Characteristics and management of children with suspected COVID-19 admitted to hospitals in India : implications for future care

Kumar, Santosh and Haque, Mainul and Shetty, Arvind and Choudhary, Sumesh and Bhatt, Rohan and Sinha, Vivek Kumar and Manohar, Balaji and Chowdhury, Kona and Nusrat, Nadia and Jahan, Nasim and Kurdi, Amanj and Mustafa, Zia Ul and Meyer, Johanna and Sefah, Israel and Abdullah, Adnan and Jairoun, Ammar Abdulrahman and Godman, Brian (2022) Characteristics and management of children with suspected COVID-19 admitted to hospitals in India : implications for future care. Cureus, 14 (7). e27230. (https://doi.org/10.7759/cureus.27230)

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Abstract

Introduction: There is a growing focus on researching the management of children with COVID-19 admitted to hospital, especially among developing countries with new variants alongside concerns with the overuse of antibiotics. Patient care can be improved with guidelines but concerns with continued prescribing of antivirals and antimalarials. Objective: Consequently, a need to document the current management of children with COVID-19 across India. Key outcome measures included the percentage prescribed antimicrobials, adherence to current guidelines, and mortality. Methodology: A point prevalence study using specially developed report forms among 30 hospitals in India. Results: The majority of admitted children were aged between 11-18 years (70%) and boys (65.8%). Reasons for admission included respiratory distress, breathing difficulties, and prolonged fever. 75.3% were prescribed antibiotics typically empirically (68.3% overall), with most on the Watch list (76.7%). There were no differences in antibiotic prescribing whether hospitals followed guidelines or not. There was also appreciable prescribing of antimalarials (21.4% of children), antivirals (15.2%), and antiparasitic medicines (27.2%) despite limited evidence. The majority of children (92.2%) made a full recovery. Conclusion: It was encouraging to see low hospitalization rates. However, concerns about high empiric use of antibiotics alongside high use of antimalarials, antivirals, and antiparasitic medicines. These can be addressed by instigating appropriate stewardship programs.

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