2020 Issue 7

Three new protocols and one  new review are available in Issue 7 of the Cochrane Database of Systematic Reviews

New COVID-19 Review

Struyf T, Deeks  JJ, Dinnes  J, Takwoingi  Y, Davenport  C, Leeflang  MMG, Spijker  R, Hooft  L, Emperador  D, Dittrich  S, Domen  J, Horn  SR A, Van den Bruel  A. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID‐19 disease. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No.: CD013665. DOI: 10.1002/14651858.CD013665

New Protocols

Ciapponi  A, Matthews  S, Cafferata  ML, Comandé  D, Gibbons  L, Núñez-González  S, Buekens  P, Arevalo-Rodriguez  I. Laboratory tests for diagnosis of congenital Zika virus in fetuses and neonates. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No.: CD013676. DOI: 10.1002/14651858.CD013676

Vonasek  B, Ness  T, Takwoingi  Y, Kay  AW, Wyk  SS, Ouellette  L, Marais  BJ, Steingart  KR, Mandalakas  AM. Screening tests for active pulmonary tuberculosis in children. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No.: CD013693. DOI: 10.1002/14651858.CD013693

Shapiro  AE, Ross  JM, Schiller  I, Kohli  M, Dendukuri  N, Steingart  KR, Horne  DJ. Xpert MTB/RIF and Xpert Ultra assays for pulmonary tuberculosis and rifampicin resistance in adults irrespective of signs or symptoms of pulmonary tuberculosis. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No.: CD013694. DOI: 10.1002/14651858.CD013694


2020 Issue 6

Three new protocols and two new reviews are available in Issue 6 of the Cochrane Database of Systematic Reviews

New COVID-19 Reviews

Deeks JJ, Dinnes J, Takwoingi Y, Davenport C, Spijker R, Taylor-Phillips S, Adriano A, Beese S, Dretzke J, Ferrante di Ruffano L, Harris IM, Price MJ, Dittrich S, Emperador D, Hooft L, Leeflang MMG, Van den Bruel A. Antibody tests for identification of current and past infection with SARSCoV2. Cochrane Database of Systematic Reviews 2020, Issue 6. Art. No.: CD013652. DOI: 10.1002/14651858.CD013652.

As part of the Cochrane Library Covid-19 resources, Jonathan Deeks and colleagues have created a suite of living systematic reviews to cover the roles of tests and characteristics in the diagnosis of COVID‐19.  Following the emergence of COVID‐19 there has been a rapid and prolific industry activity to develop accurate antibody tests, and at the time of writing (21 May 2020), there were 279 antibody tests listed, 196 of which are produced by commercial companies and are commercially available.

This new review has the objective of assessing the diagnostic accuracy of antibody tests  to determine if a person presenting in the community or in primary or secondary care has SARS‐CoV‐2 infection, or has previously had it. It includes both laboratory‐based methods ( enzyme‐linked immunosorbent assays (ELISA), chemiluminescence immunoassays (CLIA), other laboratory‐based methods (e.g. indirect immunofluorescence tests (IIFT), luciferase immunoprecipitation system (LIPS); and tests designed to be used at point‐of‐care: lateral flow assays, including both colloidal gold or fluorescence‐labelled immunochromatographic assays (CGIA or FIA). 

This first version of the review includes both commercially available tests, which have regulatory approval, and in‐house assays and assays in development. Future versions of the review are likely to be restricted to only commercially available assays. The authors identified 57 publications reporting on a total of 54 study cohorts with 15,976 samples; studies were conducted in Asia (n = 38), Europe (n = 15), and the USA and China (n = 1).  38 studies that provided results based on the time since people first noticed symptoms were analyzed; antibody tests one week after first symptoms only detected 30% of people who had COVID‐19. Accuracy increased in week 2 with 70% detected, and was highest in week 3 (more than 90% detected). Little evidence was available after week 3. Tests gave false positive results in 2% of those without COVID‐19.

There were several limitations to the studies: most of them were small, did not use the most reliable methods and did not report their results fully, and were published quickly online as ‘preprints’, without undergoing peer-review. Also, most participants were in hospital with COVID‐19, so were likely to have more severe disease than people with mild symptoms who were not hospitalised, which means that we don't know how accurate antibody tests are for people with milder disease or no symptoms. The authors conclude that the design, execution and reporting of studies of the accuracy of COVID‐19 tests requires considerable improvement; ongoing updates of this living systematic review are planned.

