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Document Type
Rapid Review
Review Code
EOC211201 RR
Question Submitted
December 23, 2021
Date Completed
January 12, 2022
Status
3. Completed
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC211201 RR
Question Submitted
December 23, 2021
Date Completed
January 12, 2022
Status
3. Completed
Research Team
EOC
Key Findings
January 12, 2022
The diagnostic accuracy of Rapid Antigen Tests (RAT) has been widely studied in various applications and in diverse populations.
Sensitivity, in the order of 75% in pooled estimates, is significantly influenced by the presence or absence of symptoms, viral load, and the timing of sampling relative to the onset of symptoms.
Specificity, in the order of 99% in pooled estimates, is consistently high across tests, populations, and sampling methods.
Post-test probability of being an infectious case following a positive test is highest in individuals with a high pre-test probability (population prevalence > 5%), such as those with COVID-19 symptoms, and those in settings with a high level of community transmission. Here, the positive predictive value is in the order of 95%. However, when used in settings with a lower pre-test probability (population prevalence < 0.5%), as in screening asymptomatic individuals, the positive predictive value is considerably reduced, as low as 25%.
Post-test probability of being an infectious case following a negative test is less than 1% (negative predictive value > 99%) in all settings except those with the highest levels of community transmission.
Category
Diagnostics
Epidemiology
Subject
Antigens
Infection Prevention and Control
Testing
Population
All
Clinical Setting
Public Health
Priority Level
Level 2 One week (7 days)
Cite As
Badea, A; Reeder, B; Groot, G; Muhajarine, N; Minion, J; Miller, L; Howell-Spooner, B. In real world settings, what is the validity of Rapid Antigen Tests (RATs) in identifying SARS-CoV-2 and how well do they predict disease? 2022 Jan 12, Document no.: EOC211201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. 15 p. (CEST rapid review report).
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Document Type
Rapid Review
Review Code
LTC020201 RR
Question Submitted
February 2, 2021
Date Completed
February 26, 2021
Status
3. Completed
Research Team
Long Term Care
Document Type
Rapid Review
Review Code
LTC020201 RR
Question Submitted
February 2, 2021
Date Completed
February 26, 2021
Status
3. Completed
Research Team
Long Term Care
Key Findings
Although rapid antigen point-of-care tests (POCT) to detect SARS-CoV-2 (COVID-19) infection have the advantage of rapid result turn-around time compared to laboratory-based reverse-transcriptase polymerase chain reaction (RT-PCR) test, their sensitivity to correctly detect positive cases is lower (Larremore et al., 2020).
Increased frequency of testing compensates for lower test sensitivity of POCTs (See et al., 2021; Larremore et al., 2020). The majority of policy guidelines and public health directives recommend basing frequency of POCT on rates of community transmission or outbreak status of the setting (Public Health Canada, 2021; Ontario Ministry of Long-term Care [LTC], 2021; CDC, 2021; Arizona Department of Health Services, 2020).
Recommended POCT frequency for screening asymptomatic individuals is 3 times per week of staff, including designated support persons, and residents if the home is in an outbreak situation and once per week of staff and designated support persons in a non-outbreak situation (Ontario Ministry of LTC, 2021; CDC, 2021; Larremore et al., 2020).
Designated support persons (i.e. family caregivers) should be tested at the same frequency as LTC staff (Ontario Ministry of LTC, 2021; Micocci et al., 2020; Vilches et al., 2020; Tennessee Department of Health, 2020).
Recommendations are consistent regarding test interpretation and follow-up actions, with the majority of policies and directives recommending a high degree of caution and follow-up RT-PCR testing after a negative POCT if there is a high pre-test probability for COVID-19 infection (i.e. symptomatic, known contact exposure)(Public Health Canada, 2021; CDC, 2021). All reviewed guidelines recommend confirmatory RT-PCR test following a positive POCT if the individual is asymptomatic in order to avoid unnecessary isolation of residents and work restrictions of staff. Contrary to other guidelines, the Oregon Health Authority (2020) considers all positive antigen tests in a symptomatic individual as a positive test regardless of follow up testing.
