Promoting the use of robust research evidence in the treatment and management of Covid-19

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On 30 January 2020, the World Health Organization declared the novel coronavirus a public health emergency of international concern. Since then, there have been multiple national lockdowns worldwide aiming to control the spread of the SARS-CoV-2 virus and an unprecedented amount of research into the prevention, diagnosis, prognosis and treatment of this disease. Considerable amounts of new evidence are being released every day.

With increasing pressures on healthcare staff and decision makers, it has been difficult to keep up to date with the latest research, particularly when so much literature is being produced. It has been even more challenging because of significant unknowns around the virus. For example, there was great uncertainty about the potential benefits of steroids in the treatment of Covid-19 in February 2020, and we now have several studies and reviews that show their benefits when used for people with severe disease.

To help decision makers have access to relevant, robust information that allow them to act quickly, Evidence Aid created a collection of verified evidence from peer reviewed published systematic reviews funded by the H2H Network which is supported by UK aid from the UK government.

The work of Evidence Aid and its Covid-19 evidence collection reflect many of the WHO framework actions, which included 50 proposed actions for a framework for managing infodemics in health emergencies. The collection provides up to date, accurate and concise summaries of relevant literature related to Covid-19 in all income settings around the world. Only the highest quality research from systematic reviews and meta-analyses transit through the screening process to writers who produce concise unbiased summaries of essential literature. (Allen C, Heaven Taylor B, Winchester C., 2020)

Where there are multiple reviews for a topic, these are grouped together into a combined summary which covers and links to all the evidence. Some examples include hygiene measures to prevent the spread of Covid, isolation and quarantine, school closures, use of telemedicine, and cancer and Covid.

Continual weekly screening of around 1,000 citations per month of current and emerging literature are screened by two volunteers. A third volunteer makes a final decision on which citations to use and prioritises systematic reviews for inclusion based on quality and relevance. The collection of summaries allows decision-makers to quickly understand developments in the Covid-19 evidence base and to filter the knowledge they need to tackle the direct and indirect effects of the pandemic. Links to the full text of the summarised reviews are available alongside the summary should readers wish to delve deeper into the evidence and we also show if the review is freely available and the language of its publication.

In an age of ‘fake news’, social media conspiracies and misinformation, Evidence Aid is providing factual, screened and secure information. Making the summaries available in multiple languages helps ensure adoption of the evidence in local contexts globally.

Working with over 100 volunteers, in the first ten months since the Covid-19 evidence collection was started, almost 10,000 articles have been screened and over 500 plain language summary articles have been written and translated, covering more than 775 systematic reviews. These multi-lingual (Arabic, Chinese Simplified and Traditional, English, French, German, Italian, Portuguese and Spanish) plain language summaries are all free to access online and the special collection has been viewed by more than 425,000 people worldwide.

The most viewed articles vary each week and often the most viewed article is in a language other than English; In December 2020 the most viewed articles were on the association of D-dimer and severity of Covid-19 (in Arabic and French), and the use of masks to prevent disease transmission (in Arabic).

In accordance with the WHO recommended framework, Evidence Aid is a trusted resource, which helps prevent misinformation. As we move into a period of vaccination, there will be another surge in publication and reviewing of vaccine-related new research, presenting evidence on safety and efficacy. Evidence Aid’s continued role of screening and summarising articles will be invaluable in facilitating the understanding of this new research, for decision-makers and the public alike.

In conclusion, as the Covid-19 infodemic shows no sign of slowing down, a trusted resource is vital for people making decisions and choices during these challenging times. Evidence Aid will continue to provide a single, simple, and accessible source of information across the full spectrum of the management of the Covid-19 pandemic.

Authors:

Claire Allen, Evidence Aid, UK

Alison Mace, Honour Health, County Durham, UK (Evidence Aid volunteer)

Epaminondas La Bella, European Reference Network for Rare Hereditary Metabolic Disorders, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy (Evidence Aid volunteer)