Covid 19 treatment in children: Guidelines issued! No Remdesivir while steroids suggested for severe cases

Comprehensive guidelines have been issued by the central government for the management and treatment of Covid-19 among children below 18 years of age.

As per the guidelines issued by the Directorate General of Health Services (DGHS) under the Health Ministry the use of Remdesivir, an emergency use authorisation drug has not been recommended.

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"Remdesivir, an emergency use authorisation drug, is not recommended in children. There is a lack of sufficient safety and efficacy data with respect to Remdesivir in children below 18 years of age," the guideline said. 

"Steroids are not indicated and are harmful in asymptomatic and mild cases of Covid-19. It is indicated only in hospitalised moderately severe and critically ill Covid-19 cases 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," DGHC said in the guideline. 

The guideline suggested only a rational usage of a high-resolution CT (HRCT) scan for knowing the extent and nature of lung involvement in Covid-19 positive patients. 

"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," it added.

As per the guidelines, children aged 5 years and under are suggested not to wear masks. 

"Children aged 5 years and under should not be required to wear masks. Children aged 6-11 years may wear a mask depending on the ability of the child to use a mask safely and appropriately under the direct supervision of parents/guardians. Children aged 12 years and over should wear a mask under the same conditions as adults," it said.

Also, children above 12 have been advised to take the 6-minute walk test under the supervision of parents to assess cardio-pulmonary exercise tolerance.