[Evidence map on post-acute COVID-19 sequelae and rehabilitation: Update as of July 2022Mapa de evidencia sobre las secuelas y la rehabilitación tras la COVID-19 aguda: versión actualizada en julio del 2022]. / Mapa de evidências sobre sequelas e reablitação da covid-19 pós-aguda: uma versão atualizada em julho de 2022.

Objective: To update the evidence map on the effects of interventions for post-acute COVID-19 rehabilitation. Method: The search scope was defined according to the population (patients with symptomatic COVID-19 and post-acute COVID sequelae), the context (interventions for rehabilitation), and the type of study (systematic reviews, rapid reviews, scoping reviews or overviews of reviews). Following a search in PubMed and the Virtual Health Library, two independent authors selected the articles for review. The map was updated on July 27, 2022, using the same procedures employed in the initial review. Results: The initial evidence map included 22 studies (four systematic reviews, four rapid reviews, four reviews of case reports, one scoping review, and nine systematic review protocols). In the present update, an additional 10 studies were included. The analysis revealed four groups of interventions (multimodal, therapeutic, complementary, and pharmacological) and seven groups of outcomes (pathological conditions, diseases/respiratory disorders, pain, physiological and metabolic markers, mental health/quality of life, sensory function, and mortality), totaling 166 associations between interventions and outcomes. The highest number of associations was observed for complementary therapies (n = 94). Among the outcomes, the highest number of associations was observed for physiological and metabolic markers, pathological conditions, and mental health/quality of life (44, 41, and 35 associations respectively). Conclusions: The map update involved the analysis of 69 associations, most notably exercise (isolated, multicomponent, or multimodal intervention), with 23 positive and four potentially positive effects) and pharmacologic and complementary therapies for sensorial functions (15 associations). The high number of systematic review protocols indicates that the literature is still incipient.

Objetivo: Actualizar el mapa de evidencia de los efectos de las intervenciones de rehabilitación tras la COVID-19 aguda. Métodos: El alcance de la búsqueda se definió en función de la población (pacientes que habían tenido COVID-19 sintomática y secuelas tras un cuadro agudo de la enfermedad), el contexto (intervenciones de recuperación de las secuelas) y el tipo de estudio (revisión sistemática, revisión sistemática rápida, revisión del alcance o revisión de revisiones). Después de realizar búsquedas en PubMed y en la Biblioteca Virtual de Salud, dos autores independientes seleccionaron los estudios de revisión. En la actualización del mapa realizada el 27 de julio del 2022 se siguieron los mismos procedimientos descritos anteriormente. Resultados: El mapa de evidencia inicial contenía 22 estudios (cuatro revisiones sistemáticas, cuatro revisiones rápidas, cuatro revisiones de estudios de casos, una revisión del alcance y nueve protocolos de revisión sistemática). En esta actualización se incluyeron otros 10 estudios. Se encontraron cuatro grupos de intervenciones (multimodales y terapéuticas, y tratamientos complementarios y farmacológicos) y siete grupos de resultados (afecciones patológicas, enfermedades y trastornos respiratorios, dolor, indicadores fisiológicos y metabólicos, salud mental/calidad de vida, funciones sensoriales y mortalidad), con un total de 166 asociaciones entre las intervenciones y los resultados. Los tratamientos complementarios presentaron más asociaciones con los resultados (n = 94). Entre los resultados, se destacaron los indicadores fisiológicos y metabólicos, las afecciones patológicas y la salud mental/calidad de vida (44, 41 y 35 asociaciones, respectivamente). Conclusiones: En la actualización del mapa, se analizaron 69 asociaciones entre las cuales se destacan el ejercicio (aislado o compuesto o una intervención multimodal, con 23 efectos positivos y cuatro potencialmente positivos) y las intervenciones farmacológicas y los tratamientos complementarios para las funciones sensoriales (15 asociaciones). El elevado número de protocolos indica que la bibliografía sigue siendo incipiente.

Clinical effectiveness of medical ozone therapy in COVID-19: the evidence and gaps map.

