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COVID Management In Children: Government Suggests Rational Use Of CT Scan, 6-Minute Walk Test, No Remdesivir

The guidelines suggested rational use of High-resolution CT (HRCT) for seeing the extent and nature of lung involvement in patients with COVID-19

COVID Management In Children: Government Suggests Rational Use Of CT Scan, 6-Minute Walk Test, No Remdesivir
Highlights
  • 6-minute walk is to assess cardiopulmonary exercise tolerance
  • The clinical test is used to unmask hypoxia – low oxygen levels
  • The use of Remdesivir is not recommended among children due to lack of data

New Delhi: The government has come out with comprehensive guidelines for the management of COVID-19 among children in which Remdesivir has not been recommended and rational use of HRCT imaging has been suggested. The guidelines issued by the Directorate General of Health Services (DGHS) under the health ministry also said that steroids are harmful in asymptomatic and mild cases of infection. The DGHS recommended steroids only in hospitalised moderately severe and critically ill COVID-19 cases under strict supervision.

Also Read: Early Diagnosis Of Multisystem Inflammatory Syndrome, COVID-Linked Disease In Children Can Reduce Morbidity: Experts

Steroids should be used at the right time, in the right dose and for the right duration. Self-medication of steroids must be avoided, it said.

The guidelines also said 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 guidelines said.

The guidelines suggested rational use of High-resolution CT (HRCT) for seeing the extent and nature of lung involvement in patients with COVID-19.

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 said.

Watch: COVID-19 In Children: How Big A Threat Is ‘MIS-C’ And What Are Its Symptoms?

They said COVID-19 is a viral infection, and antimicrobials have no role in the prevention or treatment of uncomplicated COVID-19 infection. For asymptomatic and mild cases, the guidelines said antimicrobials are not recommended for therapy or prophylaxis while for moderate and severe cases antimicrobials should not be prescribed unless there is clinical suspicion of a superadded infection. Hospital admission increases the risk of healthcare-associated infections with multidrug-resistant organisms.

For asymptomatic infection among children, the guidelines recommended no specific medication and promoted COVID-appropriate behaviour (mask, strict hand hygiene, physical distancing) and suggested giving nutritious diet. The guidelines said that for mild infection paracetamol 10-15mg/kg/dose may be given every 4-6 hours for fever and throat soothing agents and warm saline gargles in older children and adolescents have been recommended for cough. In case of moderate infection, the guidelines suggested initiating immediate oxygen therapy.

Also Read: COVID-19 Vaccine: AIIMS Delhi Starts Screening Of Children For Covaxin Trials

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

For severe COVID-19 among children, the guidelines said if Acute Respiratory Distress Syndrome (ARDS) develops, necessary management to be initiated.

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, it said.

The guidelines also recommended a six-minute walk test for children above 12 years under the supervision of parents/guardians.

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 in the confines of their room for six minutes continuously, it said.

Also Read: Third Wave Of COVID-19 Likely To Attack Children, Vaccinate The Parents Quickly: Dr Devi Shetty Of Narayana Health

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

World

23,96,06,768Cases
20,13,42,617Active
3,33,82,100Recovered
48,82,051Deaths
Coronavirus has spread to 195 countries. The total confirmed cases worldwide are 23,96,06,768 and 48,82,051 have died; 20,13,42,617 are active cases and 3,33,82,100 have recovered as on October 15, 2021 at 4:15 am.

India

3,40,37,592 16,862Cases
2,03,6782,908Active
3,33,82,100 19,391Recovered
4,51,814 379Deaths
In India, there are 3,40,37,592 confirmed cases including 4,51,814 deaths. The number of active cases is 2,03,678 and 3,33,82,100 have recovered as on October 15, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

65,86,280 2,384

33,157 6

64,13,418 2,343

1,39,705 35

Kerala

48,29,944 9,246

96,421 1,802

47,06,856 10,952

26,667 96

Karnataka

29,82,399 310

9,607 43

29,34,870 347

37,922 6

Tamil Nadu

26,83,396 1,259

15,451 199

26,32,092 1,438

35,853 20

Andhra Pradesh

20,59,122 540

6,588 27

20,38,248 557

14,286 10

Uttar Pradesh

17,10,008 12

135 4

16,86,976 16

22,897

West Bengal

15,79,012 530

7,576 81

15,52,491 601

18,945 10

Delhi

14,39,311 28

337 1

14,13,885 29

25,089

Odisha

10,33,809 521

4,890 38

10,20,645 477

8,274 6

Chhattisgarh

10,05,614 16

203 4

9,91,841 20

13,570

Rajasthan

9,54,382 8

42 6

9,45,386 2

8,954

Gujarat

8,26,244 34

215 20

8,15,943 14

10,086

Madhya Pradesh

7,92,669 12

111 1

7,82,035 11

10,523

Haryana

7,71,035 16

105 158

7,60,881

10,049 174

Bihar

7,26,016 8

42 6

7,16,313 2

9,661

Telangana

6,68,618 168

4,171 40

6,60,512 207

3,935 1

Assam

6,05,847 207

3,646 157

5,96,263 362

5,938 2

Punjab

6,01,971 33

234 11

5,85,199 16

16,538 6

Jharkhand

3,48,406 11

130 4

3,43,141 7

5,135

Uttarakhand

3,43,729 28

175 22

3,36,157 6

7,397

Jammu And Kashmir

3,30,834 93

935 11

3,25,473 104

4,426

Himachal Pradesh

2,21,113 182

1,387 5

2,16,011 173

3,715 4

Goa

1,77,356 68

679 27

1,73,342 39

3,335 2

Puducherry

1,27,259 49

647 4

1,24,763 53

1,849

Manipur

1,22,432 69

1,444 15

1,19,099 84

1,889

Mizoram

1,10,719 901

13,601 435

96,744 1,332

374 4

Tripura

84,295 4

110 8

83,369 12

816

Meghalaya

82,734 87

892 31

80,411 115

1,431 3

Chandigarh

65,295 10

32 5

64,443 15

820

Arunachal Pradesh

54,958 4

202 22

54,476 26

280

Sikkim

31,722 6

224 1

31,108 7

390

Nagaland

31,516 9

230 8

30,613 17

673

Ladakh

20,867 6

44 2

20,615 4

208

Dadra And Nagar Haveli

10,675

3 1

10,668 1

4

Lakshadweep

10,365

2 0

10,312

51

Andaman And Nicobar Islands

7,640 3

10 1

7,501 2

129

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