Table 6.

Key data sets collected and their rationale.

Key Data Sets	Rationale
Number of paediatric patients being treated in the hospital during the ten-day period and the number with COVID-19	To gain insight into current prevalence rates among children admitted to hospitals in Bangladesh compared with other conditions
Whether COVID-19 was suspected or confirmed—confirmed with PCR tests	To gain additional insight into current COVID-diagnostic practices
The ages of admitted children	Patients’ ages were broken down into 3 bands: 0–5 years; 6–10 years; 11–18 years for comparative purposes based on the pilot study in both Bangladesh and India [62,63]
Principal reason for admission to hospital with actual/suspected COVID-19	Potentially up to 3 principal reasons for admission could be recorded among participating hospitals These were taken from a drop-down menu in the Microsoft Excel® spreadsheets and consisted of (i) breathing difficulties/respiratory distress; (ii) prolonged fever; (iii) cough; (iv) diarrhoea; and (v) feeding difficulty/vomiting These reasons were taken from the current literature, combined with input from paediatricians in Bangladesh, and tested in the pilot study [8,9,11,12,13,62] Consolidating the reasons would assist with analysis and comparisons with published studies
Comorbidities	Based on evidence amongst adults that certain comorbidities do have an impact on morbidity and mortality associated with COVID-19 [94,95]
Number of children admitted to PICU and the rationale	The potential reasons for admittance taken from the literature and input from paediatricians in Bangladesh included: (i) severe respiratory distress/low O2 saturation; (ii) shock; (iii) coagulation disorders/thromboembolic manifestations; and (iv) extensive lung involvement in high-resolution CT scans (HRCTs) [9,13,62] These potential reasons were standardised in the data collection forms for ease of recording and analysis and tested in the pilot study
Number of children prescribed antibiotics and the antibiotics prescribed (by ATC Level 4 Grouping or individual antibiotics), and whether empiric or following CST findings	This was assessed given concerns with potential over-prescribing coupled with guidance from the Bangladesh Paediatric Association, advocating prudence [61] Antibiotic prescribing also assessed against the WHO Access, Watch, or Reserve (AwaRe) list, given the increasing importance of this list to guide future antimicrobial policies and practices [76,86,88,96,97] The list of antibiotics prescribed for admitted children in specific hospitals was provided in a menu in the Case Report Forms (Supplementary Material File S1) and consolidated for tabulation and analysis
Route of administration, whether the rationale for antibiotic prescribing was re-assessed, and, if so, after how many days, and total length of antibiotic prescriptions	Given prior awareness that antibiotics administered to children admitted to hospital are usually administered by IV To determine whether: ○There was any scaling down to oral antibiotics, as this can shorten hospital length of stay [91,98,99]. If so, the extent ○There was any documented rationale for the antibiotics prescribed when re-assessed, especially with high empiric use, to help guide future quality improvement programmes among hospitals in Bangladesh
The extent of prescribing of antivirals, e.g., remdesivir, antimalarials, e.g., hydroxychloroquine, and antiparasitic medicines, e.g., ivermectin	Assessed, given concerns with their effectiveness and safety as more robust data became available, and should be reserved if administered (antivirals) according to the Bangladesh Paediatric Guidelines [40,43,44,46,48,61] Potentially, remdesivir for the management of patients in hospital with moderate to severe COVID-19 requiring oxygen, in the national Ministry of Health guidelines issued in Spring 2020 [60]—discretion of the hospital consultant
The extent of prescribing of dexamethasone and other steroids, including methylprednisolone	Seen as potentially beneficial, especially among hospitalised patients, and endorsed in the guidelines [46,61,100]
Use of supplements/immune boosters including vitamins C or D or zinc	Discussed in the Bangladesh Paediatric Guidelines, with publications suggesting potential benefit [61,101,102]
Adherence to current guidelines, including those developed by the Bangladesh Paediatric Association —Table 1 [50]	Adherence to robust guidelines is increasingly recognised as a key marker of quality used in the Global PPS studies as well as across hospitals in LMICs [83,103,104,105], given the concerns that can exist among LMICs [106,107,108] Published studies have shown that adherence to guidelines improves antimicrobial prescribing, as seen with the management of surgical site infections across LMICs as well as with the monitoring of prescribing guidance, built into antimicrobial stewardship programmes [28,67,70,109] However, adherence is not monitored and potentially enforced as the Bangladesh Paediatric Association is a non-government organisation. This is different to the situation that can exist across countries, sectors and disease areas [28,110,111]
Outcome—fully recovered, morbidity or mortality	Pertinent study endpoints Taken from the medical records of children during the study period by the principal investigator in each hospital
Possible costs (principally private hospitals) (based on local currency)	These were based on possible charges by the hospital (typically private hospitals) No attempt was made to undertake costing studies in public hospitals as this was not the objective of the paper

PICU = Pediatric Intensive Care Unit.