Evidence map›Paper›PMID 33683393›Full record

ArticleRheumatology international2021

Therapeutic approaches to pediatric COVID-19: an online survey of pediatric rheumatologists.

Ales Janda, Catharina Schuetz, Scott Canna, Mark Gorelik, Maximilian Heeg, Kirsten Minden, Claas Hinze, Ansgar Schulz, Klaus-Michael Debatin, Christian M Hedrich and 1 more

Open access · hybridAbstract read
In one paragraph

Article in Rheumatology international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 9 institutions in 3 countries.

Ales JandaDepartment of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Eythstrasse 24, 89075, Ulm, Germany. ales.janda@uniklinik-ulm.de.ORCID 0000-0001-5604-8378
Catharina SchuetzDepartment of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Scott CannaUniversity of Pittsburgh, Pittsburgh, PA, USA.
Mark GorelikDepartment of Pediatrics, Division of Allergy, Immunology, and Rheumatology, Columbia University Irving Medical Center, New York Presbyterian Morgan Stanley Childrens Hospital of New York, New York, NY, USA.
Maximilian HeegInstitute for Immunodeficiency, Center for Chronic Immunodeficiency (CCI), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Kirsten MindenCharité University Medicine Berlin, German Rheumatism Research Center Berlin, Berlin, Germany.
Claas HinzeUniversity Hospital Munster, Munster, Germany.
Ansgar SchulzDepartment of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Eythstrasse 24, 89075, Ulm, Germany.
Klaus-Michael DebatinDepartment of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Eythstrasse 24, 89075, Ulm, Germany.
Christian M HedrichDepartment of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool & Department of Paediatric Rheumatology, Alder Hey Childrens NHS Foundation Trust Hospital, Liverpool, Great Britain.
Fabian SpethDepartment of Pediatric Rheumatology, Pediatric Bone Marrow Transplantation and Immunology Unit, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Universität Ulm · DEGerman Rheumatism Research Centre · DEMorgan Stanley Children's Hospital · USUniversität Hamburg · DEUniversity Hospital Carl Gustav Carus · DEUniversity Hospital Münster · DEUniversity of Freiburg · DEUniversity of Liverpool · GBUniversity of Pittsburgh · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Data on therapy of COVID-19 in immunocompetent and immunosuppressed children are scarce. We aimed to explore management strategies of pediatric rheumatologists. All subscribers to international Pediatric Rheumatology Bulletin Board were invited to take part in an online survey on therapeutic approaches to COVID-19 in healthy children and children with autoimmune/inflammatory diseases (AID). Off-label therapies would be considered by 90.3% of the 93 participating respondents. In stable patients with COVID-19 on oxygen supply (stage I), use of remdesivir (48.3%), azithromycin (26.6%), oral corticosteroids (25.4%) and/or hydroxychloroquine (21.9%) would be recommended. In case of early signs of "cytokine storm" (stage II) or in critically ill patients (stage III) (a) anakinra (79.5% stage II; 83.6% stage III) or tocilizumab (58.0% and 87.0%, respectively); (b) corticosteroids (oral 67.2% stage II, intravenously 81.7% stage III); (c) intravenous immunoglobulins (both stages 56.5%); or (d) remdesivir (both stages 46.7%) were considered. In AID, > 94.2% of the respondents would not support a preventive adaptation of the immunomodulating therapy. In case of mild COVID-19, more than 50% of the respondents would continue pre-existing treatment with immunoglobulins (100%), hydroxychloroquine (94.2%), anakinra (79.2%) or canakinumab (72.5%), or tocilizumab (69.8%). Long-term corticosteroids would be reduced by 26.9% (< = 2 mg/kg/d) and 50.0% (> 2 mg/kg/day), respectively, with only 5.8% of respondents voting to discontinue the therapy. Conversely, more than 75% of respondents would refrain from administering cyclophosphamide and anti-CD20-antibodies. As evidence on management of pediatric COVID-19 is incomplete, continuous and critical expert opinion and knowledge exchange is helpful.

Indexed as

COVID-19 Drug TreatmentAntirheumatic AgentsAntiviral AgentsAutoimmune DiseasesCase-Control StudiesChildCOVID-19HumansImmunomodulationPandemicsRheumatologySARS-CoV-2Surveys and QuestionnairesAntirheumatic AgentsAntiviral AgentsAutoimmune diseaseChildrenCOVID-19InflammationOpinion pollPediatric rheumatologySARS-CoV-2Treatment

Identifiers

PMID33683393
PMCPMC7938886
OpenAlexW3135889865

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.