Skip to main content

Table 3 The questions and supporting evidence from rapid reviews

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

Questions Rapid review(s) to answer the questions Studies included in the rapid review Was the recommendation fully supported by evidence from COVID-19 (Yes/Partially/No) Was the recommendation fully supported by evidence from children with COVID-19 (Yes/Partially /No) Proportion of preprints in the COVID-19 studies per rapid review
Clinical question 1: what are the symptoms of children with COVID-19 and who needs further assessment? One rapid review
(produced by RRG)
Wang Z et al., 2020 [45]
Number of primary studies: 49
Study design: 25 case reports, 23 case series and one cohort study
Patients: All patients are children with COVID-19
Sources: Seven preprints, 42 journal articles
Yes, 100% Yes, 100% 14.3% (7/49)
Clinical question 2: how should children who have had contact with COVID-19 patients be managed? Three rapid reviews(two rapid reviews produced by RRG, one published article) Gao Y et al., 2020 [46]
Number of primary studies:9
Study design: 9 cross-sectional studies
Patients: One article was about COVID-19 (all patients were adults), eight articles were about SARS
Sources: Zero preprint, 9 journal articles
Partially, 11% No, 0% 0.0%(0/4)
Zhou Q et al., 2020 [47]
Number of primary studies: 40
Study design: Nine case series, 30 cross-sectional studies and one case–control
Patients: Four articles were about adults with COVID-19, 25 articles were about SARS, 11 articles were about MERS
Sources: Zero preprint, 40 journal articles
Partially, 10% No, 0% 0.0%(0/1)
Nussbaumer-Streit B et al., 2020 [57]
Number of primary studies:29
Study design: Four cohort studies and 25 modelling studies
Patients: 10 articles were about COVID-19 (almost patients were adults), 15 articles were about SARS, two articles were about MERS and two articles were about SARS and other infectious diseases
Sources: Zero preprint, 28 journal articles and one unpublished report
Partially, 34% No, 0%* 0.0%(0/10)
Clinical question 3: should computed tomography (CT) scan be used for the diagnosis and monitoring of children with COVID-19? One rapid review (produced by RRG) Lv M et al., 2020 [48]
Number of primary studies: 103
Study design: 82 case series and 21 case reports
Patients: All articles were about COVID-19, 7 articles were only included children, other articles were included adults
Sources: Five preprints, 98 journal articles
Partially, 100% Partial, 6.8%a 4.8%(5/103)
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? One rapid review (produced by RRG) Shi Q et al., 2020 [49]
Number of primary studies: 23
Study design: Six randomized controlled trials and 17 cohort studies
Patients: Seven articles were about COVID-19 (almost patients were adults), 13 articles were about SARS, three articles were about MERS
Sources: Three preprints, 20 journal articles
Partially, 30% No, 0%a 42.9%(3/7)
Clinical question 5: should antibiotics be used to treat children with COVID-19? One rapid review (produced by RRG) Wang J et al., 2020 [50]
Number of primary studies: Six
Study design: Five case series and one cohort study
Patients: Five articles were about SARS and one article was about MERS
Sources: Zero preprint, six journal articles
No, 0% No, 0% NA
Clinical question 6: should systemic corticosteroids be used to treat children with severe COVID-19? One rapid review (produced by RRG) Lu S et al., 2020 [51]
Number of primary studies: 23
Study design: One randomized controlled trial and 22 cohort studies
Patients: Five articles were about COVID-19 (all patients were adults), 17 articles were about SARS and one article was about MERS
Sources: Two preprints, 21 journal articles
Partially, 22% No, 0% 40.0% (2/5)
Clinical question 7: should intravenous immunoglobulin (IVIG) be used to treat children with severe COVID-19? One rapid review (produced by RRG) Zhang J et al., 2020 [52]
Number of primary studies: Six
Study design: One randomized controlled trial, four case series and one case report
Patients: Two articles were about COVID-19 (all patients were adults) and four articles were about SARS
Sources: One preprint, five journal articles
Partially, 33% No, 0% 50.0% (1/2)
Clinical question 8: what is appropriate supportive care for children with severe COVID-19? One umbrella review (produced by RRG) Luo X et al., 2020 [53]
Number of primary studies: 18
Study design: 18 systematic reviews
Patients: 18 articles were not about COVID-19, SARS and MERS
Sources: Zero preprint, 18 journal articles
No, 0% No, 0% NA
Clinical question 9: should mothers with COVID-19 continue to breastfeed their babies? Two rapid reviews (one rapid review produced by RRG, one previously published article) Yang N et al., 2020 [54]
Number of primary studies: Six
Study design: Five case reports and one case series
Patients: Five articles were about COVID-19 (all patients were mothers) and one article was influenza
Sources: Zero preprint, six journal articles
Partially, 83% No, 0% 0.0% (0/5)
Jefferson T et al., 2011 [59]
Number of primary studies: 67
Study design: Six randomized controlled trials, 17 non-randomized controlled trials, nine case–control studies, 22 cohort studies and 13 before-after controlled studies
Patients: 67 articles were not about COVID-19 and MERS
Sources: Six journal articles
No, 0% No, 0% NA
Clinical question 10: how should parents be advised to get information on SARS-CoV-2 infection? One rapid review (produced by RRG) Li W et al., 2020 [55]
Number of primary studies: 24
Study design: 24 cross-sectional studies
Patients: Six articles were about COVID-19 (almost patients were adults), eight articles were about SARS, ten articles were about MERS
Sources: Zero preprint, 24 journal articles
Partially, 25% No, 0%a 0.0% (0/6)
  1. RRG Rapid Review Group
  2. aOnly a small population of the included COVID-19 studies were pediatric patients, so we do not consider evidence from these studies as evidence from children with COVID-19