New Reviews

Jullien S, Dissanayake HA, Chaplin M. Rapid diagnostic tests for plague. Cochrane Database of Systematic Reviews 2019, Issue 10. Art. No.: CD013459. DOI: 10.1002/14651858.CD013459.pub2.

Sophie Jullien, Harsha Dissanayake and Marty Chaplin are the authors of this new diagnostic review, which aims to determine the accuracy of the rapid diagnostic test (RDT) based on the antigen F1 (F1RDT), for detecting plague in people with suspected disease.

Plague is an ancient disease, caused by the bacteria Yersinia pestis; it is primarily a vector borne zoonosis, affecting rodents and other wild and domestic animals, and transmitted to humans by rodent fleas. Less frequently, plague can be transmitted through scratches or bites from infected animals, direct handling of infected animals, and human‐to‐human transmission by inhalation of droplets from people with pneumonic plague.

As of 2017, the Democratic Republic of the Congo (DRC), Madagascar, and Peru had the highest incidence of the disease, but new outbreaks are continuously being reported.  F1RDT is the only RDT for plague that has been developed for clinical purposes, and it detects the F1 capsular antigen of Y pestis (F1RDT), which is present in large amounts in buboes, blood, and sputum from patients infected with plague. The test gives a semi‐quantitative result within 15 minutes according to the intensity of the line (from 1+ to 4+), although it is most commonly used as a qualitative test (positive or negative result). Currently, the F1RDT that is mainly used in the field is produced in Madagascar, although other versions are produced, but not licensed for use.

The review includes eight manuscripts reporting seven studies, conducted in three countries in Africa among adults and children with any form of plague. The reference standards were bacterial isolation by culture, polymerase chain reaction (PCR), and paired serology. Against culture, the F1RDT appeared highly sensitive for diagnosing either pneumonic or bubonic plague. For any form of plague and when compared to culture, F1RDT registered positive in 100% (sensitivity) of people who had plague and registered negative in 70% of people who actually did not have plague (specificity). In conclusion, F1RDT appears to be highly sensitive for pneumonic or bubonic plague, and as it is a simple test that can be performed at a patient's bedside in remote and low‐resource areas, it can assist with plague diagnosis for early management, and appropriate preventive measures to avoid spread of the disease. However, F1RDT does not fully replace culture, which provides additional information on resistance to antibiotics and bacterial strains.

New COVID-19 Protocols

McInnes MDF, Leeflang MMG, Salameh J-P, McGrath TA, Pol CB, Frank RA, Prager R, Hare SS, Dennie C, Spijker R, Deeks JJ, Dinnes J, Jenniskens K, Korevaar DA, Cohen JF, Van den Bruel A, Takwoingi Y, de Wijgert J, Damen JAAG, Hooft L. Imaging tests for the diagnosis of COVID19. Cochrane Database of Systematic Reviews 2020, Issue 6. Art. No.: CD013639. DOI: 10.1002/14651858.CD013639.

New Protocols

Florez ID, Sierra J, Pérez-Gaxiola G. Balanced crystalloid solutions versus 0.9% saline for treating acute diarrhoea and severe dehydration in children. Cochrane Database of Systematic Reviews 2020, Issue 6. Art. No.: CD013640. DOI: 10.1002/14651858.CD013640.

Taylor M, Oliver S, Garner P. Mass drug administration for filariasis: community views and programme design influences a qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2020, Issue 6. Art. No.: CD013638. DOI: 10.1002/14651858.CD013638.

2020 Issue 5

No publications produced for Issue 5

2020  Issue  4 

Four new reviews and two new protocols are available in Issue 4 of the Cochrane Database of Systematic Reviews 

New COVID-19 Reviews

Nussbaumer‐Streit  B, Mayr  V, Dobrescu  AI, Chapman  A, Persad  E, Klerings  I, Wagner  G, Siebert  U, Christof  C, Zachariah  C, Gartlehner  G. Quarantine alone or in combination with other public health measures to control COVID‐19: a rapid review. Cochrane Database of Systematic Reviews 2020, Issue 4. Art. No.: CD013574. DOI: 10.1002/14651858.CD013574

