Evidence from Cochrane systematic reviews for controlling the dissemination of COVID-19 infection. A narrative review.

Flumignan, Ronald Luiz Gomes; Nakano, Luis Carlos Uta; Pascoal, Patricia Irene Ferreira; Santos, Brena Costa Dos; Correia, Rebeca Mangabeira; Silveira, Beatriz Périco; Takihi, Fabio Akio; Flumignan, Carolina Dutra Queiroz; Amorim, Jorge Eduardo de; Atallah, Álvaro Nagib

BACKGROUND COVID-19 infection has high transmissibility and several measures have been adopted for controlling its dissemination. OBJECTIVE To identify and summarize the evidence from Cochrane systematic reviews (SRs) regarding measures for controlling the dissemination of COVID-19 infection. DESIGN AND SETTING This review of Cochrane SRs was carried out in the Division of Vascular and Endovascular Surgery and in the Division of Emergency Medicine and Evidence-Based Medicine of Universidade Federal de São Paulo, Brazil. METHODS A comprehensive search in the Cochrane Database of Systematic Reviews retrieved all Cochrane SRs directly related to measures for controlling COVID-19 dissemination. The main characteristics and results of all the SRs included were summarized and discussed. RESULTS Three Cochrane SRs were included in the qualitative synthesis. These evaluated population-based and individual measures for controlling the dissemination of COVID-19. CONCLUSION Low-certainty evidence shows that quarantine for people exposed to confirmed or suspected COVID-19 cases prevented 44% to 81% of incident cases and 31% to 63% of deaths, compared with situations of no measures. Moreover, the sooner the quarantine measures were implemented, the greater the cost savings were. High-confidence evidence showed that clear communication about infection control and prevention guidelines was vital for successful implementation. Low-certainty evidence showed that healthcare professionals with long gowns were less exposed to contamination than were those using coveralls. In addition, coveralls were more difficult to doff. Further SRs on controlling the dissemination of COVID-19 infection are desirable.