American College of Rheumatology Guidance for the Management of Children with Pediatric Rheumatic Disease During the COVID-19 Pandemic: Version 1.
Year of Publication
2020 Jul 23
<p><strong>OBJECTIVE: </strong>To provide clinical guidance to rheumatology providers who treat children with PRD in the context of the COVID-19 pandemic.</p>
<p><strong>METHODS: </strong>The task force, consisting of 7 pediatric rheumatologists, 2 pediatric infectious disease physicians, one adult rheumatologist and one pediatric nurse practitioner, was convened on May 21, 2020. Clinical questions and subsequent guidance statements were drafted based on review of queries posed by patients, families and healthcare providers of children with PRD. An evidence report was generated and disseminated to task force members to assist with three rounds of asynchronous, anonymous voting by email using a modified Delphi approach. Voting was completed using a 9-point numeric scoring system with predefined levels of agreement ("disagreement"; "uncertain"; "agreement") and consensus. To be approved as a guidance statement, median votes were required to fall into the highest tertile for agreement with "moderate" (M) or "high" (H) levels of consensus.</p>
<p><strong>RESULTS: </strong>33 guidance statements were drafted and voted upon during rounds two and three of voting. Of these statements, all received median votes within the highest tertile of agreement and were associated with moderate (n=6) or high consensus (n=27). Statements with similar recommendations were combined, resulting in 27 final guidance statements.</p>
<p><strong>CONCLUSION: </strong>These guidance statements have been generated based on review of the available literature, indicating that children with PRD do not appear to be at increased risk for susceptibility to SARS-CoV-2 infection. This guidance is presented as a "living document," recognizing that the literature on COVID-19 is rapidly evolving, with future updates anticipated.</p>