Menu Menu
Communique

Weekly Communique # 15

23 July, 2020

WEEK IN REVIEW

Rooming-in recommendation
The Pregnancy and Perinatal Care Panel have made their third conditional recommendation. This week’s concerns Rooming-in:

For women with COVID-19 who have given birth, support rooming-in of mother and newborn. However, women with COVID-19 should use infection control and prevention measures (mask and hand hygiene) while infectious.

There is currently no evidence to indicate that a woman with a known COVID-19 infection should be separated from her newborn to prevent transmission. As there are substantial known benefits for keeping mother and newborn together postpartum, women should be supported to be with their newborn as per usual care.

Women should be encouraged and supported in using good hand hygiene before and after handling their baby, and using a mask while in close contact with their baby. To the extent possible, women who are infectious should practice physical distancing when not feeding or caring for the baby.

Policy on use of media statements, preprints and other non-peer-reviewed papers

The Taskforce has developed a policy on the use of media statements, preprints and other non-peer-reviewed papers. As a living guideline in an area of fast-moving research, timeliness in formulating and updating recommendations is critical to guide current clinical care and management of COVID-19. Read the full policy here.

Consumer Panel update

Our Consumer Panel convened again this week and has initiated work to develop preferences and values statements to inform Taskforce recommendations.

In line with GRADE methodology, preference and values statements are important to guide considerations about the certainty of available evidence, and the nature and implementability of recommendations for specific patient-focused care. Recognising that systematically collected evidence on preferences and values from patients with suspected or confirmed COVDI-19 is not yet available, the Panel will continue to work through existing recommendations while monitoring the emerging literature in this space.

The Taskforce Consumer Panel is co-convened with our Community Partner, the Consumers Health Forum of Australia.

 


QUICK STATISTICS

COVID-19 research pipeline

  • 13,672 studies published or registered in Cochrane COVID-19 Study Register, 843 added this week
  • 1,410 randomised controlled trials registered (data from Covid-nma site), 83 added this week
  • 30 randomised controlled trials published (data from Covid-nma site), 2 added this week
  • 1,716 systematic reviews registered in PROSPERO, 52 added this week

 


NEW OR UPDATED RECOMMENDATIONS

Rooming-in

Conditional recommendation

  • For women with COVID-19 who have given birth, support rooming-in of mother and newborn. However, women with COVID-19 should use infection control and prevention measures (mask and hand hygiene) while infectious.

Remdesivir for adults UPDATED

Key information revised to include specific considerations for people requiring palliative care and older people living with frailty or cognitive impairment. There has been no change to the strength or direction of the recommendation.

Hydroxychloroquine UPDATED

Minor change to the remark to note the publication of the preprint results of the RECOVERY trial on 15 July. There has been no change to the strength or direction of the recommendation.

The Taskforce is continually monitoring research to update recommendations weekly as new evidence accumulates.

 


CLINICAL FLOWCHARTS

Five clinical flowcharts have been developed by the Taskforce to cover:

  • Assessment for suspected COVID-19
  • Management of adults with mild COVID-19
  • Management of adults with moderate to severe COVID-19
  • Management of adults with severe to critical COVID-19
  • Respiratory support for adults with severe to critical COVID-19

* No changes required to flowcharts this week

 


EVIDENCE UNDER REVIEW

We are currently reviewing evidence to develop recommendations and flowcharts to guide practice in areas including:

  • Non-invasive ventilation NEW
  • Home oxygen monitoring NEW
  • Skin to skin contact for parents and newborns NEW
  • Disease-modifying treatments for pregnant woman
  • Disease-modifying treatments for children and adolescents
  • Disease-modifying treatments for people requiring palliative care and frail older people
  • Cardiac arrest
  • Hydroxychloroquine
  • Darunavir/cobicistat
  • ECMO in pregnancy

 


NEW TOPICS & QUESTIONS

It is a core mission of the Taskforce to engage with frontline clinicians to rapidly identify and address priority clinical questions.

Each week we collect suggestions for new clinical questions or topics for consideration by the Taskforce. A document that lists all of the suggested questions, topics and new patient groups that we have received to date is updated each week and available here.

Please encourage your clinical colleagues to provide their insights via the website.

 


PARTNER UPDATES

Australian Commission on Safety and Quality in Health Care
The next iteration of the Commission’s summary of ‘Potential Treatments in COVID-19′ (15 July 2020), is now available. The document now cross references with Taskforce recommendations. Read here.

Revisions to this version reflect research activity over the last three weeks, including:

  • Further developments in the large collaborative randomised RECOVERY trial
  • Further information on the WHO SOLIDARITY trial
  • The TGA’s announcement on remdesivir

Cochrane

Cochrane have developed a Special Collection that brings together Cochrane evidence on interventions that may help support the wellbeing of the healthcare workforce and reducing occupational stress. Read here.
Topics