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

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
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COVID Management In Children: Government Suggests Rational Use Of CT Scan, 6-Minute Walk Test, No RemdesivirFor asymptomatic infection among children, the guidelines recommended no specific medication and promoted COVID-appropriate behaviour
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

17,91,56,496Cases
5,81,68,051Active
11,71,06,212Recovered
38,82,233Deaths
Coronavirus has spread to 193 countries. The total confirmed cases worldwide are 17,91,56,496 and 38,82,233 have died; 5,81,68,051 are active cases and 11,71,06,212 have recovered as on June 23, 2021 at 3:45 am.

India

3,00,28,709 50,848Cases
6,43,19419,327Active
2,89,94,855 68,817Recovered
3,90,660 1,358Deaths
In India, there are 3,00,28,709 confirmed cases including 3,90,660 deaths. The number of active cases is 6,43,194 and 2,89,94,855 have recovered as on June 23, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

59,87,521 8,470

1,26,468 1,055

57,42,258 9,043

1,18,795 482

Kerala

28,29,460 12,617

1,00,881 746

27,16,284 11,730

12,295 141

Karnataka

28,15,029 3,709

1,18,615 4,541

26,62,250 8,111

34,164 139

Tamil Nadu

24,36,819 6,895

56,886 4,443

23,48,353 11,144

31,580 194

Andhra Pradesh

18,57,352 4,169

53,880 4,260

17,91,056 8,376

12,416 53

Uttar Pradesh

17,04,678 202

3,910 253

16,78,486 397

22,282 58

West Bengal

14,85,438 1,852

22,508 232

14,45,493 2,037

17,437 47

Delhi

14,32,778 397

1,918 78

14,05,927 467

24,933 8

Chhattisgarh

9,91,653 482

8,007 557

9,70,244 1,032

13,402 7

Rajasthan

9,51,393 137

2,388 303

9,40,101 437

8,904 3

Odisha

8,83,490 2,957

30,859 1,240

8,48,960 4,159

3,671 38

Gujarat

8,22,620 135

5,159 480

8,07,424 612

10,037 3

Madhya Pradesh

7,89,415 65

1,707 273

7,78,902 318

8,806 20

Haryana

7,67,726 146

2,200 137

7,56,231 263

9,295 20

Bihar

7,20,207 268

2,811 206

7,07,833 468

9,563 6

Telangana

6,15,574 1,175

16,640 606

5,95,348 1,771

3,586 10

Punjab

5,93,063 405

5,968 509

5,71,207 880

15,888 34

Assam

4,88,179 2,869

32,975 350

4,50,924 2,482

4,280 37

Jharkhand

3,44,775 110

1,417 72

3,38,256 180

5,102 2

Uttarakhand

3,38,978 171

2,896 68

3,29,030 231

7,052 8

Jammu And Kashmir

3,12,584 428

7,181 578

3,01,134 999

4,269 7

Himachal Pradesh

2,00,791 188

2,276 132

1,95,062 315

3,453 5

Goa

1,64,957 303

2,920 146

1,59,029 438

3,008 11

Puducherry

1,15,364 284

3,214 150

1,10,423 433

1,727 1

Manipur

64,993 575

9,214 84

54,714 649

1,065 10

Tripura

63,140 395

3,747 163

58,735 554

658 4

Chandigarh

61,467 23

278 33

60,383 56

806

Meghalaya

45,976 421

4,273 77

40,915 341

788 3

Arunachal Pradesh

33,664 289

2,548 9

30,956 279

160 1

Nagaland

24,438 64

1,757 87

22,204 149

477 2

Ladakh

19,871 33

360 5

19,309 38

202

Sikkim

19,458 137

2,430 18

16,732 152

296 3

Mizoram

18,409 430

4,424 197

13,900 233

85

Dadra And Nagar Haveli

10,520 4

61 1

10,455 3

4

Lakshadweep

9,504 33

315 4

9,142 36

47 1

Andaman And Nicobar Islands

7,425 10

103 6

7,195 4

127

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