scholarly journals SARS-CoV-2 and the role of fomite transmission: a systematic review

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 233
Author(s):  
Igho J. Onakpoya ◽  
Carl J. Heneghan ◽  
Elizabeth A. Spencer ◽  
Jon Brassey ◽  
Annette Plüddemann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sample Collection ◽  
Quality Of Reporting ◽  
Cycle Threshold ◽  
Healthcare Settings ◽  
Viral Culture ◽  
Mechanistic Pathway ◽  
General Wards ◽  
Study Designs

Background: SARS-CoV-2 RNA has been detected in fomites which suggests the virus could be transmitted via inanimate objects. However, there is uncertainty about the mechanistic pathway for such transmissions. Our objective was to identify, appraise and summarise the evidence from primary studies and systematic reviews assessing the role of fomites in transmission.  Methods: This review is part of an Open Evidence Review on Transmission Dynamics of SARS-CoV-2. We conduct ongoing searches using WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar; assess study quality based on five criteria and report important findings on an ongoing basis. Results: We found 64 studies: 63 primary studies and one systematic review (n=35). The settings for primary studies were predominantly in hospitals (69.8%) including general wards, ICU and SARS-CoV-2 isolation wards. There were variations in the study designs including timing of sample collection, hygiene procedures, ventilation settings and cycle threshold. The overall quality of reporting was low to moderate. The frequency of positive SARS-CoV-2 tests across 51 studies (using RT-PCR) ranged from 0.5% to 75%. Cycle threshold values ranged from 20.8 to 44.1. Viral concentrations were reported in 17 studies; however, discrepancies in the methods for estimation prevented comparison. Eleven studies (17.5%) attempted viral culture, but none found a cytopathic effect. Results of the systematic review showed that healthcare settings were most frequently tested (25/35, 71.4%), but laboratories reported the highest frequency of contaminated surfaces (20.5%, 17/83).  Conclusions: The majority of studies report identification of SARS-CoV-2 RNA on inanimate surfaces; however, there is a lack of evidence demonstrating the recovery of viable virus. Lack of positive viral cultures suggests that the risk of transmission of SARS-CoV-2 through fomites is low. Heterogeneity in study designs and methodology prevents comparisons of findings across studies. Standardized guidelines for conducting and reporting research on fomite transmission is warranted.

scholarly journals SARS-CoV-2 and the role of fomite transmission: a systematic review

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 233
Author(s):  
Igho J. Onakpoya ◽  
Carl J. Heneghan ◽  
Elizabeth A. Spencer ◽  
Jon Brassey ◽  
Annette Plüddemann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sample Collection ◽  
Quality Of Reporting ◽  
Cycle Threshold ◽  
Healthcare Settings ◽  
Viral Culture ◽  
Mechanistic Pathway ◽  
General Wards ◽  
Study Designs

Background: SARS-CoV-2 RNA has been detected in fomites which suggests the virus could be transmitted via inanimate objects. However, there is uncertainty about the mechanistic pathway for such transmissions. Our objective was to identify, appraise and summarise the evidence from primary studies and systematic reviews assessing the role of fomites in transmission.  Methods: This review is part of an Open Evidence Review on Transmission Dynamics of SARS-CoV-2. We conduct ongoing searches using WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar; assess study quality based on five criteria and report important findings on an ongoing basis. Results: We found 64 studies: 63 primary studies and one systematic review (n=35). The settings for primary studies were predominantly in hospitals (69.8%) including general wards, ICU and SARS-CoV-2 isolation wards. There were variations in the study designs including timing of sample collection, hygiene procedures, ventilation settings and cycle threshold. The overall quality of reporting was low to moderate. The frequency of positive SARS-CoV-2 tests across 51 studies (using RT-PCR) ranged from 0.5% to 75%. Cycle threshold values ranged from 20.8 to 44.1. Viral concentrations were reported in 17 studies; however, discrepancies in the methods for estimation prevented comparison. Eleven studies (17.5%) attempted viral culture, but none found a cytopathic effect. Results of the systematic review showed that healthcare settings were most frequently tested (25/35, 71.4%), but laboratories reported the highest frequency of contaminated surfaces (20.5%, 17/83).  Conclusions: The majority of studies report identification of SARS-CoV-2 RNA on inanimate surfaces; however, there is a lack of evidence demonstrating the recovery of viable virus. Lack of positive viral cultures suggests that the risk of transmission of SARS-CoV-2 through fomites is low. Heterogeneity in study designs and methodology prevents comparisons of findings across studies. Standardized guidelines for conducting and reporting research on fomite transmission is warranted.

