Centre’s guidelines for Covid-19 treatment in children: All you need to know

The guidelines advise a six-minute walk test in case of moderate infection in kids

After beginning trials of Covid-19 vaccines on children, the Centre has now issued a comprehensive set of guidelines for treatment of kids affected by the deadly virus.

The guidelines answer questions about the use of Remdesivir and steroids in children and advises a six-minute walk test in case of moderate infection.

Here is all you need to know about the new guidelines:

Can Remdesivir used for Covid-19 treatment in children?

The guidelines don't recommend use of Remdesivir in children below 18 years of age due to lack of “sufficient safety and efficacy data”.

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How to use steroids while treating Covid-19 in children?

The guidelines issued by the Directorate General of Health Services (DGHS) recommend using steroids “at the right time, in the right dose and for the right duration”.

Steroids are to be used in hospitalised Covid-19 patients who are moderately severe or critically-ill under the supervision of medical professionals.

When should you get a CT scan?

It suggests rational use of High-resolution CT (HRCT) for seeing the condition of the Covid-19 patient’s lungs.

As the information from the HRCT scan “has little impact on treatment decisions”, the guidelines recommend the medical professionals to be “highly selective” while asking for an HRCT scan for children.

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How to treat Covid-positive kids with mild or no symptoms?

In the case of asymptomatic and mild cases, the guidelines don’t advise using antimicrobials for treatment.

Asymptomatic children are advised to wear masks, wash hands regularly while maintaining social distancing. Apart from suggesting a nutritious diet, the guidelines don't have any specific medication recommendations.

However, for mild infection in children, it recommends having paracetamol tablets 10-15 mg/kg/dose every four to six hours to reduce the fever. It also asks to use throat-soothing agents and warm saline gargles to treat cough.

What is the treatment for children with moderate to severe infection?

The guidelines suggest starting oxygen therapy immediately in case of moderate infection.

"Corticosteroids are not required in all children with moderate illness; they may be administered in rapidly progressive disease and anticoagulants may also be indicated," it said.

"In case shock develops, necessary management should be initiated. Antimicrobials to be administered if there is evidence/strong suspicion of superadded bacterial infection. May need organ support in case of organ dysfunction, e.g. renal replacement therapy," according to the guidelines.

Parents are asked to conduct a simple six-minute walk test for children above 12 years, to “assess cardiopulmonary exercise tolerance and is used to unmask hypoxia”. For the walk test, attach a pulse oximeter to the child’s finger and walk in the room for six minutes continuously.