COVID-19 research briefs by Essential Evidence Plus (EE+)

Clinical Question

Can physical distancing reduce the transmission of COVID-19? Is colchicine a potential treatment option?

Bottom line

Physical distancing measures are effective in reducing COVID-19 transmission. Colchicine yielded small clinical improvements in a preliminary randomized trial. 2c

Clinical Question

What longer term symptoms follow hospitalization for COVID-19? Is a vaccine developed in China a possible solution?

Bottom line

Persistent fatigue, dyspnea, and other symptoms commonly follow hospitalization for COVID-19. Chinese researchers report a successful Phase 2 trial of a COVID-19 vaccine. 2c

Clinical Question

What is the progress on the development of a vaccine against SARS-CoV-2?

Bottom line

There is promising early data from the United States and the United Kingdom on new vaccines to prevent COVID-19. 3b

Clinical Question

How effective is antibody testing for diagnosing COVID-19? What can a population-based study that tested 86% of the population in an Italian town tell us about infection rates?

Bottom line

The accuracy of antibody tests for COVID-19 are highly variable. The results from a study that tested an entire town in Italy during the peak of the epidemic suggest an infectious period between 3.6 days to 6.5 days, with infectiousness peaking on the day of symptom onset. 2c

Clinical Question

Can personal protective equipment protect healthcare workers who are exposed to SARS-CoV-2 from developing COVID-19?

Bottom line

Healthcare workers in Wuhan who were wearing personal protective equipment (PPE) when exposed to SARS-CoV-2 did not become infected. 2c

Clinical Question

How should diabetes be managed in patients who choose to fast during Ramadan?

Bottom line

These expert-derived guidelines are updated from <a href="https://www.essentialevidenceplus.com/content/poem/71256">earlier recommendations</a> for managing diabetes in Muslim patients who desire to fast during Ramadan. The updated guidelines focus on newer hypoglycemic agents and management during the COVID-19 pandemic. See the paper for more details. 5

Clinical Question

Does use of angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) increase the likelihood or severity of COVID-19 infection?

Bottom line

This large and well-conducted Italian case-control study found no association between the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) and either infection or severe illness with COVID-19. <a href="https://www.nejm.org/doi/10.1056/NEJMoa2008975">Another study</a> in the same issue of the journal used data from New York City and came to the same conclusions. 3b

Clinical Question

Can patient-collected swabs accurately detect the presence of SARS-CoV-2? What symptoms and laboratory findings are common in patients with COVID-19?

Bottom line

Self-collected swabs are accurate in detecting SARS-CoV-2 in ambulatory settings. Fever, cough, elevated C-reactive protein levels, and ground glass opacities are common in patients with COVID-19 in China. 2c

Clinical Question

Can corticosteroids reduce mortality in hospitalized patients with COVID-19 who require oxygen or ventilation? Can postexposure prophylaxis with hydroxychloroquine improve outcomes?

Bottom line

Corticosteroids reduce mortality in hospitalized patients with COVID-19 who require oxygen or ventilatory support. In healthy people, postexposure prophylaxis with hydroxychloroquine is not effective. 2c

Clinical Question

Is remdesivir safe and effective for the treatment of COVID-19?

Bottom line

Remdesivir provides a clinically and statistically significant reduction in the duration of symptoms of COVID-19. Questions remain regarding its effects on mortality and on patients who have advanced disease that requires mechanical ventilation or extracorporeal membrane oxygenation (ECMO). 1b