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COVID care in children and adolescents-latest Indian guidelines
eMediNexus,  28 July 2021
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Immunity and COVID

India is the world’s largest democracy having a population of more than 1.2 billion. The covid-19 pandemic has badly affected the country’s socio-economic conditions. Less than 12% of the total infected people are below 20 yrs of age. 1

It was reported that among adults with confirmed COVID-19 infection, 80% experience mild illness, about 14-15% experience moderate-severe disease and 5% are critically ill. As is evident from the current scenario, children have not been affected so much by this fast-spreading infection. The available serosurvey data prior to the launch of the vaccination drive, states that children of 10-17 years had seropositivity similar to that in adults but the proportion of  <20  yr olds was lower among confirmed  COVID-19  cases than expected.  This suggests that children are also susceptible as adults to infection, but mostly remain asymptomatic. Further, children who have symptoms have the milder infection as compared to adults. 2

Besides the spread of the Coronavirus, the fear has impacted the normal life of people greatly. Hence, necessary precautions and care is the best way to prevent infection and reduce the burden on the health care system. The common symptoms in both children and adolescents include sore throat, throat irritation, cough, fever, headache, body pains, rhinorrhoea, diarrhoea Malaise/weakness, and loss of sense of smell and/or taste. 2

Enhancing the existing COVID care facilities to provide care to children with acute infection is necessary. These should have facilities where parents can accompany the child.  In paediatric hospitals, separate arrangements for COVID-care need to be set up. Additional pediatric-specific equipment, infrastructure, and pediatric formulations, more doctors and nurses and health workers should be provided.  

Children infected by COVID and having MIS-C, need to have cared more. For children who test negative for acute COVID, care has to be provided by the existing pediatric facilities.

 As per the management protocols developed by the MoHFW for children with acute COVID and MIS-C most of the drugs used in adults such as Ivermectin/ HCQ/ Favipiravir/ Antibiotics such as Doxycycline or Azithromycin are not recommended.

Children mostly have asymptomatic or mild illness and can be kept in home isolation and managed by parents. Symptomatic Treatment includes administering paracetamol for fever, throat smoothening and hot saline water gargles for sore throat and throat irritation, good monitoring and measuring of the respiratory rates, difficulty in respiration, oral intake and oxygen saturation are essential criteria’s to be followed.

Collaborative works between district hospitals, medical colleges and other health care facilities are necessary for improving the quality of care and for capacity. Few centers may be designated as the Regional Centres of Excellence for COVID care as well as research. These centers may help in providing guidance and leadership in clinical management and training. Telemedicine could be emphasized and practiced to reach out to the majority of the population and help different facilities providing COVID care.

Data collection at all levels and transmission from community to higher centers is very essential. A national registry should be launched for pediatric COVID. Encouraging and facilitating research in the area of pediatric COVID, optimal treatment for MIS-C, its management and its study through clinical trials is also important, Proper IEC campaign should be launched and encouraged to provide correct information and strict actions should be undertaken for communicating wrong information or misinformation in media and social media.  

Thus, following the proper guidelines and monitoring constantly, children, as well as adolescents, can prevent and protect themselves.


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