This review is part of Cochrane's work on Rapid Reviews in response to COVID-19. The review was   commissioned by WHO and prepared by a Cochrane Austria team led by Barbara Nussbaumer‐Streit. The review’s aim is to assess the effects of quarantine (alone or in combination with other measures) of individuals who had contact with confirmed cases of COVID‐19, who travelled from countries with a declared outbreak, or who live in regions with high transmission of the disease. It includes cohort studies, case‐control‐studies, case series, time series, interrupted time series, and mathematical modelling studies that assessed the effect of any type of quarantine to control COVID‐19, as well as studies on SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome). The authors included 29 studies; 10 modelling studies on COVID‐19, four observational studies and 15 modelling studies on SARS and MERS. Because of the diverse methods of measurement and analysis it was not possible to conduct a meta‐analysis and the authors conducted a narrative synthesis. Modeling studies consistently reported a benefit of the simulated quarantine measures, for example, quarantine of people exposed to confirmed or suspected cases averted 44% to 81% incident cases and 31% to 63% of deaths compared to no measures. When the models combined quarantine with other prevention and control measures, including school closures, travel restrictions and social distancing, the models demonstrated a larger effect on the reduction of new cases, transmissions and deaths than individual measures alone. The authors conclude that quarantine is important in reducing incidence and mortality during the COVID‐19 pandemic, and it is important to constantly monitor the outbreak situation and the impact of the measures implemented. A summary of this review is also available as a podcast and as Cochrane Clinical Answers.

Paludan-Müller  AS, Boesen  K, Klerings  I, Jørgensen  KJ, Munkholm  K. Hand cleaning with ash for reducing the spread of viral and bacterial infections: a rapid review. Cochrane Database of Systematic Reviews 2020, Issue 4. Art. No.: CD013597. DOI: 10.1002/14651858.CD013597

New Reviews

Conterno  LO, Turchi  MD, Corrêa  I, Monteiro de Barros Almeida  RA. Anthelmintic drugs for treating ascariasis. Cochrane Database of Systematic Reviews 2020, Issue 4. Art. No.: CD010599. DOI: 10.1002/14651858.CD010599.pub2

A team from Brazil, led by Lucieni O Conterno, has completed this new review, which compares the efficacy and safety of anthelmintic drugs (albendazole, mebendazole, ivermectin) used for treating people with Ascaris infection. Ascaris lumbricoides is a common infection, and mainly affects children living in low‐income areas. The authors included 30 parallel‐group RCTs, which enrolled 6442 participants from 17 countries across Africa, Asia, Central America and the Caribbean, and South America. Single dose of albendazole (four trials), mebendazole (three trials) or ivermectin (one trial) were compared to placebo. Single‐dose of albendazole, mebendazole, and ivermectin all appeared effective against Ascaris lumbricoides infection, yielding high parasitological cure at 14 to 60 days and large reductions in eggs excreted, with no differences detected between them. The drugs appear to be safe to treat children and adults with confirmed Ascaris infection. The authors conclude that albendazole, mebendazole, ivermectin are all effective against ascariasis, and it is unclear whether any outstanding questions regarding their use remain.

 Murray  M, Hine  P. Treating progressive disseminated histoplasmosis in people living with HIV. Cochrane Database of Systematic Reviews 2020, Issue 4. Art. No.: CD013594. DOI: 10.1002/14651858.CD013594 (28 Apr)

New Protocols

Deeks JJ, Dinnes J, Takwoingi Y, Davenport C, Leeflang MMG, Spijker R, Hooft L, Van den Bruel A, Emperador D, Dittrich S.  Diagnosis of SARS‐CoV‐2 infection and COVID‐19: accuracy of signs and symptoms; molecular, antigen, and antibody tests; and routine laboratory markers Cochrane Database of Systematic Reviews 2020, Issue 4. Art. No.: CD013596. DOI: 10.1002/14651858.CD013596.

Singh B, Ryan H, Kredo T, Chaplin M, Fletcher T. Chloroquine or hydroxychloroquine for prevention and treatment of COVID‐19. Cochrane Database of Systematic Reviews 2020, Issue 4. Art. No.: CD013587. DOI: 10.1002/14651858.CD013587

2020 Issue 3

No publications produced for Issue 3

2020 Issue 2 

No publications produced for Issue 2

2020 Issue 1 

No publications produced for Issue 1