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Knowledge and Library Services Part of the Barts Health Education Academy
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5th October 2021
Hello and welcome to this edition of Barts Health Knowledge and Library Services’ fortnightly COVID-19 Evidence Update.
Please let us know how we can improve future updates by providing feedback, and let us know if there are any resources or publications you would like us to feature.
To find out more about the library services available to you, including our highly-regarded literature searching service and desktop document supply service, please visit our WeShare page.
Feel free to cascade this update to any colleagues who might be interested.
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From UK Health Security Agency: UKHSA review into IPC guidance
"Recommendations for changes to COVID-19 infection prevention and control (IPC) advice to help ease pressure on the NHS..."
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New COVID-related updates in clinical decision support tool UpToDate:
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Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine–Induced Immune Thrombotic Thrombocytopenia
"This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine–induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination..."
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[Preprint] Vaccinating adolescents against SARS-CoV-2 in England: a risk-benefit analysis
"At high future case incidence of 1000/100,000 population/week over 16 weeks, vaccination could avert 4,430 hospital admissions and 36 deaths over 16 weeks. At the low incidence of 50/100,000/week, vaccination could avert 70 hospital admissions and 2 deaths over 16 weeks. The benefit of vaccination in terms of hospitalisations in adolescents outweighs risks unless case rates are sustainably very low (below 30/100,000 teenagers/week). Benefit of vaccination exists at any case rate for the outcomes of death and long COVID, since neither have been associated with vaccination to date..."
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Safety and Efficacy of COVID-19 Vaccines: A Systematic Review and Meta-Analysis of Different Vaccines at Phase 3
"A total of 12 reports on phase-3 clinical trials and observational studies of COVID-19 vaccines were included in the review. In terms of vaccine safety, mRNA vaccines showed more relevance to serious adverse events than viral vector and inactivated vaccines, but no solid evidence indicated that COVID-19 vaccines directly caused serious adverse events. Serious metabolic, musculoskeletal, immune-system, and renal disorders were more common among inactivated vaccine recipients, and serious gastrointestinal complications and infections were more common among viral vector and inactivated vaccine recipients..."
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REGEN-COV Antibody Combination and Outcomes in Outpatients with Covid-19
"In the phase 3 portion of an adaptive trial, we randomly assigned outpatients with Covid-19 and risk factors for severe disease to receive various doses of intravenous REGEN-COV or placebo. Patients were followed through day 29. A prespecified hierarchical analysis was used to assess the end points of hospitalization or death and the time to resolution of symptoms. Safety was also evaluated..."
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Antibody and cellular therapies for treatment of covid-19: a living systematic review and network meta-analysis
Concludes "In patients with non-severe covid-19, casirivimab-imdevimab probably reduces hospitalisation; bamlanivimab-etesevimab, bamlanivimab, and sotrovimab may reduce hospitalisation. Convalescent plasma, IVIg, and other antibody and cellular interventions may not confer any meaningful benefit..."
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Beneficial and Harmful Outcomes of Tocilizumab in Severe COVID-19: A Systematic Review and Meta-Analysis
"Sixty four studies were included in the present study: 54 were controlled observational studies (50 retrospective and 4 prospective) and 10 were RCTs. The overall results provided data from 20,616 hospitalized patients with COVID-19: 7668 patients received TCZ in addition to standard of care (SOC) (including 1915 patients admitted to intensive care units (ICU) with reported mortality) and 12,948 patients only receiving SOC (including 4410 patients admitted to the ICU with reported mortality)..."
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Real World Long-term Assessment of The Efficacy of Tocilizumab in Patients with COVID19: Results From A Large De-identified Multicenter Electronic Health Record Dataset in the United States
"A total of 20,399 patients were identified. 1,510 and 18,899 were in the TCZ and control groups, respectively. After MW adjustment, no statistically significant differences in all-cause mortality were found for the TCZ vs. control group (Hazard Ratio [HR]:0.76, p=0.06). Survival curves suggested a better trend in short-term observation, driven from a subgroup of patients requiring oxygen masks, BIPAP or CPAP.... We observed a temporal (early) benefit of TCZ, especially in patients on non-invasive high-flow supplemental oxygen. However, the benefit effects faded with longer observation..."
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Recommendations for the recognition, diagnosis, and management of long COVID: a Delphi study
"Thirty-three clinicians representing 14 specialties reached consensus on 35 recommendations. Chiefly, GPs should consider long COVID in the presence of a wide range of presenting features (not limited to fatigue and breathlessness) and exclude differential diagnoses where appropriate. Detailed history and examination with baseline investigations should be conducted in primary care. Indications for further investigation and specific therapies (for myocarditis, postural tachycardia syndrome, mast cell disorder) include hypoxia/desaturation, chest pain, palpitations, and histamine-related symptoms. Rehabilitation should be individualised, with careful activity pacing (to avoid relapse) and multidisciplinary support..."
