Evidence Check

A rapid review outlining the available evidence on a discrete topic or question relating to the current COVID-19 pandemic. Evidence includes grey and peer review literature. View all Evidence Checks by date of publication.

Influenza and seasonal prophylaxis with oseltamivir

Added: 17 Jun 2022

What is the place or evidence for seasonal influenza prophylaxis (such as taking oseltamivir for 10 to 12 weeks continuously) in healthcare and aged care settings?
What is the place or evidence for seasonal influenza prophylaxis in high-risk patients who have or require frequent contact with healthcare facilities (for example, dialysis patients)?
  • No systematic reviews have been conducted on this topic since 2013. Three older reviews note that there is some evidence for the effectiveness of oseltamivir as seasonal prophylaxis in at-risk adults. However, the quality of those studies was evaluated as low. Notably, many older studies and reviews on this topic have been criticised due to their heavy involvement of pharmaceutical sponsors and lack of replication or transparent data.
  • In adults, very few studies provide real-life evidence for the use of oseltamivir for seasonal prophylaxis in at-risk adult populations. The few that do exist found a positive benefit in reducing influenza incidence and secondary complications in long-term care residents, dialysis and transplant patients.
  • In children and adolescents who are immunocompromised, unvaccinated or at risk of influenza complications, there is stronger and more recent evidence to recommended seasonal oseltamivir.

Rapid access models of care for respiratory illnesses

Added: 17 Jun 2022

What is the evidence for rapid access models of care for respiratory illnesses, especially during winter seasons, in emergency departments?
  • Alternative models of care for acute respiratory illnesses aim to reduce the demand for emergency department and other inpatient hospital services and support patients in the community and at home.
  • Existing alternative models of care include respiratory clinics which respond to referrals from the primary care clinicians or emergency departments and are staffed by specialist respiratory clinicians, pre-hospital emergency pathways which attend to emergency medical calls at homes, acute management and observation services provided by trained general practitioners and nurses, and general practice respiratory clinics for people with low acuity respiratory symptoms.

Current and emerging patient safety issues during COVID-19

Added: 17 Jun 2022

Question: What is the evidence on the current and emerging patient safety issues arising from the COVID-19 pandemic?
  • There are wide-ranging reports on the indirect impacts of COVID-19 and associated mitigation strategies such as lockdowns and service shutdowns.
  • The literature not only discusses conventional patient safety issues, but also issues around delayed access to healthcare and equity issues.

Post-acute sequelae of COVID-19

Added: 6 Dec 2021
Updated: 6 Jun 2022

What is the evidence on the prevalence, severity, diagnosis and management of long-COVID?
  • Recent prevalence estimates suggest that between 3.69 and 20% of individuals who experience COVID-19 infection develop long COVID.
  • In a clinical setting, there is no definitive test for long COVID, and diagnosis is based on ruling out other similar conditions.
  • Risk factors for long COVID include: being female, being older, living in more deprived areas, working in social care, teaching and education or health care, and having another activity-limiting health condition or disability.

Emerging variants

Added: 13 May 2022

What is the available evidence for emerging variants?
  • The World Health Organization is monitoring BA.1, BA.2, BA.3, BA.4, BA.5 and descendent lineages and BA.1/BA.2 circulating recombinant forms such as XE under Omicron, however, the World Health Organization advises that public health authorities should monitor descendant lineages as distinct lineages.
  • Variants under monitoring listed by the World Health Organization include B.1.640 and XD recombinant (Delta AY.4 and Omicron BA.1).
  • Three Omicron sublineages BA.4, BA.5 and BA.2.12.1 have acquired additional mutations that may impact their characteristics (BA.4 and BA.5 have the del69/70, L452R and F486V mutations, BA.2.12.1 has the L452Q and S704L mutations).

Chest pain or dyspnoea following COVID-19 vaccination

Added: 4 May 2022

What is evidence for chest pain or dyspnoea following COVID-19 vaccination?
  • Chest pain, fever, dyspnoea and palpitation are the most commonly-reported symptoms after COVID-19 vaccine-associated myocarditis and pericarditis.
  • Myocarditis and pericarditis occur more frequently in younger males, and following the second vaccination dose. Mean symptom onset is within one week of vaccination and cases are usually mild and resolve quickly.
  • mRNA COVID-19 vaccines are associated with a higher risk of myocarditis or pericarditis compared to non-mRNA vaccines.

Cardiac investigations and elective surgery post-COVID-19

Added: 4 May 2022

What is evidence for cardiac investigations and elective surgery post-COVID-19?
  • There is limited guidance on cardiac specific investigations for patients undergoing elective surgery following SARS-CoV-2 infection. However, standard clinical practice guidelines for perioperative cardiac risk assessment may be generalised to most patients with COVID-19 undergoing non-cardiac surgery.
  • Guidance generally recommends elective surgery be deferred seven weeks or more after COVID‑19 diagnosis.

Breathlessness post COVID-19

Added: 4 May 2022

How to determine those patients who present with ongoing breathlessness in need of urgent review or intervention due to suspected pulmonary embolus?
  • SARS-CoV-2 infection can affect multiple organs, including the respiratory and cardiovascular system.
  • Shortness of breath (dyspnoea) is one of the commonly reported symptoms in people experiencing post-acute sequelae of COVID-19.
  • The prevalence of persistent breathlessness is estimated to be around 25% three to 12 months after recovery from the acute phase of COVID-19.

Daily Evidence Digest

Rapid evidence checks are based on a simplified review method and may not be entirely exhaustive, but aim to provide a balanced assessment of what is already known about a specific problem or issue. This brief has not been peer-reviewed and should not be a substitute for individual clinical judgement, nor is it an endorsed position of NSW Health. Evidence checks are archived a year after the date of publication.

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