6-Minute Walk Test, No Remdesivir: Guidelines For Covid Management In Children

New Delhi:

The Union Health Ministry has issued clinical guidelines for the treatment of Covid-positive children amid concerns that a possible third wave of the coronavirus infection may target those aged below 18. In a detailed document titled ‘Comprehensive Guidelines for Management of COVID-19 in Children’, the ministry said the antiviral drug Remdesivir is not recommended for use on children, and steroids should be used to treat only moderately severe and critically ill patients under hospital settings.

“Remdesivir (an emergency use authorization drug) is NOT recommended in children…There is lack of sufficient safety and efficacy data with respect to Remdesivir in children below 18 years of age,” the document read.

The centre said in cases of severe Covid-induced illness, oxygen therapy must be immediately initiated, fluid and electrolyte balance should be maintained and the Corticosteroids therapy should be started.

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

“Steroids should be used at the right time, in the right dose and for the right duration,” the centre said in the document.

The government recommended use of what it called a ‘6-Minute Walk Test’ on children above 12 to assess “cardio-pulmonary exercise tolerance”.

“Attach pulse oximeter to his/her finger and ask the child to walk in the confines of their room for 6 minutes continuously. Positive test: any drop in saturation < 94%, or absolute drop of more than 3–5% or feeling unwell (lightheaded, short of breath) while performing the test or at end of 6 minutes; Children with positive 6-minute walk test may progress to become hypoxic and early admission to hospital is recommended (for observation and oxygen supplementation),” the document read.

The test is not recommended for patients with uncontrolled asthma.

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