Table 2 List of clinical questions
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 |