scholarly journals SARS-CoV-2 and the role of fomite transmission: a systematic review

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 233 ◽  
Author(s):  
Igho J. Onakpoya ◽  
Carl J. Heneghan ◽  
Elizabeth A. Spencer ◽  
Jon Brassey ◽  
Annette Plüddemann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sample Collection ◽  
Quality Of Reporting ◽  
Cycle Threshold ◽  
Healthcare Settings ◽  
Viral Culture ◽  
Mechanistic Pathway ◽  
General Wards ◽  
Study Designs

Background: SARS-CoV-2 has been detected in fomites which suggests the virus could be transmitted via inanimate objects. However, there is uncertainty about the mechanistic pathway for such transmissions. Our objective was to identify, appraise and summarise the evidence from primary studies and systematic reviews assessing the role of fomites in transmission.  Methods: This review is part of an Open Evidence Review on Transmission Dynamics of SARS-CoV-2. We conduct ongoing searches using WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar; assess study quality based on five criteria and report important findings on an ongoing basis. Results: We found 64 studies: 63 primary studies and one systematic review (n=35). The settings for primary studies were predominantly in hospitals (69.8%) including general wards, ICU and SARS-CoV-2 isolation wards. There were variations in the study designs including timing of sample collection, hygiene procedures, ventilation settings and cycle threshold. The overall quality of reporting was low to moderate. The frequency of positive SARS-CoV-2 tests across 51 studies (using RT-PCR) ranged from 0.5% to 75%. Cycle threshold values ranged from 20.8 to 44.1. Viral concentrations were reported in 17 studies; however, discrepancies in the methods for estimation prevented comparison. Eleven studies (17.5%) attempted viral culture, but none found a cytopathic effect. Results of the systematic review showed that healthcare settings were most frequently tested (25/35, 71.4%), but laboratories reported the highest frequency of contaminated surfaces (20.5%, 17/83).  Conclusions: The majority of studies report identification of SARS-CoV-2 RNA on inanimate surfaces; however, there is a lack of evidence demonstrating the recovery of viable virus. Lack of positive viral cultures and variation in cycle thresholds create uncertainty about fomites as a mode of transmission. Heterogeneity in study designs and methodology prevents comparisons of findings across studies. Standardized guidelines for conducting and reporting research on fomite transmission is warranted.

scholarly journals Variables Associated With the Subjective Experience of Coercive Measures in Psychiatric Inpatients: A Systematic Review

2017 ◽  
Vol 63 (2) ◽  
pp. 129-144 ◽  
Author(s):  
Carlos Aguilera-Serrano ◽  
Jose Guzman-Parra ◽  
Juan A Garcia-Sanchez ◽  
Berta Moreno-Küstner ◽  
Fermin Mayoral-Cleries
Keyword(s):  
Systematic Review ◽  
Subjective Experience ◽  
Total Sample ◽  
Emotional Impact ◽  
Staff Support ◽  
Coercive Measures ◽  
Mechanical Restraint ◽  
Study Designs

Objective: This systematic review presents evidence regarding factors that may influence the patient’s subjective experience of an episode of mechanical restraint, seclusion, or forced administration of medication. Method: Two authors searched CINAHL, PubMed, SCOPUS, Web of Science, and Psych-Info, considering published studies between 1 January 1992 and 1 February 2016. Based on the inclusion criteria and methodological quality, 34 studies were selected, reporting a total sample of 1,869 participants. Results: The results showed that the provision of information, contact and interaction with staff, and adequate communication with professionals are factors that influence the subjective experience of these measures. Humane treatment, respect, and staff support are also associated with a better experience, and debriefing is an important procedure/technique to reduce the emotional impact of these measures. Likewise, the quality of the working and physical environment and some individual and treatment variables were related to the experience of these measures. There are different results in relation to the most frequently associated experiences and, despite some data that indicate positive experiences, the evidence shows such experiences to be predominantly negative and frequently with adverse consequences. It seems that patients find forced medication and seclusion to be more tolerable than mechanical restraint and combined measures. Conclusions: It appears that the role of the staff and the environmental conditions, which are potentially modifiable, affect the subjective experience of these measures. There was considerable heterogeneity among studies in terms of coercive measures experienced by participants and study designs.

scholarly journals Deficiencies in the reporting quality of RCTs in neurosurgery: How can we do better?

