Guidelines for Covid management in children issued

The Union Health Ministry has issued clinical guidelines for the treatment of Covid-positive children amid concerns that a possible third wave of the coronavirus infections may target those aged below 18. In a detailed document  the ministry said antiviral drug Remdesivir is not recommended for children, and steroids should be used to treat only moderately severe and critically ill patients in hospital settings. There is lack of sufficient safety and efficacy data with respect to Remdesivir in children below 18 years of age, the document reads.

"Attach pulse oximeter to his/her finger and ask the child to walk in the confines of their room for 6 minutes continuously. Positive test: any drop in saturation  94%, or absolute drop of more than 3–5% or feeling unwell (lightheaded, short of breath) while performing the test or at end of 6 minutes; Children with positive 6-minute walk test may progress to become hypoxic and early admission to hospital is recommended (for observation and oxygen supplementation)," it said. The test is not recommended for patients with uncontrolled asthma.

As steroids are harmful in asymptomatic and mild Covid cases, they should be administered only in hospitalised moderately severe and critically ill COVID-19 patients under strict supervision. "Steroids should be used at the right time, in the right dose and for the right duration," the centre said in the document. The government has recommended use of what it called the '6-Minute Walk Test' on children above 12 to assess "cardio-pulmonary exercise tolerance".