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Document Type
Rapid Review
Review Code
INF031801v019 RR
Question Submitted
March 18, 2021
Date Completed
December 26, 2021
Status
5. Updated review
Research Team
Infectious Disease
Document Type
Rapid Review
Review Code
INF031801v019 RR
Question Submitted
March 18, 2021
Date Completed
December 26, 2021
Status
5. Updated review
Research Team
Infectious Disease
Updated Key Findings
December 14, 2021
Ontario Immunization Advisory Committee recommended that if an 11 and 12-year-old child is inadvertently given a second dose of the Pfizer-BioNTech vaccine that is not authorized for their age, the dose should be considered valid and the series complete.
National Advisory Committee on Immunization (NACI) recommends that a booster dose of an authorized mRNA COVID-19 vaccine should be offered to vulnerable population and > 50 years old, =6 months after completion of a primary COVID-19 vaccine series.
Australian Technical Advisory Group on Immunization (ATAGI) recommends COVID-19 booster vaccination with either Pfizer (Comirnaty) or Moderna (Spikevax), which are considered equally acceptable, for anyone aged 18 and older who completed their primary course of COVID-19 vaccination 5 or more months ago.
On December 8th, 2021 in a press release by Pfizer-BioNTech said that preliminary laboratory studies demonstrate that three doses of the Pfizer-BioNTech COVID-19 vaccine neutralize the Omicron variant while two doses show significantly reduced neutralization titers. Data indicate that a third dose of BNT162b2 increases the neutralizing antibody titers by 25-fold compared to two doses.
Key Findings
December 3, 2021
The Therapeutic Goods Administration (TGA) has granted provisional approval to Moderna for the use of its vaccine in children (two 10µg doses) and as booster shot for adults (one 30µg dose) in preparation for the recent emergence of the Omicron variant. This is in addition to Pfizer, which was also recently approved.
The National Advisory Committee on Immunization (NACI) recommends that a complete series with the Pfizer-BioNTech COVID-19 vaccine (10 mcg) may be offered to children 5-11 years of age who do not have contraindications to the vaccine, with a dosing interval of at least 8 weeks between the first and second dose.
NNACI also recommends that children aged 5-11 years with a history of previous SARS-CoV-2 infection should be considered no longer infectious and symptoms of an acute illness should be completely resolved prior to vaccination.
Health Canada has authorized Moderna's COVID-19 vaccine (also known as Spikevax) to be used as a booster shot, using a half-dose of the vaccine.
Category
Epidemiology
Infection Prevention and Control
Subject
Vaccines
Immunity
Infection Prevention and Control
Clinical Presentation
Population
All
Clinical Setting
Community
ICU
Medicine Unit
Primary care
Public Health
Priority Level
Level 3 Two weeks (14 days)
Cite As
Jagwani, M; Lee, S; Shumilak, G; Reeder, B; Groot, G; Hernandez, L; Howell-Spooner, B; Miller, L. How effective are COVID-19 vaccines? 2021 Dec 26. Document no.: INF031801v019 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 93 p. (CEST rapid review report)
Review History
INF031801v17 RR: November 23, 2021
INF031801v16 RR: November 12, 2021
INF031801v15 RR: October 28, 2021
INF031801v014 RR: October 16, 2021
INF031801v013 RR: September 24, 2021
INF031801v012 RR: September 10, 2021
INF031801v010 RR: August 25, 2021
INF031801v9 RR: August 23, 2021
INF031801v8 RR: August 9, 2021
INF031801v7 RR: July 20, 2021
INF031801v6 RR: July 2, 2021
INF031801v5 RR: June 22, 2021
INF031801v4 RR: June 3, 2021
INF031801v3 RR: May 24, 2021
INF031801v2 RR: May 14, 2021
INF031801 RR: March 31, 2021
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Document Type
Rapid Review
Review Code
EPM210602 RR
Question Submitted
June 22, 2021
Date Completed
July 12, 2021
Status
3. Completed
Research Team
Epidemiology & Modelling
Document Type
Rapid Review
Review Code
EPM210602 RR
Question Submitted
June 22, 2021
Date Completed
July 12, 2021
Status
3. Completed
Research Team
Epidemiology & Modelling
Key Findings
Long COVID-19 is likely to increase healthcare demands across the health system, including emergency departments, hospital admissions, primary care visits, specialists appointments, and home care and rehabilitation services.
The clinical care burden of long COVID-19 is the greatest in the first 3 months after testing and is likely to place the greatest demand on primary care services.
Patients with severe COVID-19 illness are more likely to place longer-term demands (4-6 months) on specialist care due to respiratory, circulatory, endocrine, metabolic, psychiatric and unspecified conditions.
Category
Clinical Presentation
Epidemiology
Subject
Long Covid
Health Planning
Clinical Presentation
Population
All
Clinical Setting
Ambulatory
Community
Emergency
ICU
Long Term Care
Medicine Unit
Primary care
Public Health
Priority Level
Level 1 2-3 days
Cite As
McLean, M; Williams-Roberts, H; Reeder, B; Howell-Spooner, B; Ellsworth, C. What are long COVID's demands on the healthcare system, and its severity of the illness? 2021 Jul 12, Document no.: EPM210602 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 23 p. (CEST rapid review report).
