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2019冠状病毒病大流行期间眼科患者的护理:一项快速综述。

Care of ophthalmological patients during the COVID-19 pandemic: A rapid scoping review.

作者信息

Vargas-Peirano Manuel, Navarrete Pamela, Díaz Traccy, Iglesias Gabriel, Hoehmann Martin

机构信息

Servicio Oftalmología, Hospital Carlos Van Buren, Valparaíso, Chile. Centro Interdisciplinario de Estudios en Salud (CIESAL), Universidad de Valparaíso, Valparaíso, Chile. Cátedra de Oftalmología, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile. Email:

Servicio Oftalmología, Hospital Carlos Van Buren, Valparaíso, Chile. Cátedra de Oftalmología, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile. ORCID: 0000-0003-4983-3276.

出版信息

Medwave. 2020 May 13;20(4):e7902. doi: 10.5867/medwave.2020.04.7902.

Abstract

INTRODUCTION

A new type of coronavirus (SARS-CoV-2) causes a respiratory distress syndrome that has been called COVID-19 and has generated an unprecedented pandemic. Serious complications include pneumonia, and mortality ranges from 2 to 5%. Until March 26, the World Health Organization reports 462 684 confirmed cases and 20 834 deaths worldwide. Dissemination occurs from aerosols or respiratory droplets. Different scientific societies have published clinical practice guidelines regarding ophthalmic care in the COVID-19 pandemic, but the information is presented inconsistently, which makes decision-making difficult.

METHODS

We conducted a sensitive bibliographic search in EMBASE and ophthalmic society webpages, of the clinical practice guidelines of ophthalmic care in pandemic COVID-19. We extracted the recommendations, organizing them into three categories: "Which patients to attend", "How should the clinic work", and "What interventions should be avoided". For each guideline, we assessed whether the search was systematic and whether the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was followed.

RESULTS

Fourteen relevant articles were found. Fifty-one recommendations were extracted and are shown in a summary table. None are based on a systematic search for evidence, nor do any use GRADE to develop the recommendations.

CONCLUSIONS

The clinical practice guidelines that we reviewed all recommend rescheduling all non-urgent consultations and surgeries, reinforcing contact precautions, the use of personal protection elements, and the disinfection of surfaces and instruments. The guidelines should be improved by incorporating systematic searches for evidence, using GRADE for recommendations, and Appraisal of Guidelines for Research and Evaluation (AGREE II) for reporting.

摘要

引言

一种新型冠状病毒(严重急性呼吸综合征冠状病毒2,SARS-CoV-2)引发了一种被称为2019冠状病毒病(COVID-19)的呼吸窘迫综合征,并造成了一场前所未有的大流行。严重并发症包括肺炎,死亡率在2%至5%之间。截至3月26日,世界卫生组织报告全球确诊病例达462684例,死亡20834例。传播途径为气溶胶或呼吸道飞沫。不同科学学会已发布了关于COVID-19大流行期间眼科护理的临床实践指南,但信息呈现不一致,这使得决策变得困难。

方法

我们在EMBASE和眼科协会网页上对COVID-19大流行期间眼科护理的临床实践指南进行了全面的文献检索。我们提取了相关建议,并将其分为三类:“应诊治哪些患者”“诊所应如何运作”以及“应避免哪些干预措施”。对于每一项指南,我们评估了检索是否系统,以及是否遵循了推荐分级评估、制定与评价(GRADE)方法。

结果

共找到14篇相关文章。提取了51条建议并汇总在一张表格中。这些建议均未基于系统的证据检索,也没有任何一项使用GRADE方法来制定建议。

结论

我们所查阅的临床实践指南均建议重新安排所有非紧急会诊和手术,加强接触预防措施,使用个人防护用品,以及对表面和器械进行消毒。应通过纳入系统的证据检索、使用GRADE方法制定建议以及应用指南研究与评价工具(AGREE II)进行报告来改进这些指南。

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