Dikhyaa Mohanty 
Now with the possibility of the risk to children in the events of a third outbreak of the Covid pandemic in India, the government has come out with comprehensive guidelines for the management of Coronavirus among children.
According to the report, the Directorate General of Health Services (DGHS) under the health ministry issued the guidelines. In the guidelines, it stated that the steroids are harmful in asymptomatic and mild cases of infection.
The DGHS recommended steroids only in hospitalized moderately severe and critically ill COVID-19 cases under strict supervision. The steroids should be used at the right time, in the right dose and for the right duration. Self-medication of steroids must be avoided.
The guidelines also stated that Remdesivir which is an emergency use authorisation drug is not recommended in children. The guidelines stated that there is a lack of sufficient safety and efficacy data concerning Remdesivir in children below 18 years of age.
The list of guidelines has also suggested rational use of High-resolution CT (HRCT) for seeing the extent and nature of lung involvement in patients with COVID-19. Any additional information gained from the 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. 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.
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 a nutritious diet.
The guidelines stated 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. For severe COVID-19 among children, the guidelines stated that if Acute Respiratory Distress Syndrome (ARDS) develops necessary management to be initiated. The guidelines also recommended a six-minute walk test for children above 12 years under the supervision of parents/guardians.
Image Source – Google Gu
