MoH issues new guidelines on diagnosis and treatment of COVID-19 in children

A baby with COVID-19 is treated at the Vietnam National Children’s Hospital in Hanoi. (Photo suckhoedoisong.vn)

Hanoi (VNS/VNA) – The has issued on the
in children, especially children under 12
months who are at high risk of severe disease. 

The
number of children infected with COVID-19 has tended to increase recently.

The
new guidance has replaced the one issued on November 8, 2021.

Under
the new guidance, the ministry has changed the instructions on confirmed cases
of children with .

A
child identified as a COVID-19 patient has tested positive for
SARS-CoV-2 by real-time polymerase chain reaction (RT-PCR) test; has been
in close contact with a COVID-19 case and has a positive rapid test result for
SARS-CoV-2; a child who has epidemiological factors or clinical symptoms
suspected of being COVID-19 and a positive rapid test result of SARS-CoV-2; or
a child with epidemiological factors and test results positive for
SARS-CoV-2 twice within eight hours.

In
the previous guidance, confirmed cases are defined as all cases with suspected
symptoms and a positive test result for SARS-CoV-2 by RT-PCR.

Also
following the new guidance, the ministry has added the level of asymptomatic in
children with COVID-19. Thus, there are five levels of asymptomatic, mild,
moderate, severe and critical levels in children with COVID-19.

The
new guidance also regulates treatment with the antiviral drug Remdesivir to treat children with mild
cases of COVID-19.

Accordingly, Remdesivir is indicated for the
treatment of mild inpatients with at least one risk factor, or patients with
respiratory failure requiring oxygen, continuous positive airway pressure
(CPAP), high-flow nasal cannula (HFNC) or non-invasive ventilation. In the
previous guidance, it did not regulate the use of the drug to treat children
with mild symptoms.

The
ministry also said that children with COVID-19, who have mild risk factors,
need to be considered for treatment at a medical facility.

There
are 14 risk factors that could cause severe illness for a child with COVID-19,
consisting of premature babies and low birth weight; obesity and overweight;
diabetes, genetic diseases and metabolic disorders; chronic lung diseases and
bronchial asthma; cancer; chronic kidney disease; organ transplant or
haematopoietic stem cell transplant;  cardiovascular disease; neurological
diseases; sickle cell disease, thalassaemia, other chronic haematological
diseases; congenital or acquired immunodeficiency diseases; liver failure; systemic
diseases; and children treated with corticosteroids or other
immunosuppressive drugs.

According
to the ministry, SARS-CoV-2 causes illness in both adults and children but it
is less common in children.

However,
recently, the number of children infected with COVID-19 has been increasing.
The majority of children with COVID-19 are asymptomatic or mild with upper
respiratory or gastrointestinal symptoms (over 55 percent), moderate (40 perent),
severe (4 percent) and critical (0.5 percent).

Infants
under 12 months are at high risk for severe illness. Children with COVID-19
usually have mild symptoms, so hospitalisation and death rates are low compared
to adults.

Multisystem
inflammatory syndrome in children (MIS-C) with COVID-19 is rare, occurring
between two and six weeks after SARS-CoV-2 infection. This is a serious
complication that can be fatal and tends to increase, the ministry said./.