Effectiveness of intravenous immunoglobulin for children with severe COVID-19: a rapid review

  1. on behalf of COVID-19 Evidence and Recommendations Working Group
  2. Jingyi Zhang
  3. Yinmei Yang
  4. Nan Yang
  5. Yanfang Ma
  6. Qi Zhou
  7. Weiguo Li
  8. Xia Wang
  9. Liping Huang
  10. Xufei Luo
  11. Toshio Fukuoka
  12. Hyeong Sik Ahn
  13. Myeong Soo Lee
  14. Zhengxiu Luo
  15. Yaolong Chen
  16. Enmei Liu
  17. Kehu Yang
  18. Zhou Fu

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Abstract

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  1. ScreenIT

    SciScore for 10.1101/2020.04.17.20064444: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    RandomizationWe used the Cochrane bias risk assessment tool (Risk of bias) to assess the randomized controlled trials and clinical controlled trials (20), the criteria recommended by the National Institute of Health and Clinical Optimization (NICE) for case series to assess the risk of bias (21), the Joanna Briggs Institute’(JBI) case report quality appraisal tool for case reports(22) Newcastle-Ottawa Quality Assessment Scale (NOS) for the quality of cohort studies and case-control studies (23), and Agency for Healthcare Research and Quality (AHRQ) tool for cross-sectional studies (24).
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Search strategy: We carried out a comprehensive search in the following electronic databases: the Cochrane library, MEDLINE (via PubMed), EMBASE, Web of Science, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), and Wanfang Data, by using the terms “COVID-19”, “SARS-CoV-2”, “Novel coronavirus”, “2019-novel coronavirus”, “2019-nCoV”, “SARS”, “MERS”, “IVIG”, “intravenous immunoglobulin” and their derivatives.
    Cochrane library
    suggested: (Cochrane Library, RRID:SCR_013000)
    MEDLINE
    suggested: (MEDLINE, RRID:SCR_002185)
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    EMBASE
    suggested: (EMBASE, RRID:SCR_001650)
    We also searched the World Health Organization Clinical Trials Registry Platform, ISRCTN Registry, ClinicalTrials, Google Scholar, three preprint services, including medRxiv (https://www.medrxiv.org/), bioRxiv (https://www.biorxiv.org/) and SSRN (https://www.ssrn.com/index.cfm/en/) and references of included studies.
    Google Scholar
    suggested: (Google Scholar, RRID:SCR_008878)
    bioRxiv
    suggested: (bioRxiv, RRID:SCR_003933)
    Study selection: After eliminating duplicates by EndNote software and manual check, two reviewers (J Zhang and Y Yang) independently reviewed the titles and abstracts of records retrieved from the search and selected all potentially relevant studies according to the pre-defined inclusion and exclusion criteria.
    EndNote
    suggested: (EndNote, RRID:SCR_014001)
    We used the Cochrane bias risk assessment tool (Risk of bias) to assess the randomized controlled trials and clinical controlled trials (20), the criteria recommended by the National Institute of Health and Clinical Optimization (NICE) for case series to assess the risk of bias (21), the Joanna Briggs Institute’(JBI) case report quality appraisal tool for case reports(22) Newcastle-Ottawa Quality Assessment Scale (NOS) for the quality of cohort studies and case-control studies (23), and Agency for Healthcare Research and Quality (AHRQ) tool for cross-sectional studies (24).
    Cochrane
    suggested: (Cochrane Library, RRID:SCR_013000)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strength and limitations: This is the first systematic review of IVIG treatment for children with COVID-19. There are several limitations in this systematic review. First, the use of glucocorticoids or a combination of a variety of broad-spectrum antibiotics before IVIG may lead to changes in the microecology of the body, affect the immune regulation function, and thus also affect the effect of IVIG. Second, the total sample size of this study was insufficient to make strong conclusions, and the quality of the methodology was generally low which affect the certainty of the results. Finally, we may have missed some studies as we only included studies published in Chinese and English. Conclusion: There is no direct evidence for IVIG in children with COVID-19, current evidence is insufficient to assess the effectiveness and safety of IVIG for children with severe COVID-19. Therefore, we cannot suggest use of IVIG for the treatment of COVID-19 in children. More clinical studies to address this topic are needed.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.21037/atm-20-3305
  3. Version published to 10.1101/2020.04.17.20064444 on medRxiv