Modelling studies consistently show that regular POCT screening of asymptomatic staff and residents in LTC during both outbreak and non-outbreak situations results in significant decreases in projected cases when combined with a multipronged approach to prevent transmission (Larremore et al., 2021; Holmdahl et al., 2020; See et al., 2021; Vilches et al., 2020).
Barriers to frequency of testing are availability of test kits, training of testers, human resources for testing, and a reporting strategy (Micocci et al., 2020).
Prioritization of testing should be given to symptomatic healthcare providers and residents first, then screening for residents and staff during outbreaks (See et al., 2020).
The Saskatchewan Health Authority (SHA) Point of Care COVID Testing: Long Term Care Algorithm contains most of the elements present in other algorithms. Additional information should be added on actions taken for presumptive positive or negative tests in different scenarios. Additional information should be provided on frequency of testing and the context for “high-risk contact”.
Category
Infection Prevention and Control
Diagnostics
Subject
Facilities
Antigens
Long Term Care
Testing
Population
Aged (80+)
Clinical Setting
Long Term Care
Priority Level
Level 3 Two weeks (14 days)
Cite As
Ward, H; Tupper, S; Dalidowicz, M; Mueller, M. What are the efficacies and outcomes of Point-of-Care/Antigen testing in Long Term care? 2021 Feb 26; Document no.: LTC020201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 37 p. (CEST rapid review report)
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Document Type
Rapid Review
Review Code
EOC012601 RR
Question Submitted
January 26, 2021
Date Completed
February 12, 2021
Status
3. Completed
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC012601 RR
Question Submitted
January 26, 2021
Date Completed
February 12, 2021
Status
3. Completed
Research Team
EOC
Key Findings
· Studies suggest that antigen-based rapid diagnostic tests (Ag-RDTs) can be used in a population level with high prevalence of COVID-19 disease where health systems are overwhelmed or where nucleic acid amplification tests (NAATs) such as real time reverse transcription polymerase chain reaction (rRT-PCR) are not available. · The Canadian COVID-19 Testing and Screening Expert Advisory Panel recommends the use of frequent screening with rapid diagnostic tests in selected groups to limit outbreaks. · WHO and European Center for Disease Prevention and Control recommend using Ag-RDTs with high sensitivity and specificity when NAATs are not available or turnaround time negatively affects NAATs’ clinical utility. For example, COVID-19 Ag-RDTs can be used to surveil health care workers or residents of congregate dwellings during outbreaks or when community transmission rates are high, to screen at-risk individuals to support outbreak investigations, or to screen suspected COVID-19 outbreaks in early stages in settings where NAATs are not available. · WHO does not recommend Ag-RDTs usage when expected prevalence is low (e.g., screening at points of entry) unless an Ag-RDT’s specificity is high (>99%). · Studies have shown that Panbio™ COVID-19 Ag Test (Abbott) can have overall sensitivity of 72.6% to 95.2% and specificity of 98.0% to 100% and suggest that this test is appropriate for contagious case identification and asymptomatic case screening, especially in high prevalence (>5%) settings. · WHO recommends that iterative Ag-RDT testing or confirmatory rRT-PCR testing be done in symptomatic patients or asymptomatic contacts of COVID-19 cases since a negative Ag-RDT result cannot completely exclude an active COVID-19 infection. · Challenges of population level testing (whether they succeed or fail) such as required logistics and resources (e.g., immunizers, access to Ag-RDTs and equipment), performance accuracy of Ag-RDTs (e.g., false positive or negative rates in real world settings), and public trust and engagement in testing and future measures (e.g., vaccine uptake) are yet to be considered.
