Abstract:Introduction:
With the widespread spread of novel coronavirus pneumonia, more and more countries have been affected. Some research reports have shown that traditional Chinese medicine has a significant effect on COVID-19 infection, and the treatment of traditional Chinese medicine is used in some special people, such as children. At present, there is a lack of high-quality systematic reviews on the safety and efficacy of using Chinese medicine to treat children with novel coronavirus pneumonia.
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Background
At present, many protocols for Systematic Reviews (SR) of Traditional Chinese Medicine (TCM) for coronavirus disease 2019 (COVID-19) have been registered in the International Prospective Register of Systematic Reviews (PROSPERO). This study aimed to analyze the innovativeness and rigorousness of the SR protocols and make recommendations for the design and implementation of future SRs on TCM for COVID-19. This effort is likely to enhance the value of the produced information and prevent the futility of the research.
Methods
PROSPERO was searched comprehensively for identifying SRs of TCM for COVID-19 from the inception of the database to August 2020. Two researchers independently screened the literature, extracted the data, and cross-checked the retrieved information for consistency. The following details were recorded: database, registration time, organizations, types of research included, participants, interventions, and outcome indicators. All extracted data were analyzed by an overview. The “P - participants, I - interventions, C - controls, and O - outcomes (PICO)” included in the protocols were compared for similarity. The outcomes of the included SR protocols were compared with the newly published Core Outcome Sets (COSs).
Results
Eighty protocols of SR related to TCM for COVID-19 were obtained after a primary search; finally, 71 protocols were included. The majority of the protocols were from China. Thirty-two organizations participated in the protocol registrations, including 11 hospitals and 21 universities/colleges. However, some protocols were not innovative or rigorous enough. Such as, the PICO of some protocols were similar. The searched literature was incomprehensive, and PICO was not specific and correct. In addition, outcome indicators—arterial oxygen partial pressure, a fraction of inspired oxygen, respiratory failure, and WHO Clinical Progression Scale—in the newly published COSs were infrequently used and often neglected.
Conclusions
Registering and implementing an innovative and rigorous SR ensures the usefulness of the produced information and avoids the duplication of research and the wastage of resources. It is important to focus on and solve the methodological problems, such as non-specific PICO, incomprehensive literature retrieval, COS application, and incorrect indicator name, in future SR protocols.
Background
At present, many protocols for Systematic Reviews (SR) of Traditional Chinese Medicine (TCM) for coronavirus disease 2019 (COVID-19) have been registered in the International Prospective Register of Systematic Reviews (PROSPERO). This study aimed to analyze the innovativeness and rigorousness of the SR protocols and make recommendations for the design and implementation of future SRs on TCM for COVID-19. This effort is likely to enhance the value of the produced information and prevent the futility of the research.
Methods
PROSPERO was searched comprehensively for identifying SRs of TCM for COVID-19 from the inception of the database to August 2020. Two researchers independently screened the literature, extracted the data, and cross-checked the retrieved information for consistency. The following details were recorded: database, registration time, organizations, types of research included, participants, interventions, and outcome indicators. All extracted data were analyzed by an overview. The “P - participants, I - interventions, C - controls, and O - outcomes (PICO)” included in the protocols were compared for similarity. The outcomes of the included SR protocols were compared with the newly published Core Outcome Sets (COSs).
Results
Eighty protocols of SR related to TCM for COVID-19 were obtained after a primary search; finally, 71 protocols were included. The majority of the protocols were from China. Thirty-two organizations participated in the protocol registrations, including 11 hospitals and 21 universities/colleges. However, some protocols were not innovative or rigorous enough. Such as, the PICO of some protocols were similar. The searched literature was incomprehensive, and PICO was not specific and correct. In addition, outcome indicators—arterial oxygen partial pressure, a fraction of inspired oxygen, respiratory failure, and WHO Clinical Progression Scale—in the newly published COSs were infrequently used and often neglected.
Conclusions
Registering and implementing an innovative and rigorous SR ensures the usefulness of the produced information and avoids the duplication of research and the wastage of resources. It is important to focus on and solve the methodological problems, such as non-specific PICO, incomprehensive literature retrieval, COS application, and incorrect indicator name, in future SR protocols.
Chest computed tomography (CT) has been frequently used to evaluate patients with potential COVID-19 infection. However, this may be particularly risky for pediatric patients due to high doses of ionizing radiation.
We sought to evaluate COVID-19 imaging options in pediatric patients based on published literature.
We performed an exhaustive literature review focusing on COVID-19 imaing of pediatric patients. Researcher used “COVID-19”, “SARS-CoV2”, “coronavirus”, “2019-nCoV”, “Wuhan virus”, “lung ultrasound (LUS)”, “sonography”, “lung HRCT”, “children”, “childhood” and “newborn” as search terms to query online databases including: US National Library of Medicine (PubMed), Medical Subject Headings (MeSH), Excerpta Medica dataBASE (EMBASE), LitCovid, WHO COVID-19 database and Medical Literature Analysis and Retrieval System Online (Medline Bireme). Articles meeting inclusion criteria were included in the analysis and review.
We identified only 7 studies using LUS for diagnosing SARS-CoV2 infection in children. The studies evaluated small numbers of patients and only 6% had severe or critical illness associated with COVID-19. LUS showed the presence of: B-lines in 50% of patients, sub-pleural consolidation in 43.18%, pleural irregularities in 34.09%, coalescent B-lines and white lung in 25%, pleural effusion in 6.82% and thickening of pleural line in 4.55% of newborn/children.
Researhers found 117 studies describing CXR or chest CT use in pediatric patients with COVID-19. The proportion of severely or critically ill was similar to the LUS study population.
Our review indicates that LUS utilization should be encouraged in pediatric patients, which is at highest risk for complications for medical ionizing radiation. Increased use of LUS may be of particularly high impact in low resourced areas where access to chest CT may be limited.
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