Risk of transmission of respiratory viruses during aerosol-generating medical procedures (AGMPs) revisited in the COVID-19 pandemic: a systematic review

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dc.contributor.authorLeal, Jenine
dc.contributor.authorFarkas, Brenlea
dc.contributor.authorMastikhina, Liza
dc.contributor.authorFlanagan, Jordyn
dc.contributor.authorSkidmore, Becky
dc.contributor.authorSalmon, Charleen
dc.contributor.authorDixit, Devika
dc.contributor.authorSmith, Stephanie
dc.contributor.authorTsekrekos, Stephen
dc.contributor.authorLee, Bonita
dc.contributor.authorVayalumkal, Joseph
dc.contributor.authorDunn, Jessica
dc.contributor.authorHarrison, Robyn
dc.contributor.authorCordoviz, Melody
dc.contributor.authorDubois, Roberta
dc.contributor.authorChandran, Uma
dc.contributor.authorClement, Fiona
dc.contributor.authorBush, Kathryn
dc.contributor.authorConly, John
dc.contributor.authorLarios, Oscar
dc.date.accessioned2022-08-14T00:03:50Z
dc.date.available2022-08-14T00:03:50Z
dc.date.issued2022-08-11
dc.date.updated2022-08-14T00:03:49Z
dc.description.abstractAbstract Background In many jurisdictions healthcare workers (HCWs) are using respirators for aerosol-generating medical procedures (AGMPs) performed on adult and pediatric populations with all suspect/confirmed viral respiratory infections (VRIs). This systematic review assessed the risk of VRIs to HCWs in the presence of AGMPs, the role respirators versus medical/surgical masks have on reducing that risk, and if the risk to HCWs during AGMPs differed when caring for adult or pediatric patient populations. Main text We searched MEDLINE, EMBASE, Cochrane Central, Cochrane SR, CINAHL, COVID-19 specific resources, and MedRxiv for English and French articles from database inception to September 9, 2021. Independent reviewers screened abstracts using pre-defined criteria, reviewed full-text articles, selected relevant studies, abstracted data, and conducted quality assessments of all studies using the ROBINS-I risk of bias tool. Disagreements were resolved by consensus. Thirty-eight studies were included; 23 studies on COVID-19, 10 on SARS, and 5 on MERS/ influenza/other respiratory viruses. Two of the 16 studies which assessed associations found that HCWs were 1.7 to 2.5 times more likely to contract COVID-19 after exposure to AGMPs vs. not exposed to AGMPs. Eight studies reported statistically significant associations for nine specific AGMPs and transmission of SARS to HCWS. Intubation was consistently associated with an increased risk of SARS. HCWs were more likely (OR 2.05, 95% CI 1.2–3.4) to contract human coronaviruses when exposed to an AGMP in one study. There were no reported associations between AGMP exposure and transmission of influenza or in a single study on MERS. There was limited evidence supporting the use of a respirator over a medical/surgical mask during an AGMP to reduce the risk of viral transmission. One study described outcomes of HCWs exposed to a pediatric patient during intubation. Conclusion Exposure to an AGMP may increase the risk of transmission of COVID-19, SARS, and human coronaviruses to HCWs, however the evidence base is heterogenous and prone to confounding, particularly related to COVID-19. There continues to be a significant research gap in the epidemiology of the risk of VRIs among HCWs during AGMPs, particularly for pediatric patients. Further evidence is needed regarding what constitutes an AGMP.
dc.identifier.citationAntimicrobial Resistance & Infection Control. 2022 Aug 11;11(1):102
dc.identifier.doihttps://doi.org/10.1186/s13756-022-01133-8
dc.identifier.urihttp://hdl.handle.net/1880/114987
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.titleRisk of transmission of respiratory viruses during aerosol-generating medical procedures (AGMPs) revisited in the COVID-19 pandemic: a systematic review
dc.typeJournal Article
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