Rapid advice guidelines for management of children with COVID-19

Liu, Enmei; Smyth, Rosalind L; Luo, Zhengxiu; Qaseem, Amir; Mathew, Joseph L; Lu, Quan; Fu, Zhou; Zhao, Xiaodong; Zhao, Shunying; Estill, Janne; Chan, Edwin; Liu, Lei; Qian, Yuan; Xu, Hongmei; Wang, Qi; Fukuoka, Toshio; Luo, Xiaoping; Wong, Gary; Lei, Junqiang; Nurdiati, Detty Siti; Tu, Wenwei; Zhang, Xiaobo; Zheng, Xiao; Ahn, Hyeong Sik; Wang, Mengshu; Dong, Xiaoyan; Wu, Liqun; Lee, Myeong Soo; Li, Guobao; Yang, Shu; Feng, Xiangyu; Zhao, Ruqian; Lu, Xin-Jiang; He, Zhihui; Liu, Shihui; Li, Weiguo; Zhou, Qi; Luo, Ren; Chen, Yaolong; Qiu, Li

doi:10.21037/atm-20-3754

Cited by 27 publications

(32 citation statements)

References 66 publications

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“…A total of 2018 articles were identified, and 37 records 4,5,10–44 were finally included after successive screening, including 32 guidelines 4,5,11,14–20,22,23,25–44 (86.5%) published in English language and five 10,12,13,21,24 (13.5%) in Chinese language (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 37 guidelines included, ten 4,14,20,30,32,37–41 (27.0%) were developed by international panels (Table 1). Nine 8,10‐13,15,21,24,34,44 of included guidelines were developed in China (24.3%), five 21,26,35,36,44 (13.5%) in the United States, two in Australia 38,42 (5.4%), two in Canada 22 43 (5.4%), two in South Korea 17,33 (5.4%), and one each in Germany, 25 India, 16 Italy, 19 Mexico, 31 North America (USA and Canada), 26 Poland, 29 and Spain 27 .…”

Section: Resultsmentioning

confidence: 99%

“…Twenty‐five 4,5,10–12,14–18,21,24,25,27,29–31,34–36,38–40,42,44 guidelines (67.6%) provided COVID‐19 diagnosis‐related recommendations, including seven guidelines 12,17,21,24,38,40,42 (18.9%) that contained only diagnostic recommendations. Computed tomography (CT), reverse transcription‐polymerase chain reaction (RT‐PCR), X‐rays, lung ultrasound, and routine blood tests were the most frequently recommended tests for COVID‐19 diagnosis (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 30 guidelines 4,5,10,11,13–16,18–20,22,23,25–37,39,41,43,44 (81.1%) addressed the treatment of COVID‐19. Treatment options included supportive care, antiviral therapy, glucocorticoid therapy, antibiotics, immunoglobulin, extracorporeal membrane oxygenation (ECMO), convalescent plasma, and psychotherapy (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…Recommendations on supportive care were consistent. Twenty guidelines 4,10,11,13–16,18–20,25,27,29–31,34,35,37,43 (54.1%) recommended using supportive care, mainly rest in bed, ensuring adequate calories, maintaining water‐electrolyte balance, oxygen therapy, symptomatic treatment, and nutritional supplements.…”

Section: Resultsmentioning

confidence: 99%

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Consistency of recommendations and methodological quality of guidelines for the diagnosis and treatment of COVID‐19