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Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19
"We conducted a retrospective cohort study based on linked electronic health records (EHRs) data from 81 million patients including 273,618 COVID-19 survivors. The incidence and co-occurrence within 6 months and in the 3 to 6 months after COVID-19 diagnosis were calculated for 9 core features of long-COVID (breathing difficulties/breathlessness, fatigue/malaise, chest/throat pain, headache, abdominal symptoms, myalgia, other pain, cognitive symptoms, and anxiety/depression)... Long-COVID clinical features occurred and co-occurred frequently and showed some specificity to COVID-19, though they were also observed after influenza. Different long-COVID clinical profiles were observed based on demographics and illness severity..."
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Characterising long COVID: a living systematic review
"A total of 39 studies were included: 32 cohort, 6 cross-sectional and 1 case–control. Most showed high or moderate risk of bias. None were set in low-income countries and few included children. Studies reported on 10 951 people (48% female) in 12 countries. Most included previously hospitalised people (78%, 8520/10 951). The longest mean follow-up time was 221.7 (SD: 10.9) days post COVID-19 onset. Over 60 physical and psychological signs and symptoms with wide prevalence were reported, most commonly weakness (41%; 95% CI 25% to 59%), general malaise (33%; 95% CI 15% to 57%), fatigue (31%; 95% CI 24% to 39%), concentration impairment (26%; 95% CI 21% to 32%) and breathlessness (25%; 95% CI 18% to 34%). 37% (95% CI 18% to 60%) of patients reported reduced quality of life; 26% (10/39) of studies presented evidence of reduced pulmonary function..."
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Smoking and COVID-19 outcomes: an observational and Mendelian randomisation study using the UK Biobank cohort
"We undertook large-scale observational and Mendelian randomisation (MR) analyses using UK Biobank. Most recent smoking status was determined from primary care records (70.8%) and UK Biobank questionnaire data (29.2%). COVID-19 outcomes were derived from Public Health England SARS-CoV-2 testing data, hospital admissions data, and death certificates (until 18 August 2020). Logistic regression was used to estimate associations between smoking status and confirmed SARS-CoV-2 infection, COVID-19-related hospitalisation, and COVID-19-related death... Congruent results from two analytical approaches support a causal effect of smoking on risk of severe COVID-19..."
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Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19
"We conducted a retrospective cohort study based on linked electronic health records (EHRs) data from 81 million patients including 273,618 COVID-19 survivors. The incidence and co-occurrence within 6 months and in the 3 to 6 months after COVID-19 diagnosis were calculated for 9 core features of long-COVID (breathing difficulties/breathlessness, fatigue/malaise, chest/throat pain, headache, abdominal symptoms, myalgia, other pain, cognitive symptoms, and anxiety/depression). Their co-occurrence network was also analyzed. Comparison with a propensity score–matched cohort of patients diagnosed with influenza during the same time period was achieved using Kaplan–Meier analysis and the Cox proportional hazard model..."
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All staff are now required to sign-in, and wash their hands with the gel provided, when entering our libraries.
St Bart’s Hospital Library has moved back to its original space in the department of diagnostic imaging, on the ground floor of the KGV Building. It will be staffed from 10am-4pm, Monday to Friday, and available to staff 24/7. The phone no. there is 020 3465 5467.
At Whipps Cross and Newham Hospitals we offer comfortable seats and computer access, with tea and coffee, from 10am-4pm. Please check local notices for details. Staff can continue to access our 24/7 knowledge hubs (computer rooms) on each site.
Our Library Hub at the Royal London continues to be available to staff 24/7.
Please see our new website and our Digital Library WeShare page for more information.
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New doctor at the Trust? Welcome! Our brand Junior Doctors Guide provides information and links to resources that are available to Barts Health NHS Trust staff, and our International Doctors Guide is aimed at International Doctors, Refugee Doctors, and International Medical Graduates, in order to help you with the registration process and working as a doctor in the UK.
Browse the resource collections within our COVID-19 pages; plus further services, resources, and NHS discounts have been added to our Wellbeing pages.
Our new Sepsis Factsheet will help you find and make the most of the resources and information available to you on this topic:
You can now search the entirety of our collection from the website homepage below via the Discovery search bar too...
Visit Green at Barts Health's new website, hosted and maintained by Knowledge and Library Services. The latest IPCC report is covered and the countdown to COP-26 continues...
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Read our latest monthly Leadership Update (published 4/10/21) here.
Read our previous COVID-19 Update (published 21/9/21) here.
Read our round-up of research published by Barts Health authors in the month of August 2021 (published 20/9/21) here.
Read our latest Delirium in Intensive Care Evidence Alert (published 20/9/21) here.
Read our latest Emerging Technologies in Healthcare Update (published 17/9/21) here.
Read our latest Safer Surgery Update (published 15/9/21) here.
Read our latest Staff Wellbeing Update (published 13/9/21) here.
Read our latest Health Services Management Update (published 10/9/21) here.
Read our latest monthly COVID-19 and TB Update (published 1/9/21) here.
Read our previous Inclusion and Diversity Update (published 30/9/21) here.
Catch up with all our archived updates on our Digital Library Weshare page
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Happy to help.
If you require the full text of any of the articles mentioned above, or any other assistance, please email bartshealth.library@nhs.net
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