Sarah Chapman highlights Cochrane Reviews are systematic reviews. In systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. on COVID-19 and other health effects of the pandemic, with links to reviews, blogs and other Cochrane resources.
While we’ve all been adapting to huge and sudden changes in our lives and healthcare workers have been meeting unprecedented challenges, scientists have scrambled to produce research evidence relevant to the pandemic. Cochrane is responding by producing rapid reviews of this new evidence on priority topics, and these are updated as new evidence emerges. They show that much of the research that has been done so far leaves us with more unanswered questions than answers, but we must hope that this changes as new studies are available to add to the reviews.
Here’s a round-up of some of the Cochrane evidence so far.
Signs and symptoms of COVID-19
We’re hearing a lot about temperature checks, which in many places are being used determine whether someone may enter a care home, hairdressers or other building. But what’s the evidence? We’ve blogged about a Cochrane Review, published in July 2020, on the accuracy of any signs and symptoms, either alone or in combination, for diagnosing COVID‐19.
You can read the blog: “Signs and symptoms of COVID-19: new Cochrane evidence“. There is also a podcast and a Cochrane Clinical Answer.
Antibody tests for COVID-19
Antibody tests have the potential to identify people who have had COVID-19. A Cochrane Review ‘Antibody tests for identification of current and past infection with SARS-CoV-2′ was published in June 2020 and we have blogged about it: “Antibody tests for COVID-19: new evidence on test accuracy and some considerations“.
Rapid tests for COVID-19, done during a health care visit
Tests to detect COVID-19 that can give a result ‘while you wait’ (within a couple of hours) could be really useful, helping people isolate quickly to reduce the spread of infection. A Cochrane Review on Rapid, point‐of‐care antigen and molecular‐based tests for diagnosis of SARS‐CoV‐2 infection was published in August 2020. The review authors anticipate that they will have an update of the review this autumn and lead author Jacqueline Dinnes is going to blog about the updated review here.
Quarantine for controlling COVID-19
A Cochrane A rapid review is a simplified systematic review that can be done in a few weeks to produce timely evidence for decision-making. on quarantine alone or in combination with other public health measures to control COVID-19 was published in April 2020 and updated in September 2020. It is the focus of this blog: “Quarantine for controlling COVID-19 (coronavirus). New Cochrane evidence.”
You might also be interested in this blog ““Stay at home” rules: what makes people more likely to stick to quarantine?“, which looks at two non-Cochrane rapid reviews from researchers at King’s College London.
Contact tracing aims to reduce transmission of infection by identifying people who have been in contact with someone who has it, so that they can isolate. A Cochrane rapid review published in August 2020 looked at evidence on digital contact tracing technologies in epidemics.
The review highlights an evidence gap, the authors concluding that “the The ability of an intervention (for example a drug, surgery, or exercise) to produce a desired effect, such as reduce symptoms. of digital solutions is largely unproven as there are very few published Data is the information collected through research. in real‐world outbreak settings.”
Personal Protective Equipment (PPE) for healthcare workers
Two Cochrane Reviews are systematic reviews. In systematic reviews we search for and summarize studies that answer a specific research question (e.g. is paracetamol effective and safe for treating back pain?). The studies are identified, assessed, and summarized by using a systematic and predefined approach. They inform recommendations for healthcare and research. contribute to the evidence base on PPE for healthcare workers and we have a blog about these: “Personal protective equipment (PPE) for healthcare workers: new Cochrane evidence“. They look at Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff (May 2020) and Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis (April 2020).
For the review on PPE there is a Cochrane Clinical Answer. For the review on barriers and facilitators there is podcast and a Cochrane Clinical Answer. Evidence Synthesis Ireland and Cochrane Ireland have also created an infographic summarising key messages.
Convalescent plasma – a possible treatment for COVID-19?
