The new guidance replaces the previous version on June 16, 2021. The Comprehensive Guidelines for the Management of COVID-19 in Children and Adolescents Under 18 Years of Age were reviewed to consider the current increase in mainly due to the Omicron variant of interest. Available data from other countries suggest that disease caused by the Omicron variant is less severe; however, careful monitoring is required, because of the current wave of developments. According to the Union Department of Health and Family Welfare, these guidelines will be reviewed and updated as new evidence becomes available. Some attention was also drawn to the Department’s guidance regarding the Omicron variant FAQ, revised guidance on home isolation for mild/asymptomatic COVID-19 cases, and vaccinations. for children aged 15 to 18 years.
What are the recommendations for antivirals or monoclonal antibodies?
The use of antiviral drugs or monoclonal antibodies is not recommended for children under 18 years of age, regardless of the severity of the infection. “Currently, due to the lack of efficacy and safety data, the use of antiviral drugs such as Remdesivir, Molnupiravir, Favipiravir, Fluvoxamine and monoclonal antibodies such as Sotrovimab, Casirivimab + Imdevimab is not recommended for children under 18 years of age regardless of severity of illness,” was the specific recommendation made as part of the revised guidelines.
Has there been any change in treatment?
According to the guidelines, COVID-19 is a viral infection and antibiotics have no role in the management of uncomplicated COVID-19 infections.
Parenting remains the same. It classifies cases as asymptomatic, mild, moderate and severe.
In asymptomatic and mild cases, antibiotics are not recommended for treatment or prevention, the ministry said.
In moderate and severe cases, antibiotics should not be prescribed unless there is clinical suspicion of a superinfection, the ministry said.
The common treatment for fever is to give oral paracetamol 10 to 15 mg/kg/dose, which may be repeated every 4 to 6 hours. For coughs, throat soothing agents and warm salt water gargles in older children and adolescents have been recommended. Ensuring fluid intake to maintain fluid intake and a nutritious diet is among the recommendations. No other COVID-19 specific medication is needed for mild cases.
Home isolation for asymptomatic/mild cases
Symptoms are much milder and the illness does not last more than 3 to 5 days. In children, the main symptoms are cough, cold, and fever. Symptoms of sore throat are more prominent than wheezing. However, for mild cases, RT-PCR testing is not recommended. Some pediatricians say they have instructed families to isolate for a week. For moderate and severe cases, treatment should be given at a hospital or by a medical doctor. However, testing for COVID-19 is required for those who are hospitalized.
Use of modified anticoagulants
The use of anticoagulants has been modified and if steroids are used they should be tapered over 10 to 14 days, depending on clinical improvement. A new section on postpartum care has also been added. Steroids are indicated only in critically ill and hospitalized COVID-19 cases under strict supervision. The indications and recommended doses of corticosteroids given in the guidelines can be used in cases of moderate to severe disease. daily assessment. The guidelines say to avoid steroids for the first 3 to 5 days from the onset of symptoms because it prolongs the shedding time of the virus. Prophylactic doses of modified low-molecular-weight heparin (anticoagulant).
Guidance includes the fact that it is important to teach children and young people to follow behaviors appropriate for COVID-19 such as washing hands frequently, maintaining 2 meters distance, wearing masks and staying in the air. open spaces and ventilated areas. Parents should make sure to vaccinate teens between the ages of 15 and 18 to reduce the risk of infection.
Masks are not recommended for children 5 years and under. Wearing them incorrectly can cause some breathing problems if they have underlying asthma or may be playing around, experts say. Some parents may be obsessed with forcing their child to wear a mask and therefore do not force a child under five to wear a mask. Children from 6 to 11 years old are allowed to wear masks depending on their ability to use appropriate and safe masks under the direct supervision of their parents. Children 12 years of age and older should wear masks in the same conditions as adults. It is important to make sure their hands are kept clean with soap and water, or alcohol-based hand rub while in contact with the mask.
Source: Medindia
