A comprehensive guideline for the management of COVID-19 among children has been prepared by the government, 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. “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. 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.