hne health libraries linking evidence with practice

The present gold standard for sampling is the nasopharyngeal swab method. However, several recent papers suggested that saliva-based testing is a promising alternative that could simplify and accelerate COVID-19 diagnosis.

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Post-acute covid-19 (“long covid”) seems to be a multisystem disease, sometimes occurring after a relatively mild acute illness. Clinical management requires a whole-patient perspective. This article, intended for primary care clinicians, relates to the patient who has a delayed recovery from an episode of covid-19 that was managed in the community or in a standard hospital ward. Broadly, such patients can be divided into those who may have serious sequelae (such as thromboembolic complications) and those with a non-specific clinical picture, often dominated by fatigue and breathlessness.

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LISTEN to podcast: ‘What do we know about long covid?’

A network meta-analysis was performed on data extracted from the US Centers for Disease Control and Prevention COVID-19 Research Articles Downloadable Database. 23 trials were included, in which people with suspected, probable, or confirmed covid-19 were randomised to drug treatment or to standard care or placebo. The certainty of the evidence for most comparisons was very low because of risk of bias and serious imprecision.

Glucocorticoids were the only intervention with evidence for a reduction in death compared with standard care and mechanical ventilation (moderate certainty). Three drugs might reduce symptom duration compared with standard care: hydroxychloroquine (low certainty), remdesivir (moderate certainty), and lopinavir-ritonavir (low certainty). Hydroxychloroquine might increase the risk of adverse events compared with the other interventions, and remdesivir probably does not substantially increase the risk of adverse effects leading to drug discontinuation. No other interventions included enough patients to meaningfully interpret adverse effects leading to drug discontinuation.

The value of this resource is in its ‘living’ status. The review will be updated (for up to two years) to reflect emerging evidence.

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As of 08:30 this morning Health Districts in NSW have been directed by Elizabeth Koff, NSW Health Secretary to escalate to Amber Risk Status.

Today the JHH Executive, along with Dr John Ferguson gave an update via Broadcast, the link to this broadcast can be found here.

One key requirement is that all health staff are required to wear standard, level 2 surgical masks if they are within 1.5m of patients. Visitors will also be asked to mask.

During our usual weekly JHH ALL Staff Information Broadcast on Wednesday, Dr Ferguson referred to a handwashing technique video which can be accessed via this link.  

Please keep an eye on the CE news, Webinars and COVID site on the Intranet as to how you can help us keep us all safe.