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Document Type
Rapid Review
Review Code
EPM210601 RR
Question Submitted
June 22, 2021
Date Completed
July 9, 2021
Status
3. Completed
Research Team
Epidemiology & Modelling
Document Type
Rapid Review
Review Code
EPM210601 RR
Question Submitted
June 22, 2021
Date Completed
July 9, 2021
Status
3. Completed
Research Team
Epidemiology & Modelling
Key Findings
The frequency of Long COVID symptoms varies widely across studies based on populations studied, duration of follow up and methods of assessment of symptoms.
It is estimated that 1 in 50 persons experience Long COVID symptoms after 12 weeks; however, higher estimates up to 80% have been reported in studies with a greater proportion of persons who were previously hospitalized. A recent study of a mixed cohort of 96 persons found that only 22.9% had no symptoms at 12 months post diagnosis.
A wide range of symptoms affecting multiple organ systems has been reported. For many persons symptoms improve over time while others experience persistent and/or new symptoms. Among studies with the longest duration of follow up, the most frequently reported symptoms included fatigue (up to 65%), dyspnea (up to 50%), headache (up to 45%), anosmia/ageusia (up to 25%), cognitive memory/concentration (up to 39.6%) and sleep disorders (up to 26%).
Few studies estimated the duration of symptoms with estimates ranging from 2.2% for 6 months and 27% for 7-9 months.
The mechanism(s) leading to Long COVID remain unclear but those experiencing post acute sequelae tend to be older, have a greater number of symptoms during the acute phase of illness or manifest specific symptoms and live with multiple comorbid conditions such as obesity.
The lack of consensus on a definition of Long COVID contributes to marked variations in robust prevalence estimates.
Category
Clinical Presentation
Epidemiology
Subject
Long Covid
Symptoms
Clinical Presentation
Population
All
Clinical Setting
Ambulatory
Community
ICU
Long Term Care
Medicine Unit
Primary care
Public Health
Priority Level
Level 1 2-3 days
Cite As
Williams-Roberts, H; Groot, G; Reeder, B; Howell-Spooner, B; Ellsworth, C. What is the incidence and duration of Long COVID cases? 2021 Jul 09, Document no.: EPM210601 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 19 p. (CEST rapid review report).
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Document Type
Rapid Review
Review Code
LTC060202 RR
Question Submitted
June 2, 2020
Date Completed
June 19, 2020
Status
3. Completed
Research Team
Long Term Care
Document Type
Rapid Review
Review Code
LTC060202 RR
Question Submitted
June 2, 2020
Date Completed
June 19, 2020
Status
3. Completed
Research Team
Long Term Care
Key Findings
The majority of studies show elderly persons (>65 years) have significantly longer COVID-19 incubation periods compared to younger adults with a mean difference of +3.9 days (Lieu J et al. 2020; Kong TK et al. 2020; Jiang et al. 2020; Guo et al. 2020). One study showed no difference between those >60 years and younger patients (Lian et al. 2020).
Median incubation period across all studies (all ages) was 5 days (5.4 days mean). Jiang et al. (2020) report a mean incubation period of 7 days for younger adults and 10.9 days for those over age 65.
Upper limit of incubation period is 12-14 days with one study reporting 27 days (Nanda et al. 2020).
Median duration from symptom onset to death is 11.5 days in persons >70 years vs. 14 days in younger adults (Geriatric Emergency department collaborative March 2020).
Older age and more severe infections are associated with higher viral loads; however, viral shedding is not associated with infectivity. (European Centre for Disease Prevention and Control, 2020).
Doubling time of COVID-19 among residents from a single long-term care home was estimated to be 3.4 days compared to 5.5 days in the general population in the surrounding county (Arons et al. 2020).
Infected patients over the age of 65 years remain contagious for a significantly longer period (22 days vs. 19 days, p=0.015; Ziao et al. 2020).
Viral shedding may be longer for immune compromised patients (BC CDC 2020).
Symptom duration varies by nature of the symptom with a median time from diagnosis to discharge from hospital ranging from 13 days (range = 7-17; Ki et al. 2020) to 18.5 days (range = 11-27; Kim et al. 2020).
There is limited information on basic reproduction number in older adult populations. These values vary by region and over time. R0 values for whole populations (all ages) have been reported as low as 0.48 (Ki et al. 2020) to 2.5 (Lewnard et al. 2020)
Please see related reports by the Laboratory Working Group available in the SHA COVID-19 repository (not specific to elderly). o LAB041601 RR Antibody development, viral shedding and infectiousness. o LAB040701-01 RR Proportion of disease transmission due to asymptomatic, pre-symptomatic and symptomatic cases.
Category
Epidemiology
Healthcare Services
Subject
Clinical Presentation
Transmission
Infection Prevention and Control
Elderly
Priority Level
Level 5 completed within 2 weeks
Cite As
Tupper, S; Ward, H; Dalidowicz, M; Ellsworth, C. What is the incubation period, rate of spread, and duration of infectivity of COVID-19 in older adults? 2020 Jun 19; Document no.: LTC060202 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 28 p. (CEST rapid review report)
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