Treatment of pediatric COVID on outpatient basis

Rajaram M. Weling


Background: Since December 2019, coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread, becoming the first pandemic of the 21st century by number of deaths (over 3.8 million deaths worldwide) and still increasing. Many aspects of SARS-CoV-2 infection in children and adolescents remain unclear, and optimal treatment has not yet been defined.

Methods: This is a collective descriptive study with analytical wing; on 756 children who were COVID-19 positive; at Ameya well baby clinic at Ameya orthopaedic centre and children hospital, Borivali West, Mumbai, India from December 2019 up to December 2021. In our study 756 children from birth to fifteen years who were symptomatic for COVID-19 and the diagnosis was confirmed by COVID RTPCR positive test, were treated with our standard protocol which included nebulization, bronchodilators and antibiotics on outpatient basis, with home quarantine and follow up done by teleconsultation. Data was entered and analysed using SPSS software version 11. Proportions were compared using Chi square (χ2) test of significance, categorical variables were assessed using χ2. In all the above the p value of less than 0.05 was accepted as indicating statistical significance.

Results: In the study the covid affected children were treated with our protocol improved (p value less than 0.05).

Conclusions: The findings of this study clearly establish the role of our protocol in treating COVID affected children on out-patient basis in the current COVID scenario prevailing in our country.


COVID-19, RTPCR test, Nebulization, Antibiotics

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Chan JF, Kok KH, Zhu Z, Chu H, To KK, Yuan S et al. Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerg Microbes Infect. 2020;9(1):221-36.

Biryukov J, Boydston JA, Dunning RA, Yeager JJ, Wood S, Ferris A et al. SARS-CoV-2 is rapidly inactivated at high temperature. Environ Chem Lett. 2021;1-5.

Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF. The proximal origin of SARS-CoV-2. Nat Med. 2020;26(4):450-52.

Zhang T, Wu Q, Zhang Z. Probable Pangolin Origin of SARS-CoV-2 Associated with the COVID-19 Outbreak. Curr Biol. 2020;30(7):1346-51.e2.

Song W, Gui M, Wang X, Xiang Y. Cryo-EM structure of the SARS coronavirus spike glycoprotein in complex with its host cell receptor ACE2. PLoS Pathog. 2018;14(8):e1007236.

European Medicines Agency. EMA Gives Advice on the Use of Non-Steroidal Anti-Inflammatories for COVID-19. Available at: https://www.ema. Accessed on 12 December 2020.

WHO. The use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in Patients with COVID-19. Available at: publications/i/item/the-use-of-non-steroidal-anti-inflammatory-drugs-(nsaids)-in-patients-with-covid-19. Accessed on 21 April 2020.

Martins-Filho PR. Do Nascimento-Júnior, E.M.; Santos, V.S. No current evidence supporting risk of using Ibuprofen in patients with COVID-19. Int J Clin Pract. 2020;74:e13576.

Sodhi M, Etminan M. Safety of Ibuprofen in Patients with COVID-19: Causal or Confounded? Chest. 2020;158:55-6.

World Health Organization (WHO). Modes of Transmission of virus Causing COVID-19: Implication for IPC Precaution Recommendation. 2020. Available at: Accessed on 21 April 2020.

Chiotos K, Hayes M, Kimberlin DW, Jones SB, James SH, Pinninti SG et al. Multicenter initial guidance on use of antivirals for children with COVID-19/SARS-CoV-2. J Pediatric Infect Dis Soc. 2020;9:701-5.

National Institute of Health. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Available at: guidelines/covid19treatmentguidelines.pdf. Accessed on 18 November 2020.

Eghbali A, Shokrollahi S, Mahdavi NS, Mahdavi SA, Dabbagh A. COVID-19 in pediatric patients: A case series. J Cell Mol Anesth. 2020;5-3.

Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30:269-71.

Remdesivir. Food and Drug Administration. 2020. Available at: drugsatfdadocs/label/2020/214787Orig1 s000lbl.pdf. Accessed on 12 December 2020.

Harwood R, Allin B, Jones CE, Whittaker E, Ramnarayan P, Ramanan AV et al. A national consensus management pathway for paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS): Results of a national Delphi process. Lancet Child Adolesc Health. 2020.

Henderson LA, Canna SW, Friedman KG, Gorelik M, Lapidus SK, Bassiri H et al. American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 1. Arthritis Rheumatol. 2020;72:1791-805.

Belhadjer Z, Méot M, Bajolle F, Khraiche D, Legendre A, Abakka S et al. Acute Heart Failure in Multisystem Inflammatory Syndrome in Children in the Context of Global SARS-CoV-2 Pandemic. Circulation. 2020;142:429-436.

Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, Muse A, Rowlands J et al. Multisystem Inflammatory Syndrome in Children in New York State. N Engl J Med. 2020;383:347-58.

Al-Ghafry M, Aygun B, Appiah-Kubi A, Vlachos A, Ostovar G, Capone C et al. Are children with SARS-CoV-2 infection at high risk for thrombosis? Viscoelastic testing and coagulation profiles in a case series of pediatric patients. Pediatr. Blood Cancer. 2020;67:e28737.

Loi M, Branchford B, Kim J, Self C, Nuss R. COVID-19 anticoagulation recommendations in children. Pediatr. Blood Cancer. 2020;67:e28485.

Bhattacharyya R, Iyer P, Phua GC, Lee JH. The Interplay between Coagulation and Inflammation Pathways in COVID-19- Associated Respiratory Failure: A Narrative Review. Pulm Ther. 2020;6:215-31.