Ozone therapy (OT), a medical procedure, has been showing good results during the coronavirus disease (COVID-19). We aimed to build an evidence and gaps map (EGM) of OT in the COVID-19 ranking the articles found according to levels of evidence and outcomes. The EGM brings bubbles of different sizes and different colors according to the articles. The OT intervention used was major or minor autohemotherapy, rectal insufflation and ozonized saline solution. EGM was based on 13 clinical studies using OT for COVID-19 involving a total of 271 patients. We found 30 outcomes related to OT in COVID-19. Our EGM divided the outcomes into six groups: 1-clinical improvement; 2-hospitalization; 3-inflammatory, thromboembolic, infectious, or metabolic markers; 4-radiological aspects, 5-viral infection and 6-adverse events. Major autohemotherapy was present in 19 outcomes, followed by rectal insufflation. Improvement in clinical symptoms of COVID-19, improvement of respiratory function, improvement of oxygen saturation, reduction in hospital internment, decrease in C-reactive protein, decrease in ferritin, decrease in lactate dehydrogenase, decrease in interleukin 6, decrease in D-dimer, radiological improvement of lung lesions and absence of reported adverse events were related in the papers. The most commonly used concentrations of OT in major autohemotherapy and in rectal insufflation were 40 µg/mL and 35 µg/mL, respectively. Here, we bring the first EGM showing the efficacy and safety of OT in the treatment of COVID-19. OT can be used as integrative medical therapy in COVID-19 at a low cost and improve the health conditions of the patients.

Mapa de evidências sobre sequelas e reablitação da covid-19 pós-aguda: uma versão atualizada em julho de 2022 Evidence map on post-acute COVID-19 sequelae and rehabilitation: Update as of July 2022 Mapa de evidencia sobre las secuelas y la rehabilitación tras la COVID-19 aguda: versión actualizada en julio del 2022

RESUMO Objetivo. Atualizar o mapa de evidências sobre os efeitos de intervenções para reabilitação de covid-19 pós-aguda. Métodos. O escopo da busca foi definido conforme a população (pacientes que tiveram covid-19 sintomática e sequelas da doença pós-aguda), o contexto (intervenções para recuperação das sequelas) e o tipo de estudo (revisão sistemática, revisão sistemática rápida, revisão de escopo ou revisão de revisões). Após a busca na PubMed e na Biblioteca Virtual em Saúde, dois autores independentes selecionaram estudos de revisão. A atualização do mapa feita em 27 de julho de 2022 seguiu os mesmos procedimentos descritos anteriormente. Resultados. O mapa inicial de evidências continha 22 estudos (quatro revisões sistemáticas, quatro revisões rápidas, quatro revisões de estudos de caso, uma revisão de escopo e nove protocolos de revisão sistemática). Nesta atualização, outros 10 estudos foram incluídos. Foram identificados quatro grupos de intervenções (multimodal, terapêutica, terapias complementares e farmacológica) e sete grupos de desfechos (condições patológicas, doenças/transtornos respiratórios, dor, indicadores fisiológicos e metabólicos, saúde mental/qualidade de vida, funções sensoriais, mortalidade), totalizando 166 associações entre intervenções e desfechos. As terapias complementares tiveram mais associações com os desfechos (n = 94). Entre os desfechos, destacaram-se os indicadores fisiológicos e metabólicos, as condições patológicas e a saúde mental/qualidade de vida (44, 41 e 35 associações, respectivamente). Conclusões. Na atualização do mapa, analisaram-se 69 associações, com destaque para exercício (isolado, multicomponente ou intervenção multimodal, apresentando 23 efeitos positivos e quatro potencialmente positivos) e intervenções farmacológicas e terapias complementares para funções sensoriais (15 associações). O alto número de protocolos indica que a literatura permanece incipiente.

Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map.

Background: The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes. Methods: This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects. Results: The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia. Conclusions: The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.

Traditional, complementary, and integrative medicine evidence map: a methodology to an overflowing field of data and noise.

