Evidence map›Paper›PMID 35701866›Full record

ArticlePediatrics2022

Medications and Adherence to Treatment Guidelines Among Children Hospitalized With Acute COVID-19.

Julianne E Burns, Cary Thurm, James W Antoon, Carlos G Grijalva, Matt Hall, Adam L Hersh, Gabrielle Z Hester, Emilie Korn, Mario A Reyes, Samir S Shah and 2 more

Open access · greenAbstract readMulticenter Study
In one paragraph

Article in Pediatrics, 2022. 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
0.4field-weighted citation impact, top 40% 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. Article
  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

12 authors at 9 institutions in 1 country.

Julianne E BurnsDepartment of Pediatrics, Division of Hospital Medicine, Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Cary ThurmChildren's Hospital Association, Lenexa, Kansas.
James W AntoonDepartment of Pediatrics, Vanderbilt University School of Medicine and Division of Hospital Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee.
Carlos G GrijalvaDepartment of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.
Matt HallChildren's Hospital Association, Lenexa, Kansas.
Adam L HershDepartment of Pediatrics, Division of Infectious Diseases, University of Utah, Salt Lake City, Utah.
Gabrielle Z HesterDepartment of Value and Clinical Excellence, Children's Minnesota, Minneapolis, Minnesota.
Emilie KornDepartment of Pediatrics, Division of Hospital Medicine, Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Mario A ReyesDepartment of Pediatrics, Division of Hospital Medicine, Nicklaus Children's Hospital, Miami, Florida.
Samir S ShahDepartment of Pediatrics, University of Cincinnati College of Medicine and Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Balagangadhar R TotapallyDepartment of Pediatrics, Herbert Wertheim College of Medicine, Florida International University and Division of Critical Care Medicine, Nicklaus Children's Hospital, Miami, Florida.
Ronald J TeufelDepartment of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.
Children's Hospital Association · USMiami Children's Hospital · USUniversity of Pennsylvania · USChildren's Minnesota · USMedical University of South Carolina · USMonroe Carell Jr. Children's Hospital · USUniversity of Cincinnati · USUniversity of Utah · USVanderbilt University Medical Center · US

Funding

Mentoring in transmission of influenza and strategies for preventionK24AI148459 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI GRIJALVA, CARLOS G · 2020 to 2024
$893k
NIAID NIH HHS K24 AI148459
6 · The paper itself

Abstract

objectivesCoronavirus disease 2019 (COVID-19) treatment guidelines rapidly evolved during the pandemic. The December 2020 Infectious Diseases Society of America (IDSA) guideline, endorsed by the Pediatric Infectious Diseases Society, recommended steroids for critical disease, and suggested steroids and remdesivir for severe disease. We evaluated how medications for children hospitalized with COVID-19 changed after guideline publication.

methodsWe performed a multicenter, retrospective cohort study of children aged 30 days to <18 years hospitalized with acute COVID-19 at 42 tertiary care US children's hospitals April 2020 to December 2021. We compared medication use before and after the December 2020 IDSA guideline (pre- and postguideline) stratified by COVID-19 disease severity (mild-moderate, severe, critical) with interrupted time series.

resultsAmong 18 364 patients who met selection criteria, 80.3% were discharged in the postguideline period. Remdesivir and steroid use increased postguideline relative to the preguideline period, although the trend slowed. Postguideline, among patients with severe disease, 75.4% received steroids and 55.2% remdesivir, and in those with critical disease, 82.4% received steroids and 41.4% remdesivir. Compared with preguideline, enoxaparin use increased overall but decreased among patients with critical disease. Postguideline, tocilizumab use increased and hydroxychloroquine, azithromycin, anakinra, and antibiotic use decreased. Antibiotic use remained high in severe (51.7%) and critical disease (81%).

conclusionsAlthough utilization of COVID-19 medications changed after December 2020 IDSA guidelines, there was a decline in uptake and incomplete adherence for children with severe and critical disease. Efforts should enhance reliable delivery of guideline-directed therapies to children hospitalized with COVID-19 and assess their effectiveness.

Indexed as

COVID-19 Drug TreatmentAnti-Bacterial AgentsChildHospitalizationHumansPandemicsRetrospective StudiesAnti-Bacterial Agents

Identifiers

PMID35701866
PMCPMC9444870
OpenAlexW4282913565

What Socratic holds

Textmetadata
LicenceTDM
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 Socratic graph.