Use of antivirals or monoclonal antibodies is not recommended for children less than 18 years of age, irrespective of the severity of infection, the Health Ministry said on Thursday, while releasing the revised ‘Comprehensive Guidelines for Management of COVID-19’ in children and adolescents.
Adding the cohort of adolescents to the guidelines, the Ministry said that for diagnosing multi-system inflammatory syndrome in children (MIS-C), caution should be exercised while interpreting an isolated increase in COVID-19 antibodies.
“If steroids are used, they should be tapered over 10-14 days, subject to clinical improvement,” it said, also revising the use of anticoagulants and adding a new section on post-COVID-19 care.
The guidelines have noted that anticoagulants are not indicated routinely and that all hospitalised children should be evaluated for risk of developing thrombosis and monitored for development of thrombosis.
On post-COVID-19 care, the seven-page document says children with asymptomatic infection or mild disease should receive routine childcare, appropriate vaccination (if eligible), and nutrition counselling and psychological support on follow up. In addition, for children with moderate to severe COVID-19, upon discharge from hospital, parents/caregivers should be counselled on monitoring for persistence/worsening respiratory difficulty, and provided the indications for bringing the child back to the facility.
“Children who develop any organ specific dysfunction during hospital stay or subsequently should receive appropriate care,” state the guidelines.
Cautioning that self-medication of steroids should be avoided, the guidelines say steroids are not indicated and are harmful in asymptomatic and mild cases of COVID-19.
“Steroids are indicated only in hospitalised severe and critically ill COVID-19 cases under strict supervision and should be used at the right time, in right dose and for the right duration,” the guidelines said, adding that they should be avoided in the first three-five days from the onset of symptoms as it prolongs viral shedding.
The guidelines were reviewed by a group of experts in view of the current surge, which is mainly attributed to the Omicron Variant of Concern. Available data from other countries suggest that the disease caused by the Omicron variant is less severe. However, there is need to keep careful watch as the current wave evolves. These guidelines are dynamic, and will be reviewed and updated upon availability of new evidence, the Health Ministry said.