Category
Diagnostics
Infection Prevention and Control
Subject
Antigens
Asymptomatic
Screening
Priority Level
Level 3 Two weeks (14 days)
Cite As
Azizian, A; Groot, G; Reeder, B; Hamula, C; Dalidowicz, M; Young, C. How effective is surveillance antigenic testing? 2021 Feb 12; Document no.: EOC012601 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 32 p. (CEST rapid review report)
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Document Type
Rapid Review
Review Code
EOC062201v2 RR
Question Submitted
June 22, 2020
Date Completed
January 22, 2021
Status
5. Updated review
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC062201v2 RR
Question Submitted
June 22, 2020
Date Completed
January 22, 2021
Status
5. Updated review
Research Team
EOC
Updated Key Findings
Generally speaking, data indicate that adult cancer patients and those who have recently received or are receiving anti-cancer therapy are at a higher risk of severe outcomes and death resulting from COVID-19 compared to those without cancer. However, more data are beginning to elucidate the nuances of these risks depending on patient specific factors.
Limited data indicate that pediatric cancer patients are not at a high level of risk of severe outcomes from COVID-19.
Limited evidence indicates some differences in the course and severity of SARS-CoV-2 infection depending on the type of immunosuppressive therapy a patient receives.
Key Findings
Generally speaking, data indicate that adult cancer patients and those who have recently received or are receiving anti-cancer therapy are at a higher risk of severe outcomes and death resulting from COVID-19 compared to those without cancer.
Pediatric cancer populations may not be at the same level of risk as adult populations.
There is not enough evidence at this time to determine if there are differences in the course of SARS-CoV-2 infection in patients receiving chemotherapy vs. those who are not aside from outcomes and severity.
Category
Clinical Presentation
Subject
Chemotherapy
Cancer
Comorbidities
Natural History
Population
All
Priority Level
Level 3 completed within 2-3 days
Cite As
Vanstone, J; Groot, G; Miller, L; Mueller, M. What are the differences in the clinical course of COVID-19 between patients undergoing chemotherapy and otherwise healthy individuals? 2021 Jan 22; Document no.: EOC062201v2 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 5 p. (CEST rapid review report)
Review History
EOC062201 RR: June 29, 2020
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Document Type
Rapid Review
Review Code
PPE120901 RR
Question Submitted
December 9, 2020
Date Completed
December 18, 2020
Status
3. Completed
Research Team
Personal Protective Equipment
Document Type
Rapid Review
Review Code
PPE120901 RR
Question Submitted
December 9, 2020
Date Completed
December 18, 2020
Status
3. Completed
Research Team
Personal Protective Equipment
Key Findings
Moderate evidence supporting the concept that airway management and certain surgical procedures create aerosols
No definitive evidence for the transmission of SARS-CoV-2 during AGMP
Indirect evidence from SARS-CoV-1 indicates that HCW present during AGMP are at higher risk of infection, but evidence quality is very low and very difficult to generalize
The absence of definitive evidence does not equate to the absence of risk and most policy recommendations err on the side of safety for Health Care Workers
Category
Infection Prevention and Control
Subject
Aerosols
Risk
Transmission
Population
All
Clinical Setting
Ambulatory
Long Term Care
Priority Level
Level 2 One week (7 days)
Cite As
Badea, A; Groot, G; Fox, L; Mueller, M. What is the risk of COVID-19 transmission during AGMP procedures? 2020 Dec 18; Document no.: PPE120901 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 30 p. (CEST rapid review report)
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Document Type
Rapid Review
Review Code
EOC081401v2 RR
Question Submitted
August 14, 2020
Date Completed
December 1, 2020
Status
5. Updated review
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC081401v2 RR
Question Submitted
August 14, 2020
Date Completed
December 1, 2020
Status
5. Updated review
Research Team
EOC
Key Findings
In the absence of SARS-CoV-2 specific evidence, recommendations for fallow time following AGPs in the context of the SARS-CoV-2 pandemic range widely depending on country and specialty association.
The majority of recommendations are based upon dental practices and several on thoracic surgical practice.
The most common recommendations follow the CDC’s guidelines for airborne contamination removal based on air changes per hour ventilation properties of rooms.
Assuming that most treatment rooms have a minimum of 10-12 ACH, most associations recommend a 20-minute fallow periods, or 60 minutes if ACH is unknown or below recommendations for treatment rooms.
