Knowledge and Library Services Evidence Update
Part of the Barts Health Education Academy
Hello and welcome to this bumper edition of Barts Health Knowledge and Library Services’ fortnightly COVID-19 evidence update, back after a brief break.

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News and Opinion

Guidance and Institutional Publications
Latest Research Articles
Library COVID Update
New on our Website
Our Other Recent Updates

News and Opinion

From HSJ
From The Guardian:
From NHS Executive: 78% of NHS workers volunteered or raised money during the pandemic
From The Kings Fund: Leading through Covid-19: a customer-first approach to health care
"We spoke to Dr Afsana Safa, a GP in Westminster, about remote patient monitoring, rediscovering creativity and the innovation and self-learning that can come as a result..."

Guidance and Institutional Publications

From The Department of Health and Social Care:
Updated by The Royal College of Paediatrics and Child Health:
From NICE: Medtech innovation briefing [MIB264] SYNE-COV for predicting COVID-19 outcomes
"The main points from the evidence summarised in this briefing are from 1 published study and 1 unpublished study. The published study retrospectively analysed data from a cohort of people with COVID‑19 who were admitted to an NHS hospital trust (n=879). Machine-learning algorithms were used to predict the chance of 3 clinical outcomes. Results suggest that the best model using one of 3 algorithms showing area under the receiver operating characteristic scores were 0.76 for hospital mortality, 0.84 for intensive care admission and 0.87 for having mechanical ventilation. The unpublished validation study assessed the performance of the SYNE‑COV algorithm and reported the accuracy of risk prediction compared with existing clinical risk scores as a reference standard..."
From NHS Employers: Long COVID webinar recording
"On the 22 June 2021, we hosted a webinar which provided information on how NHS organisations can best support colleagues with long COVID. In the webinar you can hear from: the authors of the COVID-19 return to work guidelines, published by The Society of Occupational Medicine;  legal firm Capsticks, who outlined the legal implications regarding what employers can and cannot do when it comes to supporting their staff with long COVID; speakers from Guy's and St Thomas' NHS Foundation Trust, who shared the work their organisation has done regarding return to work and rehabilitation support for colleagues with long COVID..."

Updated procedural instructions on Administration of the Pfizer BioNTech COVID-19 vaccine (BNT162b2) by intramuscular injection
"This procedure is now back up on the website following updating and double-blind peer review. It has been revised to take account of guidance from Public Health England that vaccinators should not use the Z-track method when giving vaccinations for COVID-19. Instead, the illustrations now show stretching the skin over the deltoid muscle in preparation for insertion of the needle..."

From The Medicines and Healthcare products Regulatory Agency (MHRA):
From Public Health England: COVID-19 Health Inequalities Monitoring in England Tool (CHIME)
"A national monitoring tool that will bring together data monitoring the direct impacts of COVID-19 on health inequalities... [with updated interactive dashboard]"
"What's New?" updates to COVID-19 entries in clinical decision support tool UpToDate:
Free elearning course from The Royal College of General Practitioners (RCGP): Long term effects of COVID-19 and Post-COVID-19 syndrome
"Introduces the key recommendations from the NICE/SIGN/RCGP guidance, post-COVID-19’s impact on patients and how to manage their symptoms and expectations..."
From NHS England and NHS Improvement: Long COVID: the NHS plan for 2021/22
"Builds on the five-point plan which outlines 10 key next steps to be taken to support those suffering from long COVID..."

Latest Research Articles

Safety and Immunogenicity Report from the Com-COV Study – a Single-Blind Randomised Non-Inferiority Trial Comparing Heterologous And Homologous Prime-Boost Schedules with An Adenoviral Vectored and mRNA COVID-19 Vaccine
"Com-COV (ISRCTN: 69254139, EudraCT: 2020-005085-33) is a participant-blind, non-inferiority trial evaluating vaccine reactogenicity and immunogenicity. Adults ≥ 50 years, including those with well-controlled comorbidities, were randomised across eight groups to receive ChAd/ChAd, ChAd/BNT, BNT/BNT or BNT/ChAd, administered at 28- or 84-day intervals... Despite the BNT/ChAd regimen not meeting non-inferiority criteria, the GMCs of both heterologous schedules were higher than that of a licensed vaccine schedule (ChAd/ChAd) with proven efficacy against COVID-19 disease and hospitalisation. These data support flexibility in the use of heterologous prime-boost vaccination using ChAd and BNT COVID-19 vaccines..."
Persistent symptoms following SARS-CoV-2 infection in a random community sample of 508,707 people
"Within rounds 3–5 of the REACT-2 study, 508,707 people in the community in England were asked about a prior history of COVID-19 and the presence and duration of 29 different symptoms. We used uni- and multivariable models to identify predictors of persistence of symptoms (12 weeks or more). We estimated the prevalence of symptom persistence at 12 weeks, and used unsupervised learning to cluster individuals by symptoms experienced..."
[Commentary] COVID-19 and the multisystem inflammatory syndrome in children: how vulnerable are the kidneys?
"When affected by coronavirus disease 2019 (COVID-19), most children have milder disease than what is experienced by adults. However, a subset of these children develops a multisystem inflammatory syndrome that can lead to shock and multiorgan failure. In the current issue, Basalely et al. characterize acute kidney injury in pediatric patients with acute COVID-19 and multisystem inflammatory syndrome. Despite the associated morbidity, this cohort provides evidence of kidney recovery in most affected children..."

