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.

Chest pain or dyspnoea following COVID-19 vaccination

Added: 4 May 2022

What is the 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.

COVID-19 pandemic and influenza

Added: 14 Apr 2022

What is the evidence for COVID-19 pandemic and influenza?
  • During the COVID-19 pandemic many jurisdictions have seen a sharp decline in influenza circulation, especially during the typical flu season, compared to pre-pandemic periods.
  • Vaccination remains one of the most effective measures to prevent influenza outbreaks, and is seen as critically important following relaxation of COVID-19 restrictions.
  • Australian Technical Advisory Group on Immunisation advises that influenza vaccines can be co-administered (i.e. on the same day) with the COVID-19 vaccines.

COVID-19 vaccines in Australia

Added: 19 Aug 2021
Updated: 18 Mar 2022

What is the evidence on COVID-19 vaccines in Australia?
  • Internationally as of 16 March 2022, 35 vaccines are approved and 11.04 billion doses have been administered.
  • In Australia, four vaccines have been approved for use - Comirnaty (Pfizer), Spikevax (Moderna), Vaxzevria (AstraZeneca), and Nuvaxovid (Novavax). As of 13 March 2022, approximately 55.1 million doses have been administered.
  • All vaccines that are approved for use have strong safety profiles and benefit to risk ratios.

Omicron (BA.2 sub-lineage)

Added: 11 Feb 2022
Updated: 18 Mar 2022

What is the available evidence for the BA.2 sub-lineage of the Omicron variant of concern?
  • Omicron includes four Pango lineages: the parental B.1.1.529 and the descendent lineages BA.1, BA.2 and BA.3. WHO is monitoring all variants under ‘Omicron’.
  • Properties of BA.2 are under investigation but remain unclear. WHO recommends that investigations into the characteristics of BA.2, including immune escape properties and virulence, should be prioritised independently (and comparatively) to BA.1.
  • The UK Health Security Agency (UKHSA) Variant Technical Group designated BA.2 as a ‘variant under investigation’ on 19 January 2022.

Archive Budesonide and aspirin for pregnant women with COVID-19

Added: 25 Feb 2022

What is the evidence for the use of Budesonide for pregnant women with COVID-19? What is the evidence for aspirin prophylaxis for pre-eclampsia in pregnant women with a COVID-19 infection?
  • While the early administration of budesonide has been shown to improve outcomes for people with COVID-19 more broadly, evidence is lacking on its use in pregnant women with COVID-19.
  • Evidence prior to COVID-19 has shown inhaled corticosteroids, including budesonide, are safe in pregnant women.
  • Narrative reviews and guidance for women with COVID-19, or during the COVID-19 pandemic, generally recommend low-dose aspirin as primary and secondary prophylaxis for pregnancy complications including preeclampsia.

Archive COVID-19 pandemic and wellbeing of critical care and other healthcare workers

Added: 18 Feb 2022

Evidence in brief on the impact of the COVID-19 pandemic on the wellbeing of critical care and other healthcare workers.
  • During the COVID-19 pandemic, critical care and other healthcare workers may be at increased risk of physical and mental stress, including depression, anxiety, exhaustion and burnout.
  • Managing the wellbeing of healthcare workers during the pandemic may include providing psychological support, assisting with basic needs and promoting self-care.
  • There is limited evidence on the effectiveness of different management strategies.

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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