Category
Administration
Infection Prevention and Control
Subject
Aerosols
Facilities
Decision Making
Priority Level
Level 4 completed within 1 week
Cite As
Badea, A; Groot G; Dalidowicz, M; Young, C; Miller, L. What are the recommendations around settling times following aerosol generating procedures on suspected or confirmed COVID-19 patients? 2020 Dec 1; Document no.: EOC081401v2 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 24 p. (CEST rapid review report)
Review History
EOC081401 RR: August 24, 2020
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Document Type
Rapid Review
Review Code
EOC090202 RR
Question Submitted
September 2, 2020
Date Completed
September 8, 2020
Status
3. Completed
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC090202 RR
Question Submitted
September 2, 2020
Date Completed
September 8, 2020
Status
3. Completed
Research Team
EOC
Key Findings
· The Intubation box was originally invented by Dr. Lai Hsien-yung, an anesthesiologist in Taiwan. · The main function of the intubation box is intended to prevent exposure of care providers to COVID-19 from aerosol droplets during intubation. · The intubation box concept emerged during the pandemic to address the challenge of adequate supply of PPEs in resource limited settings in particular but presents limitations and poses significant safety risk to the patient. · limitations include increased incubation time, discomfort from restricted hand movements for the intubation procedure, reduced first-pass intubation rates, limitation for certain body habitus and possible injury to patient · With regards to aerosol exposure, intubation boxes have been reported to increase rather than decrease airborne particle exposure.
Category
Administration
Infection Prevention and Control
Subject
Intubation
Risk
Personal Protective Equipment
Aerosols
Transmission
Population
All
Priority Level
Level 3 completed within 2-3 days
Cite As
Asamoah, G; Groot, G; Badea, A; Ellsworth, C; Fox, L. What are the safety risks or disinfection concerns with the use of intubation boxes? 2020 Sep 8; Document no.: EOC090202 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 13 p. (CEST rapid review report)
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EOC033001 RR
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Document Type
Rapid Review
Review Code
EPM072101 RR
Question Submitted
July 21, 2020
Date Completed
July 23, 2020
Status
3. Completed
Research Team
Epidemiology & Modelling
Document Type
Rapid Review
Review Code
EPM072101 RR
Question Submitted
July 21, 2020
Date Completed
July 23, 2020
Status
3. Completed
Research Team
Epidemiology & Modelling
Key Findings
· Diagnostic accuracy of tests for SARS CoV-2 varies based on the type of test, target antigen, type of sample and time of testing. · There is heterogeneity in clinical performance of rapid antigen tests; however, clinical sensitivity is lower than amplification-based assays. · Information is limited about test strategies that combine multiple approaches (e.g. molecular and serological methods) but may add value by increasing sensitivity and specificity.
Category
Diagnostics
Subject
Antigens
Testing
Serology
Polymerase Chain Reaction
Priority Level
Level 2 completed within 8 hours
Cite As
Williams-Roberts, H; Waldner, C; Dalidowicz, M; Howell-Spooner, B. What is the accuracy of diagnostic tests for the detection of SARS-CoV-2? 2020 Jul 23; Document no.: EPM072101 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 13 p. (CEST rapid review report)
Related Documents
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Less detail
Document Type
Rapid Review
Review Code
EOC051201 RR
Question Submitted
May 12, 2020
Date Completed
May 15, 2020
Status
3. Completed
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC051201 RR
Question Submitted
May 12, 2020
Date Completed
May 15, 2020
Status
3. Completed
Research Team
EOC
Key Findings
· Small simulation studies have demonstrated potential contamination of neck and back area · Many associations recommend neck coverage, or if unavailable to ensure sanitation/washing of exposed skin after doffing PPE · Several warnings that increasing amount of PPE increases chances of contamination and may decrease level of compliance
Category
Infection Prevention and Control
Clinical Management
Subject
Personal Protective Equipment
Aerosols
Priority Level
Level 3 completed within 2-3 days
Cite As
Badea, A; Groot, G; Dalidowicz, M; Miller, L. Do neck or back coverings provide additional protection to gown and N95 mask when conducting an aerosol generating procedure? 2020 May 15; Document no.: EOC051201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 9 p. (CEST rapid review report)
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Document Type
Rapid Review
Review Code
EPM051201 RR
Question Submitted
May 12, 2020
Date Completed
May 12, 2020
Status
3. Completed
Research Team
Epidemiology & Modelling
Document Type
Rapid Review
Review Code
EPM051201 RR
Question Submitted
May 12, 2020
Date Completed
May 12, 2020
Status
3. Completed
Research Team
Epidemiology & Modelling
Key Findings
·      A wide range of tests are available for detection of viral RNA as well as serological and immunoassays for antibodies developed due to exposure to SARS CoV-2 in infected persons. Despite the emerging research, information about clinical validity of tests is limited. ·      Multiple factors affect test performance including the nature of the specific test, type of specimen and its quality, severity and duration of illness at the time of testing. These individual variations hamper assessment of diagnostic accuracy and suggest that a combination of tests on multiple types of specimens at serial time points might be needed to confirm a COVID 19 diagnosis. ·      Point of care tests are desirable and needed to scale up testing in low resource settings; however, tests are of variable quality and more research is needed before they can be relied on for clinical decision making.
