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.

Oseltamivir (Tamiflu) use in healthcare settings

Added: 25 Jul 2022

What is the evidence that use of oseltamivir in healthcare workers with a symptomatic influenza diagnosis result in an earlier return to work and reduced absenteeism?
What is the evidence that use of oseltamivir in adults and children with symptomatic influenza reduces influenza transmission in health care settings?
  • Evidence on the effectiveness of antivirals in reducing absenteeism in healthcare workers with symptomatic diagnosis is lacking, and data on healthcare service disruption are not readily available.
  • Oseltamivir decreases the time until patients are symptom-free by approximately one day.
  • Oseltamivir treatment is associated with side effects including nausea and vomiting. Risk of side effects need to be balanced with the marginal benefits of treatment, especially in healthy individuals such as staff.

Alternative models of care for acute medical conditions

Added: 25 Jul 2022

What is the evidence on alternative models of care for managing patients with acute medical conditions outside of emergency or inpatient hospital settings?
  • Evidence generated on alternative models of care is context dependent, particularly with respect to country, organisation and funding, collaboration between hospital, primary care and other community or residential aged care services and patient population. This leads to difficulty in generalising findings.
  • Overall, alternative models of care can be promising in terms of reducing presentations to the emergency department and subsequent admissions, especially for younger and otherwise healthy individuals without comorbidities.

Exercise and long COVID

Added: 15 Jul 2022

Is exercise helpful in individuals with long COVID?
Is post-exertional symptom exacerbation a risk in long COVID?
  • Studies evaluating pulmonary rehabilitation and exercise in long COVID show that exercise is beneficial to improving functional outcomes such as movement, muscle strength and quality of life.
  • However, some people with long COVID appear to be at risk of post-exertional fatigue or malaise. There is little research on this to date.
  • There is a need for high quality research into long COVID rehabilitation, including the role of exercise, particularly in the context of the Omicron variant.

Archive Rapid testing - retired living evidence

Added: 14 Jul 2022

What evidence is available about rapid testing and COVID-19?
  • Rapid point-of-care tests provide results within minutes of the test being administered, allowing for rapid decisions about patient care. It also provides the possibility to extend testing to geographically isolated communities and populations that cannot readily access onsite diagnostic services.
  • Quantitative reverse transcription-PCR (RT-qPCR) assay for COVID-19 using upper and lower respiratory tract specimens (nasopharyngeal swab, throat swab and sputum) is considered the gold standard for diagnosing COVID-19.

Archive Surgery and COVID-19 - retired living evidence

Added: 14 Jul 2022

What evidence is available about surgery and COVID-19?
  • This evidence table includes information on surgery and COVID-19.
  • It focuses on testing, outcomes, vaccines, workforce, personal protective equipment and aerosol generating procedures.

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.

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).

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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