As the country gears for the third wave of COVID-19 where children are being assumed to be the most vulnerable group, parents are worried about the possible impact of the third wave on children. The government released the protocol for the management of COVID- 19 in the Paediatric Age Group, leaving behind several questions in the minds of parents. Experts have informed that the right diet and hygiene management can help prevent Coronavirus infection among children. Answering the questions regarding the possible symptoms and treatment in children affected with COVID, a panel of experts answered a few FAQs. Dr Rahul Pandit Director-Critical Care Fortis Hospitals Mumbai National COVID Task Force Member and Member Of Maharashtra State Covid Task Force ), and Dr Rajiv Parakh, Chairman, Vascular & Endovascular, Medanta, Medicity Hospital were the panel members.
Considering most children have mild symptoms, what should be the treatment protocol?
In case of asymptomatic infection, a child might not show any signs. But, take the pulse oximetre reading and make sure their oxygen saturation is above 94%. For moderate and severe ones it would be very obvious because the child will be breathing quite rapidly, you may even have the child looking very sick, fever may be very high, and saturation may be below 94 per cent. The categorisation is still based on the symptoms and the way the child is looking. It is not based on any of the test modes, the categorisation is predominately based on the clinical management.
Should children be exposed to CT Scan during treatment?
It is important for the paediatrician to assess the situation beforer recommending CT Scan. The scan is advisable only when RT PCR result is either negative or inconclusive and the clinical suspension is much higher than ordinary cough and cold. As far as repeated CT Scan is concerned, one must not expose children to the high dose of radiation and they must take the test only when prescribed by the physician, preferrably once. Exposure to high level radiations is detrimental to the growth of children.
In case of severe symptoms, what should be the treatment protocol?
The six-minute walk test is something we have been doing in adults quite extensively and for children who can walk around with a six-minute walk test to look whether they have drop-in their oxygen saturation at the end of walking for six minutes within the confines of the room. It is the most important test which actually provokes a possible plan for the admission of this child. Obviously, it is not a sensitive test for children who are below 2years of age and a bit of a question to 2 to 6 years children whether they could be able to do that in the true spirit of walk test. About the protocol, it does not involve giving too many medications, they still have a very standardised protocol, most important is to make your child hydrated well, drinking well, eating well, if not that then give IV fluids, for breastfeeding infants, they still a garage breastfeeding by the mother as that us something very important to realise and then obviously the category of moderate or severe who are sort of rapidly progressing there needs to be an intervention with the steroids to be given and the steroids have to be low as given by the trials which are 0.15mgm of Dexamethasone or the equal dose of Methylprednisolone to be given for a short course of 5 to 10 days. In fact, the guidelines go up to 14days in selective patients and then there us essentially all, rest of all is very supportive of these patients.
What should be the post- COVID care protocols for children?
Coming to children, once they recover, a paediatrician has to be involved and supervise the entire treatment. As Dr Pandit said there are not too many medications, it's basically about hydration, healthy food, avoiding junk food, avoid all these fried and white flour-containing products which children unfortunately love. So, hydration and the diet has to be extremely looked into. And, as far as the exercise is concerned don't allow them to straight away go and jump into the swimming pool because it's got or it's going to park and playing around, let them recover gradually, give them at least 4 to 6 periods a week window so that children can actually and gradually recover because let's not forget that lung have taken an insult and that will take some time for it to recover and we must actually give it time to heal, it will heal very fast but they need to be given proper care. As far as young children are concerned , the regular vaccination DPT, Cholera, typhoid and whooping cough and other regular vaccines must be provided. If the children have no COVID symptoms then make sure they are fully vaccinated, do not miss their vaccination schedule.
What are the post- COVID complications in children?
The most worrisome complication that happens in children is called the multisystem inflammatory syndrome of Child (MIS). It's a complication that lands the child in hospital more often and it involves multisystem as the names in which a child will have a rash, their blood pressure may go down, signs of shock may be present.
The child here is very sick and need to be admitted into the hospital probably into the pediatric intrusive care unit and treated accordingly. The chances of this happening are extremely low but that doesn't mean it won't happen so we need to be vigilant about it. And second thing is that children below the age of 10years have a little bit of immunity by the nature of home they have a thymus gland which is still functioning. Parents must not be kept worried about children too much.
How can parents work on increasing immunity in children and are there any preventive steps that parents can take?
Immunity means looking after yourself, good hydration, hygiene, healthy diet, and sleeping well. There aren't any medicines that can be advised or prescribed to improve immunity in children. Teach them to wear a mask, and avoid getting into crowds, and other interactions.
What should parents keep in mind while vaccinating children?
As when government approve vaccination or children, under paediatrician consultation get your vaccinated. Children may have fever as usually observed during normal vaccination too.