Participatory Approaches in Community Health in light of the COVID-19 Pandemic: A Scoping Review Protocol (preprint)

Background Participatory approaches are considered essential to ensure community health in the context of the COVID-19 pandemic. Previous reviews on community participation have explored different aspects of participation in specific contexts, such as public health emergencies, but none has examined participatory approaches both in depth and in breadth across diverse activities during the COVID-19 pandemic and considering diverse communities in all country contexts. This scoping review seeks to: (a) provide an overview of participatory approaches in terms of the features and depth of participation, the breadth of the communities and stakeholders involved, and for what types of activities and interventions in light of the COVID-19 pandemic across all country contexts; (b) explore the challenges and facilitators of participation processes; and (c) analyse to what extent participation impacts community health, including health equity, in the context of a public health emergency. Methods We developed this protocol following the latest JBI guidance on scoping reviews. A comprehensive search strategy combining the concepts of participation, community health, and COVID-19 was used to search the databases of Medline/Ovid, Embase.com, Cochrane CENTRAL, Web of Science, APA PsycInfo/Ovid, Global Health/Ovid, ERIC/OvidSP, CINAHL/EBSCOhost, ClinTrials.gov, and the grey literature through Google Scholar. At least two reviewers will perform screening of titles/abstracts and full text using the inclusion and exclusion criteria defined in this protocol. Article characteristics and data on participatory approaches and community health will be charted to provide an overview of the literature, map the variations in participatory approaches and community health, and explore patterns in the links between participation, community health, and the type of activities to address the challenges related to the COVID-19 pandemic. Discussion We anticipate that review findings will contribute to advance innovative thinking about community participation and facilitating better application and integration of participatory approaches to ensure community health in a future public health emergency or in building back better fairer in the new normal.

COVID-19 in Health-Care Workers: A Living Systematic Review and Meta-Analysis of Prevalence, Risk Factors, Clinical Characteristics, and Outcomes.

Health-care workers (HCWs) are at the frontline of response to coronavirus disease 2019 (COVID-19), being at a higher risk of acquiring the disease and, subsequently, exposing patients and others. Searches of 8 bibliographic databases were performed to systematically review the evidence on the prevalence, risk factors, clinical characteristics, and prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among HCWs. A total of 97 studies (all published in 2020) met the inclusion criteria. The estimated prevalence of SARS-CoV-2 infection from HCWs' samples, using reverse transcription-polymerase chain reaction and the presence of antibodies, was 11% (95% confidence interval (CI): 7, 15) and 7% (95% CI: 4, 11), respectively. The most frequently affected personnel were nurses (48%, 95% CI: 41, 56), whereas most of the COVID-19-positive medical personnel were working in hospital nonemergency wards during screening (43%, 95% CI: 28, 59). Anosmia, fever, and myalgia were the only symptoms associated with HCW SARS-CoV-2 positivity. Among HCWs positive for COVID-19 by reverse transcription-polymerase chain reaction, 40% (95% CI: 17, 65) were asymptomatic at time of diagnosis. Finally, severe clinical complications developed in 5% (95% CI: 3, 8) of the COVID-19-positive HCWs, and 0.5% (95% CI: 0.02, 1.3) died. Health-care workers suffer a significant burden from COVID-19, with those working in hospital nonemergency wards and nurses being the most commonly infected personnel.

Anemia and iron metabolism in COVID-19: A systematic review and meta-analysis (preprint)

Iron metabolism and anemia may play an important role in multiple organ dysfunction syndrome in Coronavirus disease 2019 (COVID-19). If confirmed, this has important implications for the more than 1.62 billion people estimated to have anemia globally. We conducted a systematic review and meta-analysis to evaluate biomarkers of anemia and iron metabolism (hemoglobin, ferritin, transferrin, soluble transferrin receptor, hepcidin, haptoglobin, unsaturated iron-binding capacity, erythropoietin, free erythrocyte protoporphyrine, and prevalence of anemia) in patients diagnosed with COVID-19, and explore their prognostic value. Six bibliographic databases were searched up to May 5th 2020. We included 56 unique studies, with data from 14,044 COVID-19 patients (59 years median age). Pooled mean hemoglobin and ferritin levels in COVID-19 patients across all ages were 130.41 g/L (95% Confidence Interval (CI), 128.42; 132.39) and 673.91 ng/mL (95% CI, 420.98; 926.84), respectively. Hemoglobin levels decreased with advancing age and increasing percentage of comorbid and critically ill patients, while levels of ferritin increased with increasing male proportion and mean hemoglobin levels. Compared to moderate cases, severe cases had lower pooled mean hemoglobin [weighted mean difference (WMD), -4.21 (95% CI -6.63; -1.78)] and higher ferritin [WMD, -730.55 ng/mL (95% CI 413.24; 1047.85)]. A significant difference in mean ferritin level of 1027.23 ng/mL (95% CI 819.53; 1234.94) was found between survivors and non-survivors, but not in hemoglobin levels. No studies provided information on anemia or other biomarkers of interest. Future studies should explore the impact of iron metabolism and anemia and in the pathophysiology, prognosis, and treatment of COVID-19.