While maintaining that a majority of children with COVID19 infection would be asymptomatic or have mild symptoms, the Union Ministry of Health and Family Welfare has came out with a set of guidelines for management of coronavirus in children.
The guidelines have been divided into three categories of COVID19 infected children — asymptomatic and mild cases, mild cases, moderate cases and severe COVID cases.
“Majority of children with COVID infection will be asymptomatic or mildly symptomatic. Common symptoms include fever, cough, breathlessness/shortness of breath, fatigue, myalgia, rhonorrhea, sore throat, diarrhea, loss of smell, loss of taste,” it noted.
However, the guidelines informed that a new syndrome named multi system inflammatory syndrome has been described in children. Such cases are characterised by unremitting fever higher than 38 degrees celsius, epidemiological linkage with SARS CoV or clinical features suggestive of Multi System Inflammatory Syndrome.
“Asymptomatic children are usually identified while screening if family members are identified. (They) require monitoring for development of symptoms subsequent treatment according to assessed severity. They do not need any investigation,” the guidelines noted.
“These children can be managed at home with hom isolation and symptomatic treatmen Children with underlying comorbid conditions includin congenital heart disease, chronic lung diseases, chronic organ dysfunction, obesity may also be managed at home,” it added.
The guidelines also mentioned that there is no role of Hydroxychloroquine, Favipiravir Ivermectin, lopinavir/ritonavir, Remdesivir, Umifenovir Immunomodulators including Tocilizumab, Interfero Bia, Convalescent plasma infusion or dexamethason in treatment of children with mild symptoms.
“Maintain monitoring chart including counting of respiratory rates 2-3 times a day, look for chest in drawing bluish discolouration of body, cold extremities, urine output, oxygen saturation, fluid intake, activity level especially for young children,” it added.
Children with SpO2 levels less than 90 per cent are categorize as having severe COVID19 infections. “They may have severe pneumonia, Acute Respirator Distress Syndrome, Septic Shock, Multi-orga dysfunction syndrome, or pneumonia with cyanosis. Clinically, such children may present with grunting severe retraction of chest, lethargy, somnolence seizure.Such children should be admitted in Dedicated Covid Hospital/ Secondary/ Tertiary level healthcare facilities,” it added.