Luo

Liu

Ren

et al. 2021

J Evidence Based Medicine

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Objective Since the beginning of the COVID‐19 epidemic, a large number of guidelines on diagnosis and treatment of COVID‐19 have been developed, but the quality of those guidelines and the consistency of recommendations are unclear. The objective of this study is to evaluate the quality of the diagnosis and treatment guidelines on COVID‐19 and analyze the consistency of the recommendations of these guidelines. Methods We searched for guidelines on diagnosis and/or treatment of COVID‐19 through PubMed, CBM, CNKI, and WanFang Data, from January 1, 2020 to August 31, 2020. In addition, we also searched official websites of the US CDC, European CDC and WHO, and some guideline collection databases. We included diagnosis and/or treatment guidelines for COVID‐19, including rapid advice guidelines and interim guidelines. Two trained researchers independently extracted data and four trained researchers evaluated the quality of the guidelines using the AGREE II instruments. We extracted information on the basic characteristics of the guidelines, guideline development process, and the recommendations. We described the consistency of the direction of recommendations for treatment and diagnosis of COVID‐19 across the included guidelines. Results A total of 37 guidelines were included. Most included guidelines were assessed as low quality, with only one of the six domains of AGREE II (clarity of presentation) having a mean score above 50%. The mean scores of three domains (stakeholder involvement, the rigor of development and applicability) were all below 30%. The recommendations on diagnosis and treatment were to some extent consistent between the included guidelines. Computed tomography (CT), X‐rays, lung ultrasound, RT‐PCR, and routine blood tests were the most commonly recommended methods for COVID‐19 diagnosis. Thirty guidelines were on the treatment of COVID‐19. The recommended forms of treatment included supportive care, antiviral therapy, glucocorticoid therapy, antibiotics, immunoglobulin, extracorporeal membrane oxygenation (ECMO), convalescent plasma, and psychotherapy. Conclusions The methodological quality of currently available diagnosis and treatment guidelines for COVID‐19 is low. The diagnosis and treatment recommendations between the included guidelines are highly consistent. The main diagnostic methods for COVID‐19 are RT‐PCR and CT, with ultrasound as a potential diagnostic tool. As there is no effective treatment against COVID‐19 yet, supportive therapy is at the moment the most important treatment option.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Consistency of recommendations and methodological quality of guidelines for the diagnosis and treatment of COVID‐19

Luo

Liu

Ren

et al. 2021

J Evidence Based Medicine

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Pneumonia in the Newborn Infant

Hooven

Randis

Polin

2022

Manual of Neonatal Respiratory Care

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Guidelines for the prevention and management of children and adolescents with COVID-19

Liu

Smyth

et al. 2022

Eur J Pediatr

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Children are the future of the world, but their health and future are facing great uncertainty because of the coronavirus disease 2019 (COVID-19) pandemic. In order to improve the management of children with COVID-19, an international, multidisciplinary panel of experts developed a rapid advice guideline at the beginning of the outbreak of COVID-19 in 2020. After publishing the first version of the rapid advice guideline, the panel has updated the guideline by including additional stakeholders in the panel and a comprehensive search of the latest evidence. All recommendations were supported by systematic reviews and graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Expert judgment was used to develop good practice statements supplementary to the graded evidence-based recommendations. The updated guideline comprises nine recommendations and one good practice statement. It focuses on the key recommendations pertinent to the following issues: identification of prognostic factors for death or pediatric intensive care unit admission; the use of remdesivir, systemic glucocorticoids and antipyretics, intravenous immunoglobulin (IVIG) for multisystem inflammatory syndrome in children, and high-flow oxygen by nasal cannula or non-invasive ventilation for acute hypoxemic respiratory failure; breastfeeding; vaccination; and the management of pediatric mental health. Conclusion : This updated evidence-based guideline intends to provide clinicians, pediatricians, patients and other stakeholders with evidence-based recommendations for the prevention and management of COVID-19 in children and adolescents. Larger studies with longer follow-up to determine the effectiveness and safety of systemic glucocorticoids, IVIG, noninvasive ventilation, and the vaccines for COVID-19 in children and adolescents are encouraged. What is Known: • Several clinical practice guidelines for children with COVID-19 have been developed, but only few of them have been recently updated. • We developed an evidence-based guideline at the beginning of the COVID-19 outbreak and have now updated it based on the results of a comprehensive search of the latest evidence. What is New: • The updated guideline provides key recommendations pertinent to the following issues: identification of prognostic factors for death or pediatric intensive care unit admission; the use of remdesivir, systemic glucocorticoids and antipyretics, intravenous immunoglobulin for multisystem inflammatory syndrome in children, and high-flow oxygen by nasal cannula or non-invasive ventilation for acute hypoxemic respiratory failure; breastfeeding; vaccination; and the management of pediatric mental health. Supplementary Information The online version contains supplementary material available at 10.1007/s00431-022-04615-4.

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Rapid advice guidelines for management of children with COVID-19

Abstract: Liu et al. Rapid advice guidelines for management of children with COVID-19

Cited by 27 publications

References 66 publications

Consistency of recommendations and methodological quality of guidelines for the diagnosis and treatment of COVID‐19

Consistency of recommendations and methodological quality of guidelines for the diagnosis and treatment of COVID‐19

Pneumonia in the Newborn Infant

Guidelines for the prevention and management of children and adolescents with COVID-19

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