Evidence check
A rapid review outlining the available evidence on a discrete topic or question. Evidence includes grey and peer review literature. View all Evidence Checks by date of publication.
Archive 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.
Archive 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).
Archive 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.
Archive 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.
Archive 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.
Archive 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.
Archive 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.
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.