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Table 2 List of clinical questions

From: Methodology and experiences of rapid advice guideline development for children with COVID-19: responding to the COVID-19 outbreak quickly and efficiently

No Initial Questions (IQ) Average score Decision of inclusion; reason, remarks Final Questions
IQ1 What are the main symptoms of children infected with the novel coronavirus? 6.33 Yes. According to experts’ comments, we revised the wording of this clinical question Clinical question 1: What are the symptoms of children with COVID-19 and who needs further assessment?
IQ2 What is confirmatory test for diagnosis novel coronavirus infection in children? 6.19 Yes. According to experts’ comments, we combined IQ2 and IQ8 into one question Clinical question 3: Should computed tomography (CT) scan be used for the diagnosis and monitoring of children with COVID-19?
IQ3 How to conduct screening to novel coronavirus for suspected childhood infection in hospitals? 6.17 No. According to experts’ comments, this clinical question was not a priority in this phase NA
IQ4 How to hierarchically manage children with novel coronavirus infection (including asymptomatic infected children)? 5.96 Yes. According to experts’ comments, the clinical question is answered in the form of a treatment pathway diagram For the pathway diagram, please refer to the original maintext of the rapid advice guidelines for management of children with COVID-19 [10]
IQ5 How to effectively prevent children getting infected novel coronavirus? (Tips for protecting children from novel coronavirus infection)? 5.96 No. According to experts’ comments, this clinical question not belong to our guideline scope NA
IQ6 Should new antiviral medications (such as lopinavir/ritonavir, remdesivir (GS-5734)) be used to treat in children with novel coronavirus infection? 5.85 Yes. According to experts’ comments, we combined IQ6 and IQ9 into one question and revised the wording Clinical question 4: Should antiviral drugs such as ribavirin, interferon, remdesivir (GS-5734), lopinavir/ritonavir or oseltamivir be used to treat children with COVID-19?
IQ7 Should systemic corticosteroid be used to treat children with novel coronavirus infection? 5.83 Yes. According to experts’ comments, we revised the wording of this clinical question Clinical question 6: Should systemic corticosteroids be used to treat children with severe COVID-19?
IQ8 Do children with non-severe novel coronavirus infection need imaging tests? 5.69 Yes. According to experts’ comments, we combined IQ2 and IQ8 into one question Clinical question 3: Should computed tomography (CT) scan be used for the diagnosis and monitoring of children with COVID-19?
IQ9 Should traditional antiviral medications (such as ribavirin, interferon) be used to children with novel coronavirus infection? 5.63 Yes. According to experts’ comments, we combined IQ6 and IQ9 into one question Clinical question 4: Should antiviral drugs such as ribavirin, interferon, remdesivir (GS-5734), lopinavir/ritonavir or oseltamivir be used to treat children with COVID-19?
IQ10 Where could parents and their children get reliable and evidence-based information about novel coronavirus epidemic and prevention? 5.63 Yes. According to experts’ comments, we revised the wording of this clinical question Clinical question 10: How should parents be advised to get information on SARS-CoV-2 infection?
IQ11 How to manage a child who has history of epidemiological exposure but without symptoms? 5.57 Yes. According to experts’ comments, we combined IQ6 and IQ9 into one question Clinical question 2: How should children who have had contact with COVID-19 patients be managed?
IQ12 Should IVIG be used to treat children with severe novel coronavirus severe infection? 5.56 Yes. According to experts’ comments, we revised the wording of this clinical question Clinical question 7: Should intravenous immunoglobulin (IVIG) be used to treat children with severe COVID-19?
IQ13 For children with no history of epidemiological exposure, what are the indications or symptoms for screening novel coronavirus? 5.37 No. We reached consensus that this clinical question was not a priority issue for this guideline NA
IQ14 Should CT test be better than normal chest X-ray in children with severe novel coronavirus pneumonia? 5.35 No. We reached consensus that this clinical question was not a priority issue for this guideline NA
IQ15 What are the imaging features of children with novel coronavirus infection in lungs, are they specific? 5.35 No. We reached consensus that this clinical question was not a priority issue for this guideline NA
IQ16 How long is the average incubation period for children infected with novel coronavirus? 5.31 No. We reached consensus that this clinical question was not a priority issue for this guideline NA
IQ17 What is the severity for novel coronavirus infection in children compared to adults? 5.15 No. We reached consensus that this clinical question was not a priority issue for this guideline NA
IQ18 What is the prognosis of children with novel coronavirus infection? 5.12 No. We reached consensus that this clinical question was not a priority issue for this guideline NA
IQ19 How to conduct psychological assessment and therapy for children diagnosed with novel coronavirus infection? 4.96 Yes. We reached consensus that this clinical question was a priority issue for this guideline Clinical question 8: What is appropriate supportive care for children with severe COVID-19?
IQ20 Could the novel coronavirus be vertically transmitted (mother to infant, breastfeeding)? If so, is there any difference in risk between natural delivery and caesarean section? 4.94 Yes. We reached consensus that this clinical question was a priority issue for this guideline Clinical question 9: Should mothers with COVID-19 continue to breastfeed their babies?
IQ21 Should antibiotic agents be used to treat novel coronavirus infection? 4.91 Yes. According to experts’ comments, this clinical question was a priority issue for this guideline Clinical question 5: Should antibiotics be used to treat children with COVID-19?
IQ22 What are the predisposing factors (gender, age, underlying diseases, ethnic differences) for novel coronavirus infection in children? 4.85 No. According to experts’ comments, this clinical question was not a priority issue for this guideline NA
IQ23 Does the complete blood count (CBC) test for children with early 2019-nCoV infection have a predictive effect on the severity of the disease? 4.85 No. According to experts’ comments, this clinical question was not a priority issue for this guideline NA
IQ24 Could a multidisciplinary cooperation improve the outcomes for children with severe novel coronavirus infection? 4.62 No. We reached consensus that this clinical question was not a priority issue for this guideline NA
IQ25 How susceptible are children compared to adults for novel coronavirus? 4.33 No. We reached consensus that this clinical question was not a priority issue for this guideline NA
IQ26 What is the severity for 2019-nCoV infection in children (e.g., mortality and ICU admission rates) compared to SARS/MERS? 4.28 No. We members reached consensus that this clinical question was not a priority issue for this guideline NA
  1. IQ Initial Question, NA Not Applicable