Centre instructs not to use Remdesivir in children for COVID treatment

New Delhi: The Centre's new guideline for the COVID treatment instructed not to administer Remdesivir as a remedial drug in children due to the absence of enough safety and efficacy data on how it works in children below 18 years.

In a detailed document titled 'Comprehensive Guidelines for Management of COVID-19 in Children', the ministry said antiviral drug Remdesivir is not recommended for children, and steroids should be used to treat only moderately severe and critically ill patients in hospital settings.

According to the ministry, there is a lack of sufficient safety and efficacy data with respect to Remdesivir in children below 18 years of age.

The guidelines suggested rational use of High-resolution CT (HRCT) for seeing the extent and nature of lung involvement in patients with COVID-19.

In order to assess "cardio-pulmonary exercise tolerance" in children above 12, the government has recommended the use of what is called the '6-Minute Walk Test'.

As per the directive, the child has to walk in the confines of their room for 6 minutes continuously with a pulse oximeter attached to his/her finger.

As children with a positive 6-minute walk test may progress to become hypoxic and early admission to the hospital is recommended for observation and oxygen supplementation. However, the test is not recommended for patients with uncontrolled asthma.

The guidelines said that for mild infection paracetamol 10-15mg/kg/dose may be given every 4-6 hours for fever and throat soothing agents and warm saline gargles in older children and adolescents have been recommended for cough.

In case of moderate infection, the guidelines suggested initiating immediate oxygen therapy.

"Corticosteroids are not required in all children with moderate illness; they may be administered in rapidly progressive disease and anticoagulants may also be indicated," the guidelines said.

As steroids are harmful in asymptomatic and mild Covid cases, they should be administered only in hospitalised moderately severe and critically ill COVID-19 patients under strict supervision.

Children aged 5 and below may not wear masks, whereas those aged between 6-11 years, may wear masks under parental supervision.

Doctors treating Covid-positive children must be highly selective in prescribing high-resolution CT scans for patients, it says.