Notes
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Category
Diagnostics
Subject
Antigens
Testing
Serology
Polymerase Chain Reaction
Priority Level
Level 4 completed within 1 week
Cite As
Williams-Roberts, H; Waldener, C. What is the accuracy of diagnostic tests for COVID-19 detection? 2020 May 12; Document no.: EPM051201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. (CEST rapid review report)
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LAB041401 RR
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EPM051201 RR

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Less detail
Document Type
Rapid Review
Review Code
EOC040101 RR
Question Submitted
April 1, 2020
Date Completed
April 1, 2020
Status
3. Completed
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC040101 RR
Question Submitted
April 1, 2020
Date Completed
April 1, 2020
Status
3. Completed
Research Team
EOC
Key Findings
· There are some recommendations and precautions from WHO, CDC, Canada and the UK that there is transmission of the COVID virus from the administration of nebulizer medication. · Some case studies of SARS found few instances that patients may likely be infected after aerosol generating procedures including nebulized medications, and although there are few evidences that demonstrates low risk of viral transmission from nebulizers, possibility of transmission remains
Category
Epidemiology
Infection Prevention and Control
Subject
Aerosols
Risk
Transmission
Population
All
Clinical Setting
Ambulatory
Priority Level
Level 2 completed within 8 hours
Cite As
Badea, A; Groot, G; Fenton, M; Dalidowicz, M; Young, C. What is the degree of COVID-19 transmission through the administration of nebulizer medication either in clinical practice or in animal experiments? 2020 Apr 1; Document no.: EOC040101 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 10 p. (CEST rapid review report)
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Document Type
Rapid Review
Review Code
EOC033001 RR
Question Submitted
March 30, 2020
Date Completed
March 30, 2020
Status
3. Completed
Research Team
EOC
Document Type
Rapid Review
Review Code
EOC033001 RR
Question Submitted
March 30, 2020
Date Completed
March 30, 2020
Status
3. Completed
Research Team
EOC
Key Findings
· Some countries like Taiwan and Malaysia have created their own intubation hood design as others offered to produce or modify the original design to fit their country’s equipment. · Several countries have also created innovation in airway management such as 3D printed respirator valves for hospitals and 3D printed ventilators. · An Emergency physician in Northern Italy shared that due to influx of patients in the hospitals, “intubation and invasive mechanical ventilators in the ED are reserved for patients not responsive to NIV” although in principle can give a more favorable chance for patients if given before their condition deteriorates.
Category
Infection Prevention and Control
Subject
Intubation
Aerosols
Population
All
Clinical Setting
Ambulatory
Cardiac unit
Priority Level
Level 2 completed within 8 hours
Cite As
Badea, A; Groot, G; Dalidowicz, M. Where and how are they producing and using intubation hoods? 2020 Mar 30; Document no.: EOC033001 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 7 p. (CEST rapid review report)
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12 records – page 1 of 1.