In a revised guidelines for Covid-19 management among children and adolescents below 18 years of age, the Centre has advises against use of antivirals and monoclonal antibodies in children and adolescents, irrespective of the severity of the disease and against the use of masks in children below age of 5.
The Comprehensive Guidelines for Management of Covid-19 in adolescents below 18 years was reviewed again by experts owing to the current surge in cases and the new guidelines were formulated.
How to treat adolescents below 18 years and kids
The guidelines says there is no role of antimicrobials in the treatment of Covid-19 in uncomplicated viral infection , further in the absence of suffient safety data of antivirals like Favipiravir, Molnupiravir, Remdesivir, Fluvoxamine and monoclonal antibodies such as Casirivimab +Imdevimab, Sotrovimab, it is not recommended for children less than 18 years of age irrespective of its severity.
The mainstay of Covid treatment in children is paracetamol for fever, warm saline gargles for cough, adequate diet and oral fluids for hydration. No other Covid -19 medication is required for mild cases, Dr Aarti Kinikar , member at Maharashtra Covid task force. Several pediatricians have instructed families to stay in isolation for 7 days and RT-PCR is not advised for mild cases. Covid tests are required for those who need to be hospitalized.
According to Dr Umesh Vaidya, pediatrician the most common symptoms among children are sore throat, cold, fever.
Use of Anticoagulants & steroids
If steroids are used they should be reduced consistently over a period of 10 to 14 days, subject to improvement in health. Use of steroids is advised only during hospitalisation or under strict supervision. Use of steroids can be avoided in the first 3-5 days since onset of symptoms as it prolongs viral shedding.
Children aged 5 and under not advised to wear mask
Children do not wear masks properly and often have breathing issues like underlying asthma, so experts don’t recommend them to wear masks. For children aged 6 to 11, they can wear a mask depending on their ability to use the mask and under supervision of a guardian. Children above 12 are advised to wear mask like adults and sanitise hands repeatedly with soap and water, hand rub.
Multi System Inflammatory Syndrome in Children
This new syndrome is characterized by epidemiological link with SARS-CoV-2 and unremitting fever. Guidelines suggest caution needs to be exercises while interpreting increase in antibodies.
Revised guidelines suggest asymptomatic children or those with mild infection need appropriate vaccination, nutrition counseling and psychological support. For children with moderate to severe Covid or on hospitalisation caregivers need to be counseled regarding monitoring persistence/worsening respiratory difficulty or on indications that the child needs to be brought back to institutional care.