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1.
Cochrane Database of Systematic Reviews ; 2022(8), 2022.
Article in English | EMBASE | ID: covidwho-1981527

ABSTRACT

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effects of molnupiravir in people with confirmed SARS-CoV-2 infection and mild-to-moderate symptoms, with or without risk factors for severe disease.

2.
Emergencias ; 34(4):305-307, 2022.
Article in Spanish | Web of Science | ID: covidwho-1976283
3.
S Afr Med J ; 111(10): 934-937, 2021 08 17.
Article in English | MEDLINE | ID: covidwho-1478412

ABSTRACT

Some clinicians prescribe ivermectin for COVID-19 despite a lack of support from any credible South African professional body. They argue that when faced by clinical urgency, weak signals of efficacy should trigger action if harm is unlikely. Several recent reviews found an apparent mortality benefit by including studies at high risk of bias and with active rather than placebo controls. If these studies are discounted, the pooled mortality effect is no longer statistically significant, and evidence of benefit is very weak. Relying on this evidence could cause clinical harm if used to justify vaccine hesitancy. Clinicians remain responsible for ensuring that guidance they follow is both legitimate and reliable. In the ivermectin debate, evidence-based medicine (EBM) principles have largely been ignored under the guise thatin a pandemic the 'rules are different', probably to the detriment of vulnerable patients and certainly to the detriment of the profession's image. Medical schools and professional interest groups are responsible for transforming EBM from a taught but seldom-used tool into a process of lifelong learning, promoting a consistent call for evidence-based and unconflicted debate integral to clinical practice.


Subject(s)
COVID-19/drug therapy , Ivermectin/administration & dosage , Practice Patterns, Physicians'/standards , /psychology , COVID-19 Vaccines/administration & dosage , Evidence-Based Medicine/standards , Humans , Ivermectin/adverse effects , Research Design , South Africa
4.
S Afr Med J ; 111(3): 227-233, 2021 03 02.
Article in English | MEDLINE | ID: covidwho-1178552

ABSTRACT

BACKGROUND: Evidence on mask use in the general population is needed to inform SARS-CoV-2 responses. OBJECTIVES: To assess the effectiveness of cloth and medical masks for preventing SARS-CoV-2 transmission in community settings. METHODS: Two rapid reviews were conducted searching three electronic databases (PubMed, Embase, Cochrane Library) and two clinical trials registries on 30 and 31 March 2020. RESULTS: We screened 821 records and assessed nine full-text articles for eligibility. One and seven RCTs were included for cloth and medical mask reviews, respectively. No SARS-CoV-2-specific RCTs and no cloth mask RCTs in community settings were identified. A single hospital-based RCT provided indirect evidence that, compared with medical masks, cloth masks probably increase clinical respiratory illnesses (relative risk (RR) 1.56; 95% confidence interval (CI) 0.98 - 2.49) and laboratory-confirmed respiratory virus infections (RR 1.54; 95% CI 0.88 - 2.70). Evidence for influenza-like illnesses (ILI) was uncertain (RR 13.00; 95% CI 1.69 - 100.03). Two RCTs provide low-certainty evidence that medical masks may make little to no difference to ILI infection risk versus no masks (RR 0.98; 95% CI 0.81 - 1.19) in the community setting. Five RCTs provide low-certainty evidence that medical masks may slightly reduce infection risk v. no masks (RR 0.81; 95% CI 0.55 - 1.20) in the household setting. CONCLUSIONS: Direct evidence for cloth and medical mask efficacy and effectiveness in the community is limited. Decision-making for mask use may consider other factors such as feasibility and SARS-CoV-2 transmission dynamics; however, well-designed comparative effectiveness studies are required.


Subject(s)
COVID-19/prevention & control , Infection Control/methods , Masks , Pneumonia, Viral/prevention & control , Humans , Influenza, Human/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/virology , SARS-CoV-2 , Textiles
5.
Samj South African Medical Journal ; 110(11):1077-1080, 2020.
Article in English | Web of Science | ID: covidwho-979208

ABSTRACT

The COVID-19 pandemic requires urgent decisions regarding treatment policy in the face of rapidly evolving evidence. In response, the South African Essential Medicines List Committee established a subcommittee to systematically review and appraise emerging evidence, within very short timelines, in order to inform the National Department of Health COVID-19 treatment guidelines. To date, the subcommittee has reviewed 14 potential treatments, and made recommendations based on local context, feasibility, resource requirements and equity. Here we describe the rapid review and evidence-to-decision process, using remdesivir and dexamethasone as examples. Our experience is that conducting rapid reviews is a practical and efficient way to address medicine policy questions under pandemic conditions.

6.
South African Medical Journal ; 2020.
Article in English | AIM (Africa) | ID: covidwho-864951

ABSTRACT

The COVID-19 pandemic requires urgent decisions regarding treatment policy in the face of rapidly evolving evidence. In response, the South African Essential Medicines List Committee established a subcommittee to systematically review and appraise emerging evidence, within very short timelines, in order to inform the National Department of Health COVID-19 treatment guidelines. To date, the subcommittee has reviewed 14 potential treatments, and made recommendations based on local context, feasibility, resource requirements and equity. Here we describe the rapid review and evidence-to-decision process, using remdesivir and dexamethasone as examples. Our experience is that conducting rapid reviews is a practical and efficient way to address medicine policy questions under pandemic conditions.

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