‘The Comprehensive Guidelines for Management of COVID-19 in Children and Adolescents Below 18 Years’ were reviewed by a group of experts in view of the current surge of cases, attributed mainly to the Omicron variant of the coronavirus.
What to give, not give
The guidelines note that Covid-19 is a viral infection and say antimicrobials have no role in the management of uncomplicated Covid-19 infection.
“As of now in the absence of efficacy and safety data, the use of antivirals such as Remdesivir, Molnupiravir, Favipiravir, Fluvoxamine and monoclonal antibodies such as Sotrovimab, Casirivimab +Imdevimab are not recommended for children less than 18 years of age irrespective of severity of illness,” the guidelines say.
Overall, the management of children remains the same. The mainstay of treatment for fever is to give paracetamol. For cough, the guidelines advise throat soothing agents and warm saline gargles in older children and adolescents. They recommend ensuring oral fluids to maintain hydration and a nutritious diet.
“No other Covid-19 specific medication is needed for mild cases,” said Dr Aarti Kinikar, member of the Maharashtra paediatric Covid task force.
Leading paediatrician Dr Umesh Vaidya said that in children, the main symptoms are cough, cold and fever; sore throat symptoms are more prominent than wheezing. Most paediatricians check for circumstantial evidence whether anyone in the family is symptomatic. For mild cases, RT-PCR tests are not being advised. Several paediatricians said that they have instructed families to stay in isolation for a week. However, Covid tests are required for those who need to be hospitalised.