2015 ◽  
Vol 42 (S1) ◽  
pp. S12-S12
Author(s):  
A Mansouri ◽  
B Cooper ◽  
S Shin ◽  
D Kondziolka
Keyword(s):  
Sample Size Calculation ◽  
Reporting Quality ◽  
Allocation Concealment ◽  
High Yield ◽  
Quality Of Reporting ◽  
Randomized Controlled ◽  
Study Designs ◽  
Design Factors

Background: Deficiencies in design and reporting of randomized controlled trials (RCTs) limit their validity. The quality of recent RCTs in neurosurgery was analyzed to assess adequacy of design and reporting. Methods: A high-yield search of the MEDLINE and EMBASE databases (2000-present) was conducted. The CONSORT and Jadad scales were used to assess the quality of design/reporting. A PRECIS-based scale was used to designate studies on the pragmatic-explanatory continuum. Spearman’s test was used to assess correlations. Regression analysis was used to assess associations. Results: Sixty-one articles were identified. Vascular was the most common sub-specialty (37%). The median CONSORT and Jadad scores were 36 (IQR 27.5-39) and 3 (IQR 2-3). Blinding, sample size calculation and allocation concealment were most deficiently reported. The quality of reporting did not correlate with the study impact. The majority of studies (83%) had pragmatic objectives; while pragmatic studies had compatible design factors, trials with explanatory objectives were less successful. Conclusions: The prevalence and quality of neurosurgical RCTs is low. Many study designs are not compatible with stated objectives. Given the role of RCTs as one of the highest levels of evidence, it is critical to improve on their methodology and reporting. Alternative methodologies merit discussion.

scholarly journals SARS-CoV-2 and the role of airborne transmission: a systematic review

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 232
Author(s):  
Carl J. Heneghan ◽  
Elizabeth A. Spencer ◽  
Jon Brassey ◽  
Annette Plüddemann ◽  
Igho J. Onakpoya ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hospital Setting ◽  
Infectious Agent ◽  
Serial Passage ◽  
Sample Volume ◽  
Rt Pcr ◽  
Airborne Transmission ◽  
Viral Culture ◽  
Reported Data

Background: Airborne transmission is the spread of an infectious agent caused by the dissemination of droplet nuclei (aerosols) that remain infectious when suspended in the air. We carried out a systematic review to identify, appraise and summarise the evidence from studies of the role of airborne transmission of SARS-CoV-2. Methods: We searched LitCovid, MedRxiv, Google Scholar and the WHO Covid-19 database from 1 February to 20 December 2020 and included studies on airborne transmission. Data were dual extracted and we assessed quality using a modified QUADAS 2 risk of bias tool. Results: We included 67 primary studies and 22 reviews on airborne SARS-CoV-2. Of the 67 primary studies, 53 (79%) reported data on RT-PCR from air samples, 12 (18%) report cycle threshold values and 18 (127%) copies per sample volume. All primary studies were observational and of low quality. The research often lacked standard methods, standard sampling sizes and reporting items. We found 36 descriptions of different air samplers deployed. Of the 42 studies conducted in-hospital that reported binary RT-PCR tests, 24 (57%) reported positive results for SARs-CoV-2 (142 positives out of 1,403 samples: average 10.1%, range 0% to 100%). There was no pattern between the type of hospital setting (ICU versus non-ICU) and RT-PCR positivity. Seventeen studies reported potential air transmission in the outdoors or in the community, of which seven performed RT-PCR sampling, and two studies reported weak positive RNA samples for 2 or more genes (5 of 125 samples positive: average 4.0%). Ten studies attempted viral culture with no serial passage. Conclusion:  SARS-CoV-2 RNA is detected intermittently in the air in various settings. Standardized guidelines for conducting and reporting research on airborne transmission are needed. The lack of recoverable viral culture samples of SARS-CoV-2 prevents firm conclusions from being drawn about airborne transmission.

scholarly journals Association Between SARS-CoV-2 Cycle Threshold Values and Clinical Outcomes in Patients With COVID-19: A Systematic Review and Meta-analysis

