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Document Type
Rapid Review
Review Code
EOC021901v2 RR
Question Submitted
February 19, 2021
Date Completed
October 29, 2021
Status
5. Updated review
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC021901v2 RR
Question Submitted
February 19, 2021
Date Completed
October 29, 2021
Status
5. Updated review
Research Team
EOC
Updated Key Findings
October 29, 2021
In October, WHO released a consensus definition of post COVID-19 condition that includes 12 domains. This development should lead to better standardization of reporting and contribute to more precise prevalence estimates and better understanding of associated risk factors.
The effects of Variants of Concern (VoC) and COVID vaccination on progression of Long COVID symptoms remains unclear.
Risk factors for developing Long COVID symptoms were similar but limited evidence suggests that pre-pandemic psychological distress and poor general health were associated with developing persistent symptoms. Evidence is too limited to determine whether vaccination reduces the risk of developing Long COVID among persons with breakthrough infections.
Given the protean manifestations of Long COVID symptoms, the underlying causes are likely multifactorial; however, strong evidence to substantiate the theories of causation remains limited.
Research related to longer-term consequences of SARS CoV-2 infections in pediatric populations is growing but remains limited.
Key Findings
March 15, 2021
There is a lack of consensus around the clinical definition of Long COVID which in turn causes challenges with understanding the incidence and prevalence as well as the potential impact for the health care system
Information about the natural history of Long COVID is incomplete but limited evidence suggests that the immune response trajectories differ for those with few or no symptoms compared to those with severe disease. Individuals with severe disease are more likely to exhibit immunological marker abnormalities but anyone can experience functional limitations.
The mechanisms underlying the development of persistent symptoms in Long COVID remain an enigma. Despite multiple theories, there is little empirical evidence for specific immunological and or biochemical abnormalities in samples of individuals with symptoms consistent with Long COVID.
Risk factors for Long COVID include female gender, older age, higher body mass index, pre-existing asthma and the number of symptoms.
Few studies explored the short-term impact of Long COVID on health care utilization patterns and found a higher impact for those with severe disease compared with mild disease.
Category
Healthcare Services
Clinical Presentation
Subject
Long Covid
Clinical Presentation
Health Planning
Symptoms
Population
All
Clinical Setting
Ambulatory
Long Term Care
Primary care
Priority Level
Level 5 Four weeks+ (28 days+)
Cite As
Williams-Roberts, H; Groot, G; Mueller, M; Dalidowicz, M. Long COVID: What does it mean for the healthcare system and programs? 2021 Oct 29. Document no.: EOC021901v2 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 14 p. (CEST rapid review report).
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Document Type
Rapid Review
Review Code
EOC210302 RR
Question Submitted
March 30, 2021
Date Completed
April 21, 2021
Status
3. Completed
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC210302 RR
Question Submitted
March 30, 2021
Date Completed
April 21, 2021
Status
3. Completed
Research Team
EOC
Key Findings
The group designated in Saskatchewan as Clinically Extremely Vulnerable (CEV) is a heterogenous clinical population with factors that impair their immune response to differing degrees.
Very Limited evidence is currently available to assess the immune response following vaccination is selected clinical populations; no evidence is available to assess vaccine efficacy or effectiveness in these populations. The clinical relevance of measured immune response with respect to protection from disease is still uncertain.
In considering the immune response of the CEV population, it is recommended that the absolute difference in immune response between 1 and 2 doses be considered, as it is possible some patient groups will have lowered protection regardless of vaccine strategy.
In terms of clinical subgroups: oOrgan transplantation recipients on immunosuppressive medication: solid organ transplant recipients receiving anti-metabolite maintenance immunosuppression therapy were less likely to develop an antibody response to an mRNA vaccine, compared to those receiving other types of therapies (37% vs 63%). In a study of 242 kidney transplant recipients on immunosuppressive therapy only 10.8% became seropositive at 28 days after a single dose of mRNA vaccine. oCancer: A study of 151 elderly patients with solid and hematological malignancies and 54 healthy controls who received one or two doses of BNT162b2 (Pfizer-BioNTech) vaccine shows approximately 39% of solid cancer patients, 13% of hematological cancer patients, and 97% of healthy controls (p<0.0001) developed anti-S IgG 21 days following a single dose vaccine. However, response in solid cancer patients increased to 95% within 2 weeks of the second dose at 21 days. oOther immunocompromising conditions (e.g., auto-immune disorders and therapy): some level of immunity is generated with vaccination; however, what this means clinically is unknown. It seems that ensuring the dosing is properly timed around biologic therapy is important.
Category
Clinical Management
Healthcare Services
Subject
Vaccines
Vaccination
Risk
Comorbidities
Population
All
Other
vulnerable populations (clinically)
Clinical Setting
Cardiac unit
Community
Dialysis unit
ICU
Long Term Care
Medicine Unit
NICU
Oncology
Primary care
Public Health
Priority Level
Level 3 Two weeks (14 days)
Cite As
Azizian, A; Lee, S; Shumilak, G; Groot, G; Reeder, B; Miller, L; Howell-Spooner, B. What are the risks or benefits of extended intervals between doses of COVID-19 vaccines compared to recommended dosing in extremely vulnerable populations? 2021 Apr 20, Document no.: EOC210302 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 15 p. (CEST rapid review report).
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Document Type
Rapid Review
Review Code
EOC071001 RR
Question Submitted
July 10, 2020
Date Completed
July 27, 2020
Status
3. Completed
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC071001 RR
Question Submitted
July 10, 2020
Date Completed
July 27, 2020
Status
3. Completed
Research Team
EOC
Key Findings
· The terms cluster and outbreak both describe the occurrence of new disease cases within a particular location and time period. The number of cases within a cluster are not necessarily greater than what is expected, however in an outbreak the number of cases does exceed the usual norm. · In an outbreak the cases are confirmed to be epidemiologically linked while in a cluster an epidemiological connection is only suspected. · Not all clusters are outbreaks, however each cluster needs to be investigated
· Understanding how to characterize COVID-19 cases based on a suspected or proven epidemiological link can better guide prevention of disease spreading
Category
Administration
Epidemiology
Subject
Disease Outbreak
Public Health
Health Planning
Decision Making
Population
All
Clinical Setting
Community
Emergency
Long Term Care
Other
All acute care.
Priority Level
Level 5 completed within 2 weeks
Cite As
Radu, L; Badea, A; Groot, G; Ellsworth, C; Young, C. What is the definition of an outbreak versus a cluster for COVID-19 in different clinical and community settings in Canada, the US, and the UK? 2020 Jul 27; Document no.: EOC071001 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 11 p. (CEST rapid review report)
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