific medication for asymptomatic patients has been recommended and COVID-appropriate behavior like wearing face masks, hand hygiene, social distancing and having a nutritious diet is suggested.

Edited by Mehak Agarwal; with PTI inputs

Also read: Will third COVID-19 wave seriously affect children? AIIMS chief clears air

Also read: India needs 93 lakh COVID-19 vaccinations per day to achieve herd immunity by Sept: FinMin

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