2021 ◽  
Vol 8 (9) ◽  
Author(s):  
Vishal P Shah ◽  
Wigdan H Farah ◽  
James C Hill ◽  
Leslie C Hassett ◽  
Matthew J Binnicker ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Disease Severity ◽  
Meta Analysis ◽  
Severe Disease ◽  
Sample Type ◽  
Sample Collection ◽  
Cycle Threshold ◽  
Significant Difference ◽  
Polymerase Chain

Abstract Cycle threshold (CT) values are correlated with the amount of viral nucleic acid in a sample and may be obtained from some qualitative real-time polymerase chain reaction tests used for diagnosis of most patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, CT values cannot be directly compared across assays, and they must be interpreted with caution as they are influenced by sample type, timing of sample collection, and assay design. Presently, the correlation between CT values and clinical outcomes is not well understood. We conducted a systematic review and meta-analysis of published studies through April 19, 2021, that reported an association between CT values and hospitalization, disease severity, and mortality in patients ≥18 years old with SARS-CoV-2. A meta-analysis of 7 studies showed no significant difference in mean CT values between hospitalized and nonhospitalized patients. Among hospitalized patients, those with CT values <25 had a high risk of more severe disease and mortality than patients with CT values >30 (odds ratio [OR], 2.31; 95% CI, 1.70 to 3.13; and OR, 2.95; 95% CI, 2.19 to 3.96; respectively). The odds of increased disease severity and mortality were less pronounced in patients with CT values of 25–30 compared with >30.

Maternal Leisure-time Physical Activity and Risk of Preterm Birth: A Systematic Review of the Literature

2016 ◽  
Vol 13 (7) ◽  
pp. 796-807 ◽  
Author(s):  
Mira Kahn ◽  
Kim Robien ◽  
Loretta DiPietro
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Quality Reporting ◽  
Gestational Age At Delivery ◽  
Study Designs

Background:Preterm birth is a leading cause of infant death and the role of maternal physical activity on this risk remains unclear. This systematic review examined low, moderate and vigorous leisure-time physical activity (LTPA) during pregnancy and the outcome of preterm birth.Methods:Key words related to preterm birth and physical activity were used to search relevant databases (Medline, Cochrane, CINAHL, Sports Discuss and Scopus). Studies were excluded if they did not measure physical activity as an exposure in pregnant women, did not provide information on gestational age at delivery, and were not published in English. All study designs and sample sizes were considered.Results:The search generated 1472 studies. There were 27 studies included in this review of which 23 received high quality reporting scores. Eleven studies reported a lower risk of preterm birth for women who performed LTPA during pregnancy, while 14 studies reported null findings. Only 2 studies detected a significantly higher risk of preterm birth with LTPA during pregnancy.ConclusionThis review of literature up to 2014 provides additional evidence to support the assertion that healthy pregnant women can engage in low, moderate, and even some vigorous levels of LTPA without risk for preterm birth.

Surgical Care during Humanitarian Crises: A Systematic Review of Published Surgical Caseload Data from Foreign Medical Teams

2012 ◽  
Vol 27 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Jason W. Nickerson ◽  
Smita Chackungal ◽  
Lisa Knowlton ◽  
Kelly McQueen ◽  
Frederick M. Burkle
Keyword(s):  
Systematic Review ◽  
Surgical Care ◽  
Published Data ◽  
Quality Of Reporting ◽  
Surgical Disease ◽  
Humanitarian Crises ◽  
Qualitative Trend Analysis ◽  
Medical Teams ◽  
Surgical Teams

AbstractObjectiveHumanitarian surgery is often organized and delivered with short notice and limited time for developing unique strategies for providing care. While some surgical pathologies can be anticipated by the nature of the crisis, the role of foreign medical teams in treating the existing and unmet burden of surgical disease during crises is unclear. The purpose of this study was to examine published data from crises during the years 1990 through 2011 to understand the role of foreign medical teams in providing surgical care in these settings.MethodsA literature search was completed using PubMed, MEDLINE, and EMBASE databases to locate relevant manuscripts published in peer-reviewed journals. A qualitative review of the surgical activities reported in the studies was performed.ResultsOf 185 papers where humanitarian surgical care was provided by a foreign medical team, only 11 articles met inclusion criteria. The reporting of surgical activities varied significantly, and pooled statistical analysis was not possible. The quality of reporting was notably poor, and produced neither reliable estimates of the pattern of surgical consultations nor data on the epidemiology of the burden of surgical diseases. The qualitative trend analysis revealed that the most frequent procedures were related to soft tissue or orthopedic surgery. Procedures such as caesarean sections, hernia repairs, and appendectomies also were common. As length of deployment increased, the surgical caseload became more reflective of the existing, unmet burden of surgical disease.ConclusionsThis review suggests that where foreign medical teams are indicated and requested, multidisciplinary surgical teams capable of providing a range of emergency and essential surgical, and rehabilitation services are required. Standardization of data collection and reporting tools for surgical care are needed to improve the reporting of surgical epidemiology in crisis-affected populations.Nickerson JW, Chackungal S, Knowlton L, McQueen K, Burkle FM Jr. Surgical care during humanitarian crises: a systematic review of published surgical caseload data from foreign medical teams. Prehosp Disaster Med. 2012;27(2):1-6.