Every day there is criticism about lack of evidence on traditional, complementary, and integrative medicine (TCIM). But is this narrative evidence-based? Are we really missing research about TCIM? Or are we just not looking correctly at the evidence? Evidence maps are a useful method with the dual function of synthesizing available evidence on a specific topic and identifying knowledge gaps. This article presents a six-step evidence map methodology along with recently published TCIM evidence maps, including one related to COVID-19. TCIM evidence maps are useful instruments to inform decision-making for policymakers, health practitioners, and patients.

Es habitual que se critique la falta de evidencia con respecto a las medicinas tradicionales, complementarias e integrativas. Sin embargo, ¿se basa en la evidencia este discurso? ¿Falta realmente investigación sobre las medicinas tradicionales, complementarias e integrativas o es que simplemente no estamos analizando la evidencia de forma adecuada? Los mapas de evidencia son un método útil que tiene una función doble: sintetizar la evidencia disponible por temas específicos y determinar si hay alguna laguna en el conocimiento. En este artículo se presenta una metodología de elaboración de mapas de la evidencia en seis pasos, junto con los mapas de la evidencia de las medicinas tradicionales, complementarias e integrativas publicados recientemente, incluido un mapa sobre la COVID-19. Los mapas de la evidencia de las medicinas tradicionales, complementarias e integrativas son instrumentos útiles para fundamentar la toma de decisiones por parte de los encargados de las políticas, el personal de salud y los pacientes.

A crítica é diária de que faltam evidências em medicinas tradicionais, complementares e integrativas (MTCI). Mas será que esta narrativa se baseia em evidências? Realmente faltam pesquisas em MTCI? Ou será que simplesmente não estamos atentando corretamente às evidências? Os mapas de evidências consistem em uma metodologia útil de dupla função: sintetizar as evidências existentes em um determinado tópico e identificar as lacunas de conhecimento. Neste artigo é apresentada uma metodologia de mapa de evidências de seis passos junto com mapas de evidências de MTCI recém-publicados, incluindo um relacionado à COVID-19. Os mapas de evidências de MTCI são instrumentos úteis para subsidiar a tomada de decisão dos responsáveis por políticas, profissionais da saúde e pacientes.

Evidence map on the contributions of traditional, complementary and integrative medicines for health care in times of COVID-19.

BACKGROUND: Due to the pandemic, there is a significant interest in the therapeutic resources linked to TCIM to support potentially therapeutic research and intervention in the management of Coronavirus - 19 (COVID-19). At the date of this evidence map´s publication, there is no evidence of specific treatments for COVID-19. This map organizes information about symptoms management (especially on dimensions related to mental health and mild viral respiratory infections, as well as immune system strengthening and antiviral activity). METHOD: This evidence map applies methodology developed by Latin American and Caribbean Center on Health Sciences Information based on the 3iE evidence gap map. A search was performed in the Traditional, Complementary and Integrative Medicine Virtual Health Library and PubMed, using the MeSH and DeCS terms for respiratory viral diseases associated with epidemics, COVID-19 symptoms, relevant mental health topics, pharmacological and non-pharmacological interventions related to TCIM. RESULTS: For the map, 126 systematic reviews and controlled clinical studies were characterized, distributed in a matrix with 62 interventions (18 phytotherapy, 9 mind-body therapies, 11 traditional Chinese medicine, 7 homeopathic and anthroposophic dynamized medicines and 17 supplements), and 67 outcomes (14 immunological response, 23 mental health, 25 complementary clinical management of the infection and 5 other). CONCLUSION: The map presents an overview of possible TCIM contributions to various dimensions of the COVID-19 pandemic, especially in the field of mental health, and it is directed to researchers and health professionals specialized in TCIM. Most of the antiviral activity outcomes described in this map refers to respiratory viruses in general, and not specifically to SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus 2). This information may be useful to guide new research, but not necessarily to support a therapeutic recommendation. Finally, any suspicion of COVID-19 infection should follow the protocols recommended by the health authorities of each country/region.