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Centre issues guidelines for management of Covid-19 among children, discourages use of Remdesivir

For severe infection, 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 Centre on Wednesday issued comprehensive guidelines to manage Covid-19 among children, according to which use of anti-viral drug Remdesivir has not been recommended and rational use of HRCT imaging has been suggested.

The Directorate General of Health Services under the health ministry issued the advisory which stated that use of steroids is harmful in asymptomatic and mild cases of infection in children.

The rational use of High-resolution CT (HRCT)has been suggested  for seeing the extent and nature of lung involvement in patients with Covid-19. However, any additional information gained from HRCT scans of the chest often has little impact on treatment decisions, which are based almost entirely on clinical severity and physiological impairment, the guidelines stated.

For severe infection, 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.

In case of moderate infection, the advisory suggested initiating immediate oxygen therapy. 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 mild infection, paracetamol 10-15mg/kg/dose can be given every 4 to 6 hours for fever and throat soothing agents. Warm saline gargles in older children and adolescents have been recommended for cough.

The new guidelines come as anxiety over the third wave continues, which claims to affect children specifically. Even top doctors in India, involved with the national coronavirus task force, have said that there is no data to suggest any such threat to children. 

AIIMS director Dr Randeep Guleria has said that 60-70 percent of the children, who got infected and were hospitalised during the second wave, had either co-morbidities or low immunity, and healthy children recovered with mild illness without need for being admitted.

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Dr VK Paul said that it is uncertain that a wave would affect children specifically. Till now, children have displayed similar seroprevalence as adults, which means, they are as much affected as adults, he added.

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