scholarly journals Ketamine Treatment for Refractory Anxiety: A systematic review

2021 ◽  
Author(s):  
Jamie Tully ◽  
Amelia Dahlén ◽  
Connor Haggarty ◽  
Helgi Schiöth ◽  
Samantha Brooks
Keyword(s):  
Systematic Review ◽  
Pain Relief ◽  
Anxiety Reduction ◽  
Competitive Antagonist ◽  
Administration Routes ◽  
Beneficial Effects ◽  
Nmda Glutamate Receptor ◽  
Study Designs ◽  
Fast Acting

There is a growing interest in the psychiatric properties of the dissociative anesthetic ketamine, as single doses have been shown to have fast-acting mood-enhancing and anxiolytic effects, which persist for up to a week after the main psychoactive symptoms have diminished. Therefore, ketamine poses potential beneficial effects in patients with refractory anxiety disorders, where other conventional anxiolytics have been ineffective. Ketamine is a non-competitive antagonist of the N-methyl-D-aspartate (NMDA) glutamate receptor, which underlies its induction of pain relief and anaesthesia. However, the role of NMDA receptors in anxiety reduction is still relatively unknown. To fill this paucity in the literature, this systematic review assesses the evidence that ketamine significantly reduces refractory anxiety and discusses to what extent this may be mediated by NMDA receptor antagonism. We highlight the temporary nature of the anxiolytic effects and discuss the high discrepancy among the study designs regarding many fundamental factors such as administration routes, complementary treatments, and other treatments.

scholarly journals SARS-CoV-2 and the role of airborne transmission: a systematic review

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 232
Author(s):  
Carl Heneghan ◽  
Elizabeth A. Spencer ◽  
Jon Brassey ◽  
Annette Plüddemann ◽  
Igho J. Onakpoya ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hospital Setting ◽  
Infectious Agent ◽  
Serial Passage ◽  
Sample Volume ◽  
Rt Pcr ◽  
Airborne Transmission ◽  
Viral Culture ◽  
Reported Data

Background: Airborne transmission is the spread of an infectious agent caused by the dissemination of droplet nuclei (aerosols) that remain infectious when suspended in the air. We carried out a systematic review to identify, appraise and summarise the evidence from studies of the role of airborne transmission of SARS-CoV-2. Methods: We searched LitCovid, MedRxiv, Google Scholar and the WHO Covid-19 database from 1 February to 20 December 2020 and included studies on airborne transmission. Data were dual extracted and we assessed quality using a modified QUADAS 2 risk of bias tool. Results: We included 67 primary studies and 22 reviews on airborne SARS-CoV-2. Of the 67 primary studies, 53 (79%) reported data on RT-PCR air samples, 12 report cycle threshold values and 18 copies per sample volume. All primary studies were observational and of low quality. The research often lacked standard methods, standard sampling sizes and reporting items. We found 36 descriptions of different air samplers deployed. Of the 42 studies conducted in-hospital that reported binary RT-PCR tests, 24 (57%) reported positive results for SARs-CoV-2 (142 positives out of 1,403 samples: average 10.1%, range 0% to 100%). There was no pattern between the type of hospital setting (ICU versus non-ICU) and RT-PCR positivity. Seventeen studies reported potential air transmission in the outdoors or in the community. Seven performed RT-PCR sampling, of which two studies report weak positive RNA samples for 2 or more genes (5 of 125 samples positive: average 4.0%). Ten studies attempted viral culture with no serial passage for viral culture. Conclusion:  SARS-CoV-2 RNA is detected intermittently in the air in various settings. Standardized guidelines for conducting and reporting research on airborne transmission are needed. The lack of recoverable viral culture samples of SARS-CoV-2 prevents firm conclusions over airborne transmission.

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