COVID-19 Management For 1 Month - 19 Years Old

• Fever, headache, myalgia, fatigue, tiredness, coryza, cough, sore throat, rapid breathing (anyone) OR
• Diarrhea, vomiting, abdominal pain OR
• Poor feeding in an infant, loss of taste or smell (>8 year) OR
• Rash, conjunctival congestion, mucositis, shock OR
• Asymptomatic but has a close/household contact with a COVID-19 case

* Symptoms and signs of COVID-19 are nonspecific and mimic any viral illness.

• Testing is recommended ideally for all the suspect cases (to avoid transmission to other household members)
• Prior to any procedure/hospitalization
• However, if resources are scarce, then testing may be deferred for both asymptomatic contacts and children with mild symptoms AND no comorbidities^# AND a known positive family member (Should be isolated)
• Such children may be presumed to be COVID-19 infected and be managed as per the guidelines in this document

# Chronic kidney disease/congenital heart disease/chronic liver disease/neurodisability/morbid obesity/severe malnutrition/current malignancy/immunocompromised state/diabetes

• Testing should be done as soon as possible after onset of symptoms
• Rapid Antigen Test (RAT) in nasopharyngeal swabs (low sensitivity, so if negative, RT-PCR should be done)
• RT-PCR in nasopharyngeal oropharyngeal swabs (Xpert SARS-CoV-2 and Truenat give faster results)
• SARS-CoV-2 antibodies also, if features of MIS-C

Children with symptoms suggestive of COVID-19 but negative RT-PCR test, should undergo repeat RT-PCR and evaluated for other illnesses. If symptoms are protracted and RT-PCR is negative, CT chest may be done. If no alternative diagnosis, treat as per COVID-19