美国风湿病学会关于 COVID-19 大流行期间儿童风湿病管理的指南：第 1 版。
American College of Rheumatology Guidance for the Management of Pediatric Rheumatic Disease During the COVID-19 Pandemic: Version 1.
机构信息
Children's Hospital at Montefiore and Albert Einstein College of Medicine, New York, New York.
Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
出版信息
Arthritis Rheumatol. 2020 Nov;72(11):1809-1819. doi: 10.1002/art.41455. Epub 2020 Sep 28.
OBJECTIVE
To provide clinical guidance to rheumatology providers who treat children with pediatric rheumatic disease (PRD) in the context of the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
The task force, consisting of 7 pediatric rheumatologists, 2 pediatric infectious disease physicians, 1 adult rheumatologist, and 1 pediatric nurse practitioner, was convened on May 21, 2020. Clinical questions and subsequent guidance statements were drafted based on a review of the queries posed by the patients as well as the families and healthcare providers of children with PRD. An evidence report was generated and disseminated to task force members to assist with 3 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 (categorized as disagreement, uncertainty, or agreement, with median scores of 1-3, 4-6, and 7-9, respectively) and consensus (categorized as low, moderate, or high). To be approved as a guidance statement, median vote ratings were required to fall into the highest tertile for agreement, with either moderate or high levels of consensus.
RESULTS
The task force drafted 33 guidance statements, which were voted upon during the second and third rounds of voting. Of these 33 statements, all received median vote ratings within the highest tertile of agreement and were associated with either moderate consensus (n = 6) or high consensus (n = 27). Statements with similar recommendations were combined, resulting in 27 final guidance statements.
CONCLUSION
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.
目的
在 2019 年冠状病毒病（COVID-19）大流行背景下，为治疗儿科风湿病（PRD）患儿的风湿病医生提供临床指导。
方法
该工作组由 7 名儿科风湿病专家、2 名儿科传染病医生、1 名成人风湿病医生和 1 名儿科执业护士组成，于 2020 年 5 月 21 日召开会议。根据患者、PRD 患儿家属和医护人员提出的问题，起草临床问题和后续指导意见。生成证据报告并分发给工作组成员，采用改良 Delphi 法通过电子邮件进行 3 轮异步、匿名投票。投票使用 9 分制数字评分系统进行，预设了同意程度（分为不同意、不确定或同意，中位数评分分别为 1-3、4-6 和 7-9）和共识程度（分为低、中和高）。要作为指导意见获得批准，中位数投票评分必须属于同意程度的最高三分位，且共识程度为中或高。
结果
工作组起草了 33 条指导意见，并在第二轮和第三轮投票中进行了投票。在这 33 条意见中，所有意见的中位数评分都在同意程度的最高三分位内，且共识程度为中或高（分别为 6 条意见和 27 条意见）。具有相似建议的意见被合并，最终形成了 27 条最终指导意见。
结论
这些指导意见是基于对现有文献的回顾得出的，表明 PRD 患儿似乎不易感染 SARS-CoV-2。本指导意见为“活文档”，认识到 COVID-19 相关文献正在迅速发展，预计未来会进行更新。
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