Table 3 The questions and supporting evidence from rapid reviews
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MERS and two articles were about SARS and other infectious diseases Sources: Zero preprint, 28 journal articles and one unpublished report | Partially, 34% | No, 0%* | 0.0%(0/10) | ||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., 2020Â [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., 2020Â [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., 2020Â [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) |