Many Clinical trials are research studies involving people who use healthcare services. They often compare a new or different treatment with the best treatment currently available. This is to test whether the new or different treatment is safe, effective and any better than what is currently used. No matter how promising a new treatment may appear during tests in a laboratory, it must go through clinical trials before its benefits and risks can really be known. are being done to investigate the potential benefits or harms of using plasma from people who have recovered from COVID-19 to treat people who are currently ill with it. This blog: “Convalescent plasma to treat people with COVID-19: the evidence so far” looks at a Cochrane rapid review on convalescent plasma to treat people with COVID-19, updated in July 2020.
Oxygen therapy for adults in intensive care with acute respiratory distress syndrome
A Cochrane rapid review on oxygen targets in the intensive care unit during mechanical ventilation for acute respiratory distress syndrome has brought together evidence on this topic. The review authors explain the context:
“A health condition (or episodes of a health condition) that comes on quickly and is short-lived. respiratory distress syndrome (ARDS) is a very severe breathing problem with a high death The speed or frequency of occurrence of an event, usually expressed with respect to time. For instance, a mortality rate might be the number of deaths per year, per 100,000 people. (chance of dying). It has many potential causes, including viral infections such as COVID‐19, and there are no specific treatments for it except for giving patients oxygen via a ventilator (artificial breathing machine) on an intensive care unit, often for long periods of time. However, large amounts of oxygen (either a high concentration of oxygen or oxygen administered for a long period of time) are associated with increased harm due to other illnesses (e.g. heart attack or stroke).”
Here’s what they found:
Interventions for heavy menstrual bleeding
Pandemics disrupt healthcare provision. With this in mind, a Cochrane Overviews of reviews (Overviews) are intended to summarize multiple Cochrane Reviews addressing the effects of two or more potential interventions (for example a drug, surgery, or exercise) for a single condition or health problem. (July 2020) has been done on interventions commonly available during pandemics for heavy menstrual bleeding. You can see summaries of the review here, including an infographic to help women make choices about Something done with the aim of improving health or relieving suffering. For example, medicines, surgery, psychological and physical therapies, diet and exercise changes.. There is also a podcast about this review and two Cochrane Clinical Answers.
Routine vaccinations during the pandemic
The World Health Organization (WHO) has emphasized the importance of keeping up with routine vaccinations during the pandemic, advice endorsed by Public Health England. A Cochrane Review on vaccines for measles, mumps, rubella and varicella in children (published April 2020) was discussed in this blog: “MMR vaccines: do they work and are they safe?“.
There are two Cochrane Clinical Answers related to this review.
Social isolation and loneliness in older people
With restrictions imposed during the pandemic increasing isolation for many, a Cochrane rapid review (May 2020) looked for evidence on video calls for reducing social isolation and loneliness in older people. We discuss the review in this blog: “Loneliness in older people: could video calls help?”
Quitting smoking to improve respiratory health
Given the current threat from COVID-19, an acute respiratory infection, there has never been a better time to stop smoking, and the World Health Organization is urging people to do so. We have looked at evidence from a new Cochrane Special Collection, COVID-19: Effective options for quitting smoking during the pandemic, in this blog: “Smoking and coronavirus (COVID-19): time to quit.”
The Special Collection on quitting smoking during the pandemic is one of seven Cochrane Special Collections on COVID-19. Developed with experts from our global Cochrane network, they are based on World Health Organization interim guidance, and continuously updated.
Like the reviews themselves, we update our blogs to reflect the latest evidence. There are new reviews coming up, as well as updates of existing reviews, so check back for additions to this blog. Among others, we are anticipating a suite of three reviews on mouthwashes/nasal sprays to protect healthcare workers and patients from COVID-19 infection and a review on travel restrictions.
Keeping up to date
As well as coming back to this blog, you can find Cochrane resources and news on COVID-19 here and this will also be continually updated.
What COVID-19 evidence have you found useful and what would you like to see in the future? Please complete this Cochrane survey to let us know. Thank you.
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Sarah Chapman has nothing to disclose.
Editor’s note: This blog was last updated on the 14th September 2020.