[Special Report] SARS-CoV-2 Variants and Vaccines
"Viral variants of concern may emerge with dangerous resistance to the immunity generated by the current vaccines to prevent coronavirus disease 2019 (Covid-19). Moreover, if some variants of concern have increased transmissibility or virulence, the importance of efficient public health measures and vaccination programs will increase. The global response must be both timely and science based..."

Taskforce report on the diagnosis and clinical management of COVID-19 associated pulmonary aspergillosis
"A group of 28 international experts reviewed current insights in the epidemiology, diagnosis and management of CAPA and developed recommendations using GRADE methodology... The prevalence of CAPA varied between 0 and 33%, which may be partly due to variable case definitions, but likely represents true variation. Bronchoscopy and bronchoalveolar lavage (BAL) remain the cornerstone of CAPA diagnosis, allowing for diagnosis of invasive Aspergillus tracheobronchitis and collection of the best validated specimen for Aspergillus diagnostics. Most patients diagnosed with CAPA lack traditional host factors, but pre-existing structural lung disease and immunomodulating therapy may predispose to CAPA risk. Computed tomography seems to be of limited value to rule CAPA in or out, and serum biomarkers are negative in 85% of patients. As the mortality of CAPA is around 50%, antifungal therapy is recommended for BAL positive patients, but the decision to treat depends on the patients’ clinical condition and the institutional incidence of CAPA. We recommend against routinely stopping concomitant corticosteroid or IL-6 blocking therapy in CAPA patients..."
How a corona infection changes blood cells in the long run
"Method could help as an early warning system to detect future pandemics by unknown viruses... Using real-time deformability cytometry, researchers at the Max-Planck-Zentrum für Physik und Medizin in Erlangen were able to show for the first time: Covid-19 significantly changes the size and stiffness of red and white blood cells - sometimes over months. These results may help to explain why some affected people continue to complain of symptoms long after an infection (long covid)..."
RECOVERY trial finds Regeneron’s monoclonal antibody combination reduces deaths for hospitalised COVID-19 patients who have not mounted their own immune response
"The treatment uses a combination of two monoclonal antibodies (casirivimab and imdevimab, known as REGEN-COV in the US) that bind specifically to two different sites on the coronavirus spike protein, neutralising the ability of the virus to infect cells..."
[Preprint] Inequalities in healthcare disruptions during the Covid-19 pandemic: Evidence from 12 UK population-based longitudinal studies
"Participants reported disruptions from March 2020 up to late January 2021. Associations between social characteristics and three types of self-reported healthcare disruption (medication access, procedures, appointments) and a composite of any of these were assessed in logistic regression models, adjusting for age, sex and ethnicity where relevant. Random-effects meta-analysis was conducted to obtain pooled estimates..."
Cardiovascular biomarkers in COVID-19
"Cardiovascular biomarkers, including markers of myocardial injury (cardiac troponins), haemodynamic stress (B-type natriuretic peptides), and fibrin degradation products (D-dimer), are commonly elevated in proportion to disease severity in COVID-19. The frequency of myocardial injury is particularly high in critically ill patients with ARDS, those requiring mechanical ventilation and in non-survivors..."

Library COVID Update

All staff are now required to sign-in, and wash their hands with the gel provided, when entering our libraries.

St Bart’s Hospital Library has moved back to its original space in the department of diagnostic imaging, on the ground floor of the KGV Building. It will be staffed from 10am-4pm, Monday to Friday, and available to staff 24/7. The phone no. there is 020 3465 5467.

At Whipps Cross and Newham Hospitals we offer comfortable seats and computer access, with tea and coffee, from 10am-4pm. Please check local notices for details. Staff can continue to access our 24/7 knowledge hubs (computer rooms) on each site.

Our Library Hub at the Royal London continues to be available to staff 24/7.

Please see our new website and our Digital Library WeShare page for more information.

New on Our Website

Browse the resource collections within our COVID-19 pages; plus further services, resources, and NHS discounts have been added to our Wellbeing pages.

Our  Leadership and Management subject guide collects all our services and resources on the topic, and signposts to external help.

You can now search the entirety of our collection from the website homepage below via the Discovery search bar too...

Visit Green at Barts Health's new website, hosted and maintained by Knowledge and Library Services:


Our Other Recent Updates

Read our latest monthly Leadership Update (published 7/6/21) here.
Read our latest Health Services Management Update (published 4/6/21) here.
Read our latest Inclusion and Diversity Update (published 28/5/21) here.
Read our previous COVID-19 Update (published 24/5/21) here.
Read our latest monthly Delirium in ICU Evidence Alert (published 17/5/21) here.
Read our latest Staff Wellbeing Update (published 13/5/21) here.
Read our latest COVID-19 and TB Update (published 5/5/21) here.
Read our round-up of research published by Barts Health authors in the month of April 2021 (published 4/5/21) here.
Read our latest Safer Surgery Update (published 18/5/21) here.

Catch up with all our archived updates on our Digital Library Weshare page.

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