New Delhi, June 10: The Directorate General of Health Services (DGHS), under the Ministry of Health and Family Welfare, has issued guidelines for the treatment of children infected with coronavirus (COVID-19). Titled "Comprehensive Guidelines for Management of COVID-19 in Children", the guidelines say antiviral drug Remdesivir is not recommended for children. Revised COVID-19 Vaccination Policy Guidelines Issued by Centre; Vaccines To Be Allocated to States/UTs Based on Population, Disease Burden; Check Full List of Guidelines.
On Remdesivir, the guidelines say: "Remdesivir (an emergency use authorization drug) 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 DGHS recommended steroids only for hospitalised moderately severe and critically ill COVID-19 patients under strict supervision. "Steroids should be used at the right time, in the right dose and for the right duration. Self-medication of steroids must be avoided," reads the guidelines. COVID-19 in Children: Threats, Precautions and Impact of Coronavirus on Kids; All You Need To Know About Necessary Protocols Required for Safety of Children.
The guidelines also say doctors should be highly selective in ordering High-resolution CT (HRCT) imaging of the chest in COVID-19 patients. It adds: "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." About mucormycosis or black fungus, the DGHS asked doctor to treat the disease as an emergency and not wait for "culture results".
The guidelines recommended the "6-Minute Walk Test" on children above 12 to assess "cardio-pulmonary exercise tolerance". "Attach pulse oximeter to his/her finger and ask the child to walk in the confines of their room for 6 minutes continuously. Positive test: any drop in saturation < 94%, or absolute drop of more than 3–5% or feeling unwell (lightheaded, short of breath) while performing the test or at end of 6 minutes; Children with positive 6-minute walk test may progress to become hypoxic and early admission to hospital is recommended (for observation and oxygen supplementation)," it said.
Guidelines for COVID-19 Management in Children:
The guidelines have been issued amid concerns that a possible third wave of the coronavirus pandemic may target minors. India has reported 2,91,83,